Before signing, please complete the following information:

The information from this form will be used in the signing of your document(s). Once you’ve filled out and verified the applicable information below, you’ll have a chance to sign this form.

Your information

Gender *
Please select your level of dive certification, if your a student or non-certified select 'None'
Please list your approximate number of logged dives prior to your reservation
Nitrox Diver *
Cruise ship passengers do not have to pay this fee but you can fill in 'CRUISE'

Don't have a nature tag yet? Purchase at Stinapa Nature Fee Tag

Emergency Contact Information

LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT
Please read carefully, fill in all the blanks and initial each paragraph before signing.

I, the undersigned, am a (non)-certified diver trained in the proper use of scuba diving equipment and sport diving procedures. I also hereby affirm that I am aware that skin and scuba diving have inherent risks which may result in serious injury or death.

I, the undersigned,  might be a certified student diver, however I am receiving instructions in scuba diving and agree to dive within the limitations of the course. I understand that I may not practice any skills from my ongoing course independently without instructional staff until I am certified to do so. I understand that I can dive independently of the instructional staff within my current certification level.

I, the undersigned,  understand and agree that neither Wanderlust Dive Center Bonaire nor any of their respective employees, officers, agents, contractors or assigns (hereinafter referred to as “released parties”) may be held liable or responsible in any way for any injury, death or other damages to me, my family, estate, heirs or assigns that may occur as a result of my participation in diving while a guest of Wanderlust Dive Center Bonaire or as a result of the negligence of any party, including the released parties, whether passive or active.

In consideration of being allowed to dive while a guest of Wanderlust Dive Center Bonaire, I hereby personally assume all risks in connection with said diving, whether foreseen or unforeseen that may befall me while I am a guest of Wanderlust Dive Center Bonaire.

I, the undersigned,  further release, exempt and hold harmless released parties from any claim or lawsuit by me, my family, estate, heirs or assigns arising out of my participation in said diving.

I, the undersigned,  also understand, that skin and scuba diving are physically strenuous activities and that I will be exerting myself during said activities, and that if I am injured as a result of a heart attack, panic, hyperventilation, drowning or any other cause, that I expressly assume the risk of said injuries and that I will not hold the released parties responsible for the same.

I, the undersigned,  agree to take full responsibility for my own actions and safety while skin and/or scuba diving with equipment, transportation or other services provided by Wanderlust Dive Center Bonaire.

I, the undersigned,  also understand, that all reef areas, coral, fish, shells and other organisms around the territory of Bonaire are fully protected by law. I understand that it is a criminal offence to carry a spear gun, to deface, destroy, pollute, injure or molest any reef or reef organism and that failure to comply with such laws will result in imprisonment, fines and/or expulsion from Bonaire.

I, the undersigned,  further state, that I am at lawful age and legally competent to sign this liability release or that I have acquired the written consent of my parent or guardian.

I, the undersigned,  understand that the terms herein are contractual and not a mere recital and that I have signed this document 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 un-enforceable provision had never been contained herein.

I, the undersigned,  understand and agree that I am not only giving up my right to sue the Released Parties but also any rights my heirs, assigns, or beneficiaries may have to sue the Released Parties resulting from my death. I further represent I have the authority to do so and that my heirs, assigns, or beneficiaries will be estopped from claiming otherwise because of my representations to the Released Parties.

I, the undersigned, understand that I must check in all rental equipment and weights at the dive shop the day before departure.

I, the undersigned, understand that every day rental gear is not returned I will be charged for the equipment rental and we assume you are diving.

I, the undersigned, verify that given rental equipment is in good condition when received and is fully responsible for the equipment and will be charged at costs for any loss or damage of the gear.

I, the undersigned, understand that I will be charged $100 for rinsing the regulator set without the dust cap on it's proper place.

I, the undersigned,

BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE WANDERLUST DIVE CENTER BONAIRE AND ALL RELATED ENTITIES AS DEFINED ABOVE FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, INCLUDING BUT NOT LIMITED TO THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE.

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

CERTIFIED NITROX DIVERS ONLY

I, the undersigned, am a certified oxygen enriched air diver.

  • I, the undersigned,  am fully aware of the risks and procedures of enriched air diving.
  • I, the undersigned,  understand that diving with oxygen enriched air (“Enriched Air”) involves inherent risks of oxygen toxicity
  • I, the undersigned,  will personally verify the oxygen content of each enriched air tank.
CERTIFIED NITROX DIVERS ONLY *

I certify the above information is accurate.