UTD Waiver and Medical History Form

UTD Registration, Medical History Form, and Waiver

  • Date Format: DD dash MM dash YYYY
  • UTD General Release of Liability and Covenant Not to Sue for Recreational, Technical and Overhead Environment SCUBA Diving, Zuba Diving, and Snorkeling.

    In consideration of permitting me to participate in SCUBA diving or any other in-water activities, including preparation to enter the water, in-water, and post water activities:
  • BY WAY OF MY VOLUNTARY DIGITAL SUBMISSION, I AGREE THAT I HAVE FULLY READ AND UNDERSTAND THIS DOCUMENT IN ITS ENTIRETY. I UNDERSTAND THAT THIS IS A LEGALLY BINDING CONTRACT NOT TO SUE AND AGREE TO BE BOUND BY IT.

  • IF PARTICIPANT IS UNDER THE AGE OF 18:

    If the participant is under the age of 18, then the parent or guardian must PRINT AND SIGN this agreement and agree to be legally bound by it and furthermore be legally responsible for the minor participant, including being responsible for all damages, injury or death which may occur as a result of the minor’s participation in diving activities. The parent or guardian hereby agrees to be fully responsible to the “Released Parties” for any damage, injury or death caused by the minor, including actions brought by the minor, for any damages whatsoever.
  • Signature of Parent or Guardian

    ___________________________________________________________ Signature of Parent or Guardian ___________________________________________________________ Date