Guest Information Liability Release and Waiver

Please fill out our online Guest Information Liability Release and Waiver or download the pdf version.

Guest Information Liability Release and Waiver Form [pdf]
You can save data typed into the pdf form with Adobe Reader or you can print, fill out and email a scanned version to info@mermaid-liveaboards.com

(* these fields are required)

Cruise Destination*:

Cruise Date*:


First Name*: Surname*:

Sex*: Date of Birth*:

Nationality*: Passport Number*:

Issue Date*: Expiry Date*:

Issuing Authority*:

Address*:

Town/District*: Zip/Postal Code*:

Country*:

Phone No. + country code*:

Email*:


Dive Certification/Level:

No. Dives: Date of Last Dive:


Transfer Details

Transfer from before cruise:

Transfer to after cruise:


Rental Equipment

BCD Wetsuit Fins

RegulatorMask/SnorkelDive TorchDive ComputerUnderwater Camera

Special Meal Requirements:

Remarks:


Emergency and Medical Diving Insurance Information

Emergency Contact*:

Relationship:

Phone No. + country code*:

E-mail:

Insurance Company:

Policy: Contact No. of Company:


LIABILITY RELEASE AND WAIVER

1. I herewith certify and acknowledge that I understand that my acceptance of a diving tour organized and conducted by Mermaid Liveaboards- PT Indonesia Liveaboards Bali Indonesia hereafter referred to as the Company, is predicated on my assurance that I am physically fit to engage in ocean scuba diving, and that I am a certified diver, and that I fully understand the risk of ocean diving, of living and traveling on board a ship and the dangers arising from force of nature, and I am prepared to assume such risk.

2. To induce the Company to accept me as a member of the aforementioned diving tour, I hereby release and absolve Mermaid Livebaoards - PT Indonesia Liveaboards, its agents, employees and invitees thereof from any and all damages resulting from death or personal injuries, including loss of services, which I may sustain on account of, arising from, or in connection with the aforemen- tioned diving tour or from the ownership, maintenance, use, operation or control of any automobile, ship, boat, water sport equipment or otherwise.

3. I further understand that the remoteness of the destination, local custom and/or prevailing weather conditions might cause minor inconvenience or modification to the diving portions of the tour and the Company reserves the right to modify and/or cancel diving arrangements due to unfavorable weather conditions and/or technical difficulties.

4. I also agree to pay compensations at full current market value to the Company for any and all damages or loss of property and equipment belonging to the Company resulting from abuse or negligence on my part. Mermaid Liveaboards and PT Indonesia Liveaboards do not accept any legal liability for loss or damage to any luggage or dive equipment while being transferred to/from the vessel nor while on board.

5. This liability waiver contract signed by me is all subject to the terms and conditions above, which have been read, understood and unconditionally agreed to. I further agree to strictly observe and comply with any additional reasonable terms and regulations the Company or any of its employees may deem desirable or need to instigate during the course of the diving tour.


Vessel: MV MERMAID

*By checking the box, I acknowledge that I have read and understand this "Liability Release and Waiver" and agree to its terms.

Date*:

Validation Code*: