Mission Rec Mission Tech Waiver -

Participant Info:

Name *

First

Last

Date of Birth *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home Phone *

Daytime Phone *

Email *

Occupation *

Gender *

Male
Female

Who is your local dive shop? *

Highest Certification Level *

Are you planning to purchase gear tested here? *

Yes, just final testing
Depends on the gear
Nope, just here for fun

How did you hear about us? *

Dive Shop
Social Media
TDISDI Newsletter
Other

How did you hear about us - Other

Emergency Contact 1:

Name *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Relationship *

Emergency Contact 2:

Name *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Relationship *

Media Release:

THIS MODEL AGREEMENT AND RELEASE (“Agreement”) is dated

Model Release Date *

and is between the undersigned companie(s) (“Photographer”) and the undersigned model/performer (“I”). Agreement as follows: For good and valuable consideration of $0.00, I hereby grant the undersigned Photographer permission to photograph me. I further give my irrevocable consent to Photographer and his/her direct or indirect licensees (International Training, Scuba Diving International, Technical Diving International, Emergency Response Diving International) and assignees to publish, republish or otherwise transmit the images of myself in any medium for all purposes throughout the world. I understand that the images may be altered or modified in any manner. I hereby waive any right that I may have to inspect and approve a finished product or the copy that may be used in connection with an image that the Photographer has taken of me, or the use to which it may be applied. I further release the Photographer and his/her direct or indirect licensees and assignees, from any claims for remuneration associated with any form of damage, foreseen or unforeseen associated with the use of the images.

Click to Accept *

I am of legal age and have the full legal capacity to execute this authorization without the consent or knowledge of any other person.

Mission Rec / Mission Tech Liability Release:

For Mission Rec Mission Tech training program under sanction through TDI.

Event You Are Attending *

Please read carefully, fill in all blanks and check each paragraph before submitting at the bottom.

I,

Full Name *

hereby affirm that I have been advised and thoroughly informed of the inherent hazards of scuba diving activities.

Click to Accept *

Further, I understand that diving with compressed air, oxygen enriched air (nitrox), oxygen, or trimix supplied by standard open-circuit scuba, semi-closed or fully closed circuit rebreathers involves certain inherent risks including decompression sickness, embolism, oxygen toxicity, inert gas narcosis, marine life injuries or other barotrauma/hyperbaric injuries can occur that require treatment in a recompression chamber. I further understand that the open water diving trips, which are necessary for training and certification, may be conducted at a site that is remote, either by time of distance or both, from such a recompression chamber. I still choose to proceed with such instructional, introductory, or supervised dives in spite of the possible absence of a recompression chamber in proximity to the dive site.

Click to Accept

I understand and agree that neither my instructor(s), the facility through which I received my instruction, (which event you're attending)

Select All That Apply *

International Training and Technical Diving International, Dive Soft, Silent Diving, AP Diving, DUI, OMS, Ursuit, SF2, Dive Rite, Atomic Aquatics, BARE Sports, Hollis, Oceanic, Stahlsac, Suunto, Zeagle, Garmin, nor the officers, directors, shareholders, affiliated companies, employees, agents, or assigns of the above listed entities and/or individuals, nor the authors of any materials including texts and tables expressly used for training and certification (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, heirs, or assigns that may occur as a result of my participation in this diving class or as a result of the negligence of any party, including the Released Parties, whether passive or active.

Click to Accept *

In consideration of being allowed to enroll in these instructional, introductory, or supervised activity(s) , I hereby personally assume all risks in connection with said activity(s) , for any harm, injury, or damage that may befall me while I am enrolled as a participant of this activity(s), including all risks connected therewith, whether foreseen or unforeseen.

Click to Accept *

I further agree to save, defend, indemnify, and hold harmless said activity(s) and Released Parties from any claim or lawsuit by me, anyone purporting to act on my behalf, my family, estate, heirs or assigns, arising directly or indirectly out of my enrollment and participation in said activity(s) including both claims arising during the activity(s) or after, even if such claims may be groundless, false or fraudulent.

Click to Accept *

I also understand that diving activities are physically strenuous and that I will be exerting myself during this diving activity(s), and that if I am injured as a result of heart attack, panic, hyperventilation, oxygen toxicity, inert gas narcosis, drowning, etc. that I expressly assume the risk of said injuries and that I will not hold the above listed individuals or companies responsible for the same, and I agree to defend, indemnify, and hold harmless said activity(s) and Released Parties for any such injuries incurred by me.

Click to Accept *

I understand that these activities may place me deeper than I am able to safely execute a free (without breathing gas) ascent from.

Click to Accept *

I understand that I may be required to furnish my own equipment and that I am responsible for its operating condition and maintenance.

Click to Accept *

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 guardian.

I further state that I am already a qualified and certified scuba diver from the following training agencies:

Agencies Certified With *

and that I hold training to the level of:

Highest Certification Level *

Click to Accept *

I am aware of the required certification level and/or experience necessary and recommended to enroll in this diving course and I stipulate I meet those requirements for prior certification or equivalent experience.

I have been a certified diver since

Year Certified *

and have been diving for years

Number of Years *

for a total of

Total # of Dives Made *

dives to a maximum depth of

Text only - Max depth

Click to Accept *

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. Further that I understand and agree that, in the event that one or more of the provisions of this agreement, for any reason, is held by a court of competent jurisdiction to be invalid or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision hereof, and this agreement shall be construed as if such invalid, illegal or unenforceable provision or provisions had never been contained herein.

IT IS THE INTENTION OF

Your Full Name *

BY THIS INSTRUMENT TO EXEMPT AND RELEASE MY INSTRUCTORS,

Instructor *

(AND OTHERS),

Additional Instructors *

THE FACILITY THROUGH WHICH I RECEIVED MY INSTRUCTION,

Event you're attending *

THE TRAINING AGENCY SDI/TDI

AND INTERNATIONAL TRAINING INC. AND TECHNICAL DIVING INTERNATIONAL, AND ALL OTHER RELATED ENTITIES AND RELEASED PARTIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, OR ARISING OUT OF, DIRECTLY OR INDIRECTLY, 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 LIABILITY RELEASE AND EXPRESS ASSUMPTION OF RISK BY READING IT BEFORE SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS.

This document is required for all courses and Specialties taught under sanction by Technical Diving International. No alterations, changes, omissions or revisions may be made.

Mission Rec Mission Tech Waiver

Get in the water quicker by completing your MRMT waiver ahead of time

Participant Info:

Emergency Contact 1:

Emergency Contact 2:

Media Release:

Mission Rec / Mission Tech Liability Release: