Registration

You MUST consult a Qualified Physician if you have any of the following:

You SHOULD consult a Qualified Physician if you have ever had:

You are AWARE that you could be unfit to dive if you have or develop during the course, any of the following conditions:

Medical Certificate

Please upload your medical certificate if required.

Parent / Guardian

I, the undersigned parent/guardian, hereby give permission for my child to participate in scuba diving activities organized by Captain Mimi's Diving Center. I understand that scuba diving involves inherent risks, including but not limited to physical injury, drowning, and other potential hazards. I agree to release, waive, and hold harmless Captain Mimi's Diving Center, its instructors, employees, and volunteers from any liability, claims, demands, or causes of action that may arise from my child's participation in this activity. Medical Information: I confirm that my child is in good health and does not have any medical conditions that would prevent them from participating in scuba diving activities. If my child requires any special accommodations, I have listed them below.

Liability & Contact

I, the undersigned participant, hereby acknowledge and agree that scuba diving is an inherently risky activity that may result in physical injury, drowning, or other hazards. By signing this waiver, I agree to release, waive, discharge, and hold harmless Captain Mimi's Diving Center, its instructors, employees, and volunteers from any liability, claims, demands, or causes of action that may arise from my participation in this scuba diving activity. I understand and agree that this waiver and release of liability extends to any and all claims of every nature and kind, including, but not limited to, any claims for bodily injury, property damage, or wrongful death arising out of my participation in this scuba diving activity. Assumption of Risk: I confirm that I am in good health and do not have any medical conditions that would prevent me from participating in scuba diving activities. I acknowledge that I am voluntarily participating in this activity and assume all risks associated with it. Medical Information: I agree to disclose any medical conditions or required accommodations to the scuba diving instructors prior to participation. If I require emergency medical treatment during the activity, I give my consent for Captain Mimi's Diving Center to seek such treatment on my behalf. Insurance: I acknowledge that I have an adequate insurance policy that covers the activities that I will be participating in. Acknowledgement and Agreement: I have read and understood the risks associated with scuba diving. By signing below, I voluntarily agree to the terms and conditions outlined in this liability release waiver.