Diver’s Information Form

    Personal Information

    Diving Experience

    Diving Preferences

    Step 2

    Liability Release and Assumption of Risk Agreement

    Please read carefully and then click on the "I have fully informed myself... " checkbox below.

    I hereby affirm that I am aware that skin and scuba diving have inherent risks which may result in serious injury or death. I understand that diving with compressed air involves certain inherent risks; including but not limited to decompression sickness, embolism, or other hyperbaric/air expansion injury that require treatment in a recompression chamber. I further understand that the open water diving trips which are necessary for training and for certification 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 such dives in spite of the possible absence of a recompression chamber in proximity to the dive site.

    I understand this Liability Release and Assumption of Risk Agreement (Agreement) hereby encompasses and applies to all diver training activities and courses in which I choose to participate. These activities and courses may include, but are not limited to, altitude, boat, cavern, AWARE, deep, enriched air, photography/ videography, diver propulsion vehicle, drift, dry suit, ice, multilevel, night, peak performance buoyancy, search & recovery, rebreather, underwater naturalist, navigator, wreck, adventure diver, rescue diver and other distinctive specialties (hereinafter “Programs”).

    I understand and agree that neither my instructor(s), divemasters(s), the facility which provides the Programs BELIZE PRO DIVE CENTER, nor PADI Americas, Inc., nor its affiliate and subsidiary corporations, nor any of their respective employees, officers, agents, contractors or assigns (hereinafter referred to as “Released Parties”) may be held liable or responsible in any way for any injury, death or other damages to me, my family, estate, heirs or assigns that may occur as a result of my participation in the Programs or as a result of the negligence of any party, including the Released Parties, whether passive or active. In consideration of being allowed to participate in the Programs, I hereby personally assume all risks of the Programs, whether foreseen or unforeseen, that may befall me while I am a participant in the Programs including, but not limited to, the academics, confined water and/or open water activities. I further release, exempt, and hold harmless said Programs and Released Parties from any claim or lawsuit by me, my family, estate, heirs or assigns, arising out of my enrollment and participation in this program including both claims arising during the program or after I receive my certification(s).

    I understand that past or present medical conditions may be contraindicative to my participation in the Programs. I declare that I am in good mental and physical fitness for diving and that I am not under the influence of alcohol, nor am I under the influence of any drugs that are contraindicated to diving. If I am taking medication, I declare that I have seen a physician and have the approval to dive while under the influence of the medication/drugs. I affirm it is my responsibility to inform my instructor of any and all changes to my medical history at any time during my participation in the programs and agree to accept responsibility for my failure to do so. I also understand that skin diving and scuba diving are physically strenuous activities and that I will be exerting myself during this program, and that if I am injured as a result of heart attack, panic, hyperventilation, drowning, or any other cause, that I expressly assume the risk of said injuries and that I will not hold the Released Parties responsible for the same.

    I further state that I am of lawful age and legally competent to sign this Liability Release and Assumption of Risk Agreement, or that I have acquired the written consent of my parent or guardian. I understand the terms herein are contractual and not a mere recital, and that I have signed this Agreement 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 hereby state and agree this Agreement will be effective for all activities associated with the Programs in which I participate within one year from the date on which I sign this Agreement. I understand and agree that I am not only giving up my right to sue the Released Parties but also any rights my heirs, assigns, or beneficiaries may have to sue the Released Parties resulting from my death. I further represent I have the authority to do so and that my heirs, assigns, or beneficiaries will be estopped from claiming otherwise because of my representations to the Released Parties.

    I BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE MY INSTRUCTORS, DIVEMASTERS, THE FACILITY WHICH OFFERS THE PROGRAMS AND PADI AMERICAS, INC., AND ALL RELATED ENTITIES AND RELEASED PARTIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS NON-AGENCY DISCLOSURE AND ACKNOWLEDGMENT AGREEMENT, LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT, MEDICAL STATEMENT AND STANDARD SAFE DIVING PRACTICES STATEMENT OF UNDERSTANDING BY READING THEM BEFORE SIGNING BELOW ON BEHALF OF MYSELF AND MY HEIRS.

    I have fully informed myself of the contents of this liability release and assumption of risks agreement by reading it before I signed it on behalf of myself and my heirs.


    Step 3

    Standard Safe Diving Practices Statement Of Understanding

    Please read carefully before signing

    This is a statement in which you are informed of the established safe diving practices for skin and scuba diving. These practices have been compiled for your review and acknowledgment and are intended to increase your comfort and safety in diving. Your signature on this statement is required as proof that you are aware of these safe diving practices. Read and discuss the statement prior to signing it. If you are a minor, this form must also be signed by a parent or guardian.

    I, understand that as a diver I should:

    1. Maintain good mental and physical fitness for diving. Avoid being under the influence of alcohol or dangerous drugs when diving. Keep proficient in diving skills, striving to increase them through continuing education and reviewing them in controlled conditions after a period of diving inactivity.
    2. Be familiar with my dive sites. If not obtain a format dive orientation from a knowledgeable, local source. If diving conditions are worse than those in which I am experienced, postpone diving or select an alternate site with better conditions.
    3. Use complete, well maintained, reliable equipment with which I am familiar, and inspect it for correct fit and function prior to each dive. I am aware that even if others have assisted with my dive equipment, it is my responsibility to check proper function prior to every dive. Always have a buoyancy control device, pressure gauge, and alternate air source, as well as emergency procedures for their use.
    4. Listen carefully to dive briefings and directions and respect the advice of those supervising my dive activities. Recognize that additional training is recommended for participation in specialty diving activities, in other geographic areas and after periods of inactivity that exceed 6 months.
    5. Adhere to the buddy system throughout every dive. Plan dives-including communication, procedures for reuniting in case of separation, emergency procedures with my buddy.
    6. Be proficient in decompression theory and the use of the dive tables and dive computers, having the means to monitor depth and time while underwater. Limit maximum depth to my level of experience and training. Ascend at a rate less than 60 feet per minute. Make a safety stop at 15 feet on every dive, for at least 3 minutes. Maintain proper buoyancy. Adjust weighting at the surface for neutral buoyancy with no air in my buoyancy control device.
    7. Maintain neutral buoyancy while underwater. Be buoyant for surface swimming and resting. Have weights clear for easy removal and establish positive buoyancy when in distress.
    8. Breathe properly for diving. Never breath-hold or skip-breath when diving. Avoid overexertion while in and underwater and dive within my limitations.
    9. Know and obey local dive laws and regulations, including fish and game and dive flag laws.

    This is a statement in which you are informed of the established safe diving practices for scuba diving. Your agreement on this statement is required as proof that you are aware of these safe diving practices. Read and discuss the statement prior to signing it. If you are a minor, this form must be signed by a parent or guardian.


    Step 4

    Diver Medical | Participant Questionnaire

    Directions

    Recreational scuba diving requires good physical and mental health. There are a few medical conditions that can be hazardous while diving, listed below. Those who have, or are predisposed to, any of these conditions should be evaluated by a physician.

    This Diver Medical Participant Questionnaire provides a basis to determine if you should seek out that evaluation. If you have any concerns about your diving fitness not represented on this form, consult with your physician before diving.

    If you are feeling ill, avoid diving. If you think you may have a contagious disease, protect yourself and others by not participating in dive training and/or dive activities.

    References to “diving” on this form encompass recreational scuba diving.

    If you answer yes to questions 3, 10, and Yes to any of the questions on Box A, C, D, E, F, and G then you are required to consult a physician, prior to diving with Aldora Divers.

    If you answer yes to question 2 or any of the questions on Box B, we strongly recommend you consult a physician, for your own safety, prior to diving with Belize Pro Diver Center.

    This form is principally designed as an initial medical screen for new divers. If you are a repetitive Belize Pro Dive Centers customer and we already know you, and it’s been cleared in the past, you don’t have to repeat the process all over again.

    Please complete this questionnaire as a prerequisite to recreational scuba diving. Note to women: If you are pregnant, or attempting to become pregnant, do not dive.

    1. I have had problems with my lungs/breathing, heart, blood, or have been diagnosed with COVID-19.
    2. I am over 45 years of age.
    3. I struggle to perform moderate exercise (for example, walk 1.6 kilometer/one mile in 14 minutes or swim 200 meters/yards without resting), OR I have been unable to participate in a normal physical activity due to fitness or health reasons within the past 12 months.
    4. I have had problems with my eyes, ears, or nasal passages/sinuses.
    5. I have had surgery within the last 12 months, OR I have ongoing problems related to past surgery.
    6. I have lost consciousness, had migraine headaches, seizures, stroke, significant head injury, or suffer from persistent neurologic injury or disease.
    7. I am currently undergoing treatment (or have required treatment within the last five years) for psychological problems, personality disorder, panic attacks, or an addiction to drugs or alcohol; or, I have been diagnosed with a learning disability.
    8. I have had back problems, hernia, ulcers, or diabetes.
    9. I have had stomach or intestine problems, including recent diarrhea.
    10. I am taking prescription medications (with the exception of birth control or anti-malarial drugs other than mefloquine/Lariam).

    Participant Statement: I have answered all questions honestly, and understand that I accept responsibility for any consequences resulting from any questions I may have answered inaccurately or for my failure to disclose any existing or past health conditions.

    Step 5

    Diver's E-Signature