Please answer the following questions on your past and present medical history with a YES or NO. If you are not sure, answer YES. If any of these items apply to you, we must request that you consult with a physician prior to participating in the Experience. Your instructor will supply you with an RSTC Medical Statement and Guidelines for Recreational Scuba Diver's Physical Examination to take to a physician.
I AM AWARE THAT THE EXPERIENCE CONSISTS OF SKIN AND SCUBA DIVING ACTIVITIES AND THAT THERE ARE INHERENT RISKS AND DANGERS ASSOCIATED WITH PARTICIPATION IN THE EXPERIENCE, INCLUDING SERIOUS INJURY OR DEATH. I AM VOLUNTARILY PARTICIPATING IN THE EXPERIENCE WITH KNOWLEDGE OF THE DANGERS INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS INHERENT TO PARTICIPATION IN THE EXPERIENCE, INCLUDING RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN, AND WHETHER CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OR OTHER CONDUCT BY THE AQUARIUM, ITS EMPLOYEES, OFFICERS, AGENTS, REPRESENTATIVES OR BY ANOTHER PERSON.
I, as a condition to my participation in Shark Scuba Experience (the "Experience") at the Long Island Aquarium & Exhibition Center (the "Aquarium"), am executing and delivering this Assumption of Risk and Waiver of Liability Agreement ("Agreement") to Atlantis Marine World, LLC.
I also understand that diving with compressed air involves certain inherent risks; decompression sickness, embolism or other hyperbaric injury can occur that requires treatment in a recompression chamber. I further understand that this Experience may be conducted at a site that is remote, either by time or distance or both, from such a recompression chamber. I still choose to proceed with this Experience in spite of the absence of a recompression chamber in proximity to the dive site.
I understand that skin diving and scuba diving are physically strenuous activities and that I will be exerting myself during this Experience and that if I am injured as a result of heart attack, panic, hyperventilation, etc. that I expressly assume the risk of said injuries.
The information I have provided about my medical history on the Medical Questionnaire is accurate to the best of my knowledge. I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health conditions.
AS A CONDITION TO AND IN CONSIDERATION FOR BEING PERMITTED BY THE AQUARIUM TO PARTICIPATE IN THE PROGRAM, I AGREE THAT THE DIVE PROFESSIONALS CONDUCTING THE EXPERIENCE, ATLANTIS MARINE WORLD LLC, D/B/A THE LONG ISLAND AQUARIUM & EXHIBITION CENTER, ITS PARENT, SUBSIDIARIES, AND AFFILIATED ENTITIES AND THEIR RESPECTIVE DIRECTORS, OFFICERS, MEMBERS, SHAREHOLDERS, EMPLOYEES AND AGENTS (COLLECTIVELY THE "RELEASED PARTIES"), SHALL NOT BE LIABLE FOR, AND I HEREBY WAIVE ANY RIGHT THAT I MAY HAVE FOR, ANY AND ALL DAMAGES, INCLUDING WITHOUT LIMITATION, PERSONAL INJURY, DEATH, OR PROPERTY DAMAGE, RELATED, DIRECTLY OR INDIRECTLY, TO (I) MY PARTICIPATION IN THE EXPERIENCE, (II) NEGLIGENCE OR OTHER ACTS, WHETHER DIRECTLY CONNECTED TO THESE ACTIVITIES OR NOT, AND HOWEVER CAUSED, BY ANY OF THE RELEASED PARTIES OR OTHER THIRD PARTY, OR (III) THE CONDITION OF THE FACILITIES WHERE THE EXPERIENCE ACTIVITIES OCCUR, WHETHER OR NOT I AM THEN PARTICIPATING IN THE ACTIVITIES.
I hereby agree not to sue any of the Released Parties or file a claim with any of their insurance providers for any claims, demands, damages, rights or causes of action present or future of any kind or nature, whether known or unknown, anticipated or unanticipated, resulting from or arising out of my participation in the Experience, whether or not arising from the negligence of any of the Related Parties. I also agree that in the event of my death, my heirs, distributes, guardians, spouse or legal representatives will not make a claim against, sue or attach the property of any of the Released Parties in connection with any of the matters covered by this Agreement.
I further state that I am of lawful age and legally competent to sign this Assumption of Risk and Waiver of Liability Agreement, or that I have acquired the written consent of my parent or guardian.
I understand that the terms herein are contractual and not a mere recital and that I have signed this Release of my own free act and with the knowledge that I hereby agree to waive my legal rights. I further agree that if any provision of this Agreement is found to be unenforceable or invalid, that provision shall be severed from this Agreement. The remainder of this Agreement will then be construed as though the unenforceable provision had never been contained herein.
I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS ASSUMPTION OF RISK AND WAIVER OF LIABILITY AGREEMENT BY READING IT BEFORE SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS.
