Shark Dive Waiver

Full-Face Mask Shark Scuba Experience

Each Shark Dive participant must fill out a waiver. Begin by answering the questions on this page. When you have completed your first waiver, you will have the opportunity to proceed to a purchasing page or to return here to fill out additional waivers for other divers.

Read the following paragraphs carefully. This Statement, which includes a Medical Questionnaire and an Assumption of Risk and Waiver of Liability Agreement, informs you of some inherent potential risks involved in scuba diving and of the conduct required of you during the Full-Face Mask Shark Scuba Experience (“Experience”). Your signature is required in order to participate in the Experience. If you are a minor, you must have the Participant Statement (which includes and acknowledges the Medical Questionnaire and the Liability Release and Assumption of Risk Agreement) signed by a parent or guardian.

You will also need to learn from the instructor the most important safety rules regarding breathing and equalization while scuba diving. Improper use of scuba equipment can result in serious injury or death. You must be thoroughly instructed in its use under the direct supervision of a qualified instructor to use it safely.

Is the Shark Dive participant 12 years of age or older?

Participant Information

First Name

Middle Initial

Last Name

Address 1

City

State

Zip / Post Code

Country

Phone

Email

Date of Birth

Gender

Emergency Contact Information

First Name

Last Name

Phone

Medical

Please answer the following questions on your past and present medical history with a YES or NO. If you are not sure, answer YES. If any of these items apply to you, we must request that you consult with a physician prior to participating in the Experience. Your instructor will supply you with an RSTC Medical Statement and Guidelines for Recreational Scuba Diver's Physical Examination to take to a physician.

Do you currently have an ear infection?

Do you have a history of ear disease, hearing loss or problems with balance?

Do you have a history of ear or sinus surgery?

Are you currently suffering from a cold, congestion, sinusitis or bronchitis?

Do you have a history of respiratory problems, severe attacks of hayfever or allergies, or lung disease?

Have you had a collapsed lung (pneumothorax) or history of chest surgery?

Do you have active asthma or history of emphysema or tuberculosis?

Are you currently taking medication that carries a warning about any impairment of your physical or mental abilities?

Do you have behavioral health, mental or psychological problems or a nervous system disorder?

Are you or could you be pregnant?

Do you have a history of colostomy?

Do you have a history of heart disease or heart attack, heart surgery or blood vessel surgery?

Do you have a history of high blood pressure, angina, or take medication to control blood pressure?

Are you over 45 and have a family history of heart attack or stroke?

Do you have a history of bleeding or other blood disorders?

Do you have a history of diabetes?

Do you have a history of seizures, blackouts or fainting, convulsions or epilepsy or take medications to prevent them?

Do you have a history of back, arm or leg problems following an injury, fracture or surgery?

Do you have a history or fear of closed or open spaces or panic attacks (claustrophobia or agoraphobia)?

Assumption of Risk and Waiver of Liability

I AM AWARE THAT THE EXPERIENCE CONSISTS OF SKIN AND SCUBA DIVING ACTIVITIES AND THAT THERE ARE INHERENT RISKS AND DANGERS ASSOCIATED WITH PARTICIPATION IN THE EXPERIENCE, INCLUDING SERIOUS INJURY OR DEATH. I AM VOLUNTARILY PARTICIPATING IN THE EXPERIENCE WITH KNOWLEDGE OF THE DANGERS INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS INHERENT TO PARTICIPATION IN THE EXPERIENCE, INCLUDING RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN, AND WHETHER CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OR OTHER CONDUCT BY THE AQUARIUM, ITS EMPLOYEES, OFFICERS, AGENTS, REPRESENTATIVES OR BY ANOTHER PERSON.

I, as a condition to my participation in Shark Scuba Experience (the "Experience") at the Long Island Aquarium & Exhibition Center (the "Aquarium"), am executing and delivering this Assumption of Risk and Waiver of Liability Agreement ("Agreement") to Atlantis Marine World, LLC.

I also understand that diving with compressed air involves certain inherent risks; decompression sickness, embolism or other hyperbaric injury can occur that requires treatment in a recompression chamber. I further understand that this Experience may be conducted at a site that is remote, either by time or distance or both, from such a recompression chamber. I still choose to proceed with this Experience in spite of the absence of a recompression chamber in proximity to the dive site.

I understand that skin diving and scuba diving are physically strenuous activities and that I will be exerting myself during this Experience and that if I am injured as a result of heart attack, panic, hyperventilation, etc. that I expressly assume the risk of said injuries.

The information I have provided about my medical history on the Medical Questionnaire is accurate to the best of my knowledge. I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health conditions.

AS A CONDITION TO AND IN CONSIDERATION FOR BEING PERMITTED BY THE AQUARIUM TO PARTICIPATE IN THE PROGRAM, I AGREE THAT THE DIVE PROFESSIONALS CONDUCTING THE EXPERIENCE, ATLANTIS MARINE WORLD LLC, D/B/A THE LONG ISLAND AQUARIUM & EXHIBITION CENTER, ITS PARENT, SUBSIDIARIES, AND AFFILIATED ENTITIES AND THEIR RESPECTIVE DIRECTORS, OFFICERS, MEMBERS, SHAREHOLDERS, EMPLOYEES AND AGENTS (COLLECTIVELY THE "RELEASED PARTIES"), SHALL NOT BE LIABLE FOR, AND I HEREBY WAIVE ANY RIGHT THAT I MAY HAVE FOR, ANY AND ALL DAMAGES, INCLUDING WITHOUT LIMITATION, PERSONAL INJURY, DEATH, OR PROPERTY DAMAGE, RELATED, DIRECTLY OR INDIRECTLY, TO (I) MY PARTICIPATION IN THE EXPERIENCE, (II) NEGLIGENCE OR OTHER ACTS, WHETHER DIRECTLY CONNECTED TO THESE ACTIVITIES OR NOT, AND HOWEVER CAUSED, BY ANY OF THE RELEASED PARTIES OR OTHER THIRD PARTY, OR (III) THE CONDITION OF THE FACILITIES WHERE THE EXPERIENCE ACTIVITIES OCCUR, WHETHER OR NOT I AM THEN PARTICIPATING IN THE ACTIVITIES.

I hereby agree not to sue any of the Released Parties or file a claim with any of their insurance providers for any claims, demands, damages, rights or causes of action present or future of any kind or nature, whether known or unknown, anticipated or unanticipated, resulting from or arising out of my participation in the Experience, whether or not arising from the negligence of any of the Related Parties. I also agree that in the event of my death, my heirs, distributes, guardians, spouse or legal representatives will not make a claim against, sue or attach the property of any of the Released Parties in connection with any of the matters covered by this Agreement.

I further state that I am of lawful age and legally competent to sign this Assumption of Risk and Waiver of Liability Agreement, or that I have acquired the written consent of my parent or guardian.

I understand that the terms herein are contractual and not a mere recital and that I have signed this Release of my own free act and with the knowledge that I hereby agree to waive my legal rights. I further agree that if any provision of this Agreement is found to be unenforceable or invalid, that provision shall be severed from this Agreement. The remainder of this Agreement will then be construed as though the unenforceable provision had never been contained herein.

I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS ASSUMPTION OF RISK AND WAIVER OF LIABILITY AGREEMENT BY READING IT BEFORE SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS.

By checking this box, you are confirming that you have read the liability waiver in full (including the information described on clicking the "Please read our entire liability waiver statement" link), and agree to the terms. I agree, and it is my intent, to sign this record/document by checking this box and by electronically submitting this record/document to the Long Island Aquarium. I understand that my signing and submitting this document in this fashion is the legal equivalent of having placed my handwritten signature on the submitted document. I understand and agree that by electronically signing and submitting this document in this fashion I am affirming to the truth of the information contained therein.

Parental Consent

Is the participant a minor under the age of 18?

We're sorry. Shark Dive participants must be at least 12 years of age.