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LIBERTY SCUBA DIVING BOAT – LIBERTY DIVE CO LLC
SCUBA DIVING TRIP - ASSUMPTION OF RISK AND RELEASE OF LIABILITY
A.
I have been trained in the proper use of skin and scuba diving equipment and certified through the following training agency:
(You will need to provide your a
gency name certification number and date certified)
B.
I am currently being trained and am under the supervision of my SCUBA instructor:
(You will need to provide you agency name / Instructors name & Instructor Certification number)
C.
I am accompanying this dive trip as a passenger/non-diver only
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Please choose an option from above
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(A) I have been trained in the proper use of skin and scuba diving equipment and certified through the following training agency
(B) I am currently being trained and am under the supervision of my SCUBA instructor
(C) I am accompanying this dive trip as a passenger/non-diver only
Required
PLEASE ENTER THE FOLLOWING INFORMATION:
(A) Your Certification Agency & Certification Number
(B) Instructors name and Certification number if you are under instruction and
NOT CERTIFIED.
(C) Type, "Passenger Only" If attending this trip as only a passenger
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Diver Certification Level
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Student
OpenWater
Advanced Open Water
Rescue Diver
Dive Master
Dive assistant instructor
Dive instructor
Other
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