DIVER’S REGISTRATION AND LIABILITY FORM

First Namerequired
Last Namerequired
Date of Birthrequired
Emailrequired
Phone (Digits Only)required

Countrytextrequireddb save

I will be diving through:

Buddy Dive Resort
Belmar
Buddy Dive Watersports Downtown
Your Scuba Store

Emergency contact (not diving with you):

Emergency Contact Nametextrequireddb save
Emergency Contact Phonenumberrequireddb save

Arrival Datedaterequireddb save
Departure Datedaterequireddb save

Certification agency:

PADI
GUE
NAUI
SSI
TDI|SDI
NOB
CMAS
Other
If Other, please specifytextoptionalno save
CERTIFICATION NUMBERtextrequireddb save

DIVING WITH:

AIR
NITROX
CUSTOM GASSES

required

Upload (the back of) certification card

optional

Upload (the back of) Nitrox certification (mandatory if diving with Nitrox)

Please bring your certification card to the dive shop check-in.


DIVING ACCIDENT INSURANCE DISCLAIMER-WAIVER

IMPORTANT NOTE: If you are 70 years of age or older and would like DAN insurance, you will need to contact DAN directly to discuss your options for diving insurances.

If you need Dive Insurance and do not already have it, please choose one of our Dive Accident Coverage Plan options from DAN World, as indicated below. This will be charged to your room account upon arrival.

If you already have a Dive Insurance policy, please choose the last option as indicated below.

Check one

1 day coverage - $10.00
2 day coverage - $20.00
3-5 day coverage - $30.00
6-10 day coverage - $40.00
11-30 day coverage - $50.00
I do not wish to purchase Diving Accident Coverage Plan for this trip/vacation. I understand and agree that the facility and staff will not be held responsible for any evacuation, medical and/or other costs that may incur as a result of a diving accident.
I already have a Dive Insurance Policy

Date: 07.06.2024

Time: 7:44 PM

Signature of Participantrequired
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STATEMENT OF UNDERSTANDING AND WAIVER

As a diver with Buddy Dive I will:

  1. Be in good mental and physical condition for diving at all times.
  2. Avoid being under the influence of alcohol or drugs while diving. Buddy Dive staff may disqualify me from diving activities if I am under influence or have a hangover.
  3. Engage only in diving activities consistent with my training, comfort and experience.
  4. Listen carefully to the dive briefings and respect the advice of the dive guides supervising my activities.
  5. Adhere to the buddy system throughout every dive.
  6. Follow local diving rules of the national marine park with which I am familiar since I have watched the marine park orientation video and I have purchased my mandatory nature fee tag.
  7. Never exceed the depth or time limitations planned by the dive guides and never exceed the maximum depth according to my level of certification, which ever one is the most conservative.
  8. Ascend no faster than 30 feet per minute and do a three (3) minute safety stop at fifteen (15) feet on all dives.
  9. Make cancellations at least 4 hours before the scheduled date and dive time. All no shows and late cancellations will not be refunded or credited.
  10. Understand that the failure to respect Bonaire’s fragile reef systems by deliberately touching the reef could result in the premature termination of my planned dives.
  11. When using dive equipment that is not provided by Buddy Dive, be fully responsible for it being in proper working condition. In the unlikely event I require emergency repairs on said equipment I can’t hold Buddy Dive liable nor responsible.
  12. When renting equipment, have examined the rental equipment, and have satisfied myself that it is in good order and working condition before i go diving. I hereby accept the equipment in the condition as is. Buddy watersports b.v. accepts no responsibility for any defect in the equipment and does not warrant that it is suitable for any particular purpose. I agree that the use of said equipment is at my own risk. I shall return the same in good order and working condition and shall be financially liable for any deviations therefrom.

I, [ First Name ] [ Last Name ], have read, fully understand and will conform with all of the above statements. I hereby exempt and release buddy dive and all the agents associated from all liability for personal injury, wrongful death or property loss or damage.

LIABILITY RELEASE AND ASSUMPTION OF RISK

I, [ First Name ] [ Last Name ], understand and agree that neither my buddy dive guide(s), divemaster or instructors, or other staff; Buddy Dive Watersport B.V.; Padi Americas, inc., or other certifying agencies, or any of their respective employees, officers or agents; or travel partners (hereinafter referred to as released parties), may be held liable or responsible in any way for any injury, death or other damages to me or my family, estate, heirs or assigns that may occur as a result of my participation in this scuba diving or as a result of the negligence of any party, including the released parties, whether passive or active. I further agree that any and all suits or claims against the released parties will be disputed only in the Dutch Caribbean, Bonaire, accepting the rules, laws and regulations of the Dutch Caribbean Bonaire. No complaints, suits or demands will be filed in any other country regardless of the client’s country of origin or address. I accept the rules and the courts of the local government of the Dutch Caribbean Bonaire for all disputes of any kind.


I, [ First Name ] [ Last Name ], further understand that diving with compressed, and any mixture of oxygen and nitrogen (nitrox), air involves certain inherent risks. Decompression sickness, embolism, or hyperbaric injuries can occur that require treatment in a recompression chamber. I still choose to participate in scuba diving activities.

In consideration of being allowed to participate in scuba diving activities, I hereby personally assume all risk in connection with scuba diving, for any harm, injury or damage that may befall me while I am participating in scuba diving, including all risks connected therewith, whether foreseen or unforeseen.

Signify your agreement with the following statements with your initials


Initialsrequired

I further hold harmless released parties from any claim or lawsuit by me, my family, estate, heirs, or assigns, arising out of my participation in scuba diving activities, including both claims arising during scuba diving and after participating.


Initialsrequired

I also understand that scuba diving is a strenuous activity and that I will be exerting myself while scuba diving, and if I am injured as a result of heart attack, panic, hyperventilation, etc. That I expressly assume the risk of said injuries and that I will not hold the released parties responsible for same.


Initialsrequired

I further state that I am of lawful age and legally competent to sign this liability release or that i have acquired the written consent of my parent or legal guardian.


Initialsrequired

I understand that the terms herein are contractual and not a mere recital, and that I have signed this document of my own free act.


I, [ First Name ] [ Last Name ], by this instrument do exempt and release any and all related entities as defined above, from all liability or responsibility whatsoever. I have fully informed myself of the contents of this liability release and express assumption of risk by reading it before I signed it on behalf of myself and my heirs.


Date: 07.06.2024

Time: 7:44 PM

Signature of Participantrequired
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Parent/Legal Guardian (if Participant is under 18)

Parent/Legal Guardian Nametextoptionalnot save
Relationshiptextoptionalnot save
Parent/Legal Guardian Signatureoptionalnot save
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Date: 07.06.2024

Time: 7:44 PM


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