Form – Scuba Diving in Havelock Island

👤 Participant Information

Email Address *

Full Name *

Date of Diving *

Date of Birth *

Gender *

Male Female

Home Address *

Staying In (Resort Details) *

Phone Number *

Emergency Contact *

How did you come to know about us?

Upload ID Proof (Optional)

Aadhar, Passport, or any valid ID

📜 Liability Release Agreement

↓ Please scroll to read all terms ↓

DECLARATION

I hereby affirm that I am aware that scuba diving is an inherently dangerous activity that can cause permanent injury or death.

I understand that diving with compressed air involves certain inherent risks, including but not limited to decompression sickness, embolism, oxygen toxicity, inert gas narcosis or other hyperbaric injuries.

RELEASE OF LIABILITY

I hereby fully RELEASE AND DISCHARGE DIVEANDAMAN from any liability, claims, demands, or causes of action whatsoever arising out of any damage, loss, injury, or death while participating in diving activities.

ASSUMPTION OF RISK

I understand and accept that diving entails certain known and unanticipated risks including equipment malfunction, improper operation, and other hazards. I voluntarily assume all risks.

PHYSICAL CONDITION

I confirm that I have completed the Medical Statement honestly. I certify that I am physically fit and have not been advised by a medical professional not to participate in diving activities.

WAIVER OF CLAIMS

I understand that by signing this Release, I voluntarily release and agree to indemnify DIVEANDAMAN from any liabilities connected with my participation in diving activities.

By filling this form, you provide your digital signature valid as per legal norms.

E-Signature *

By signing above, you provide your digital signature valid as per legal norms.

I agree that I have filled all the details in the form honestly, to the best of my knowledge, thoroughly read the RISK LIABILITY RELEASE and am aware that this digital form is legally valid as a physical document with signature.

Submitting your registration...

DIVE ANDAMAN

👤 Participant Information

🩺 Medical Questionnaire

Applicant Signature *

Parent/Guardian Details

📜 Liability Release Agreement

DECLARATION

RELEASE OF LIABILITY

ASSUMPTION OF RISK

PHYSICAL CONDITION

WAIVER OF CLAIMS

E-Signature *

DIVE ANDAMAN

👤 Participant Information

🩺 Medical Questionnaire

Applicant Signature *

Parent/Guardian Details

📜 Liability Release Agreement

DECLARATION

RELEASE OF LIABILITY

ASSUMPTION OF RISK

PHYSICAL CONDITION

WAIVER OF CLAIMS

E-Signature *

Registration Successful!