LUNARFINS

JSC Skin & Scuba Diving Club

WAIVER, RELEASE AND INDEMNITY AGREEMENT

I hereby certify that the statements made on the diver information sheet regarding my experience, knowledge and training are correct and I understand that my acceptance on this trip is predicated upon my assurance that I am physically and mentally fit to engage in scuba diving, snorkeling, and/or swimming and have sufficient training for this activity, and I fully understand all of the risks and dangers involved and do personally and totally assume all such risks. I understand that the trip is organized by the Lunarfins Club but that all trip management and safety issues are solely the responsibility of the diver himself and the dive operator providing the dive activity, including boat and underwater safety. I further understand the remoteness of the areas involved, and understand the problems associated with the possible lack of adequate medical facilities, personnel, and equipment in this area, and do hereby authorize the official trip leaders to act in my behalf, as they see fit, at their sole discretion, in the event of my involvement in a medical emergency and/or my incapacitation and/or death, and do hereby assume and agree to pay to, and do hereby transfer said liability to my estate and my heirs, any and all medical expenses, evacuation expenses, or related expenses incurred or committed for, in or on my behalf by the trips leaders or their agents, and do agree to hold the trip leaders or their agent(s)harmless for such actions as they may take on my behalf as outlined above.

For and in consideration of permitting

(name) ____________________________________________________to participate in the Lunarfins Dive Club trip to ________________________________________________beginning on or about

[date] __________________ and ending on or about [date] _______________ the Undersigned hereby voluntarily Releases, Discharges, Waives and Relinquishes any and all actions or causes of action for personal injury, including sickness and/or disease, property damage or wrongful death occurring to the Undersigned arising out of or as a result of engaging in any said activity or activities incidental thereto whatever or however the same may occur and for whatever period said activities may continue, and the Undersigned on his/her behalf and on behalf of his/her heirs, executors, administrators, and assigns hereby Release, Waive, Discharge and Relinquish as well as assuming the entire responsibility and liability for any and all damages or injury of any kind or nature whatsoever including death resulting there from whether the Lunarfins Club sometimes hereinafter referred to as Club or its representatives are negligent. If any claims for such damage or injury is made or asserted

whether or not the said claim is based upon the negligence of Club, its representatives, officers, directors, or employees, the Undersigned agrees to INDEMNIFY, HOLD HARMLESS and DEFEND Club from any and all such claims, costs,

expenses, liability, including legal fees and disbursements that Club may sustain, suffer or incur as a result thereof. The Undersigned does on his/her behalf or on behalf of his/her heirs, executors, administrators and assigns RELEASE, WAIVE and DISCHARGE and agrees to INDEMNIFY, DEFEND and HOLD HARMLESS Club from any and all claims, demands, actions, causes of action or liability of any kind or character whatsoever arising from the activity engaged in and agrees that under no circumstances will he/she or his/her heirs, executors, administrators, or assigns prosecute or present any claim for personal injury, including sickness, and/or disease, property damage or wrongful death against the Club or any of its officers, directors, agents, trip leaders, members, servants, employees or in general for any of said causes of action, whether or not caused by the negligence or conduct of Club.

The Undersigned, realizing that the Club Diving Safety Rules stipulate that all diving on Club trips is to be done in accordance with training obtained outside the Club he/she has had, and accordingly therefore he/she hereby voluntarily Releases, Discharges, Waives, and Relinquishes and agrees to INDEMNIFY, DEFEND and HOLD HARMLESS the Club, its officers, directors, agents, trip leaders, members, servants, employees or in general for any and all actions or causes of actions for personal injury including sickness and/or disease, property damage or wrongful death occurring to him/her even if same is the result of the negligence of anyone from the Club. The Undersigned acknowledges and agrees to abide by the Club, Official Trip Standards, a copy of which is available to the

Undersigned and is made part of this agreement. The Undersigned acknowledges that he/she had read the foregoing and is fully and completely aware of the potential dangers incidental to engaging in the activities involved in this activity, and is fully aware of the legal consequences of signing this instrument.

Signature of Participant ____________________________________________________ Date _______________________________

Witness (Name)_____________________________________Signature __________________________________________________

Signature of Parent or Guardian if Participant is a Minor ____________________________________________________________