Diverstime - Participant Risk and Liability Agreement

Please read carefully.

This agreement records your understanding of the risks associated with diving activities organised by Diverstime.

If you are under 18 your parent or legal guardian must provide consent and sign.

Participant Details

Statement of Risk and Liability

This statement informs you of the potential risks associated with participating in scuba diving activities organised by Diverstime.

Scuba diving involves inherent risks, including the possibility of injury, illness or, in exceptional circumstances, death. Although Diverstime takes appropriate precautions and follows established safety procedures, these risks cannot be completely eliminated.

By participating in a diving activity with Diverstime, you acknowledge and understand that:

• You are responsible for following all safety instructions, dive briefings and directions provided by Diverstime instructors and staff.

• You must provide accurate information regarding your diving qualifications, experience and medical fitness to dive.

• You must use diving equipment responsibly and in accordance with the instructions provided.

• You must inform Diverstime staff of any concerns that could affect your ability to participate safely.

• You understand that failing to follow safety procedures or acting negligently may increase the risk of injury to yourself or others.

You acknowledge that you participate in diving activities with an understanding of these inherent risks.

Where no negligence or breach of legal duty has occurred on the part of Diverstime or its staff and representatives, you accept the risks associated with your participation.

Nothing in this agreement excludes or restricts liability for death or personal injury caused by negligence, or any other liability that cannot lawfully be excluded or restricted.

If you do not understand any part of this statement, please contact Mark Griffin at info@diverstime.com before signing.

Acceptance of Risk

I acknowledge and understand that scuba diving involves inherent risks, including the possibility of injury, illness or death.

I understand that neither Diverstime, its instructors, employees, representatives nor associated personnel can eliminate all risks associated with diving activities, even when appropriate safety measures are followed.

I accept responsibility for my own actions and conduct while participating in diving activities, including any injury, loss or damage resulting from my own negligence or failure to follow safety instructions.

I understand that, in the absence of negligence or any other breach of legal duty by Diverstime or its staff, I participate at my own risk.

Nothing in this agreement excludes or limits Diverstime's liability for death or personal injury caused by negligence, or any other liability that cannot legally be excluded or limited.

By signing this agreement, I confirm that:

• I have read and understood the Statement of Risk and Liability.

• I understand and acknowledge the inherent risks associated with scuba diving.

• I agree to follow all safety instructions, procedures and directions provided by Diverstime staff.

• I have had the opportunity to ask questions and seek clarification before participating.

• I voluntarily agree to participate in the diving activity, acknowledging the risks outlined above.

Medical Fitness to Dive

Have you ever had or suffered from any of the following?

Please read all 24 questions carefully before completing your medical declaration.

1. Diseases or conditions of the heart and circulation, including high blood pressure (or taking tablets for high blood pressure), chest pains, angina, heart attack, heart rhythm problems, heart murmur or palpitations?

2. Chest or heart surgery?

3. Significant bleeding or blood disorders?

4. Asthma, chronic obstructive airways disease or ever used an inhaler?

5. Collapsed lung, pneumothorax or any other lung injury or problem (except COVID-19)?

6. A requirement for Medical Referee assessment in the guidance on return to diving after COVID-19 at ukdmc.org?

7. Blackouts, loss of consciousness, any ongoing secondary effects of this, fainting or recurrent dizziness?

8. Abdominal surgery, ileostomy, colostomy or repair of a hiatus hernia?

9. Epilepsy or fits?

10. Disease of the brain or nervous system (including strokes or multiple sclerosis) or recurrent migraines?

11. Back or spinal surgery or any serious back problems?

12. Psychological illness of any kind, fear of small spaces, suicidal thoughts or panic attacks?

13. A requirement for Medical Referee assessment in the guidance on Neurodiversity/ASD/ADHD at ukdmc.org?

14. Diabetes? All diabetics require a medical and need to complete Diabetes Forms A & B annually (see ukdmc.org).

15. Cancer, malignant disease or a tumour?

16. Decompression illness, immersion-induced pulmonary oedema or other diving-related problem?

17. Do you currently have a requirement for any prescribed medication (except the contraceptive pill or HRT)?

18. Do you have a BMI of 40 or greater? To calculate BMI, go to www.nhs.uk.

19. Have you had regular ear problems in the past 10 years?

20. Have you had a head injury with loss of consciousness in the past 5 years?

21. Have you had any problem with alcohol or drug abuse in the last 5 years?

22. Have you ever been refused a diving medical certificate or life insurance, or been offered special terms?

23. Are you currently receiving medical care or have you consulted a doctor in the last year other than for mild, self-limiting illnesses that have completely resolved? (Please discuss any symptoms of the upper or lower respiratory tract with a UKDMC Medical Referee.)

24. Are you concerned about any other medical issue that has not been covered by the questions on this page?

Participant Age Confirmation

Declaration and Agreement

I confirm that I have read and understood the Diverstime Statement of Risk and Liability and Acceptance of Risk.

I acknowledge the inherent risks associated with scuba diving and agree to follow all safety instructions, dive briefings and procedures provided by Diverstime.

I confirm that the information supplied in this form is accurate.

Where the participant is under 18, I confirm that I am their parent or legal guardian and have the authority to provide consent on their behalf.

Digital Signature

By signing below, I confirm that I have read and understood this agreement and voluntarily acknowledge the risks associated with participating in diving activities organised by Diverstime.

If the participant is under 18, this agreement must be signed by their parent or legal guardian.