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EQUIPMENT
RENTAL AGREEMENT
LIABILITY RELEASE AND
EXPRESS ASSUMPTION OF RISK |
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Newport Diving Center |
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550 Thames Street |
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Newport , RI 02840 |
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Tel: (401) 847-9293 |
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Fax: (401) 847-1346 |
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| THIS
AGREEMENT is entered into between The Newport Diving Center - 550 Thames St.
- Newport, RI 02840 and |
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, hereinafter "RENTOR,"
for the rental of scuba |
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| ( rentor ) |
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| and/or skin
diving equipment. |
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| This
AGREEMENT is a release of the RENTOR'S rights to sue for injuries or death
resulting from the rental and/or use |
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equipment. RENTOR expressly assumes all risks of skin and/or scuba diving
related in any way to the rental |
| and/or use
of this equipment. |
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| Name: |
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Date Rented: |
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Date Due: |
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| Address: |
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Date Returned: |
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Received By: |
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D/L No.: |
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Home ( ) |
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Other ID: |
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| Work ( ) |
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| Local
Address: |
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Equipment Prepared By: |
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(Dive Center
Employee) |
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Phone (
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All Renters must have a credit card on file |
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Card Number |
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| Expiration Date |
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Billing Zip Code |
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| Certification
Level: |
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Date: |
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Certification#: |
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Agency: |
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| RENTOR
hereby acknowledges receipt of the equipment designated in this form, and, if
any of this equipment is to be |
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for scuba diving, that RENTOR is a certified scuba diver or student in a
scuba diving course/program under the |
| supervision
of a certified instructor. |
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| RENTOR
acknowledges that the equipment is in good working condition and that he/she
has examined the equipment to |
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that it is free from defects, including checking both the quality and
quantity of air in any scuba tank(s) rented. |
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| RENTOR
also understands that The Newport Diving Center and it employees, owners,
officers, or agents |
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| (hereafter
"Released Parties"), shall not be held liable or responsible in any
way for any injury, death or other damage |
| to RENTOR
or his/her family, heirs, or assigns which may occur as a result of the
rental and/or use of the equipment, or |
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result of product defect, or negligence of any party, including the Released
Parties, whether passive or active. |
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| ( Continued on
reverse side ) |
| EQUIPMENT RENTAL AGREEMENT,
LIABILITY RELEASE AND EXPRESS ASSUMPTION OF RISK
(CONTINUED) |
| Quantity |
Description |
Size/Style |
Customer has checked |
Customers
initials |
Daily Rate |
Amount |
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Mask &
Snorkel |
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Proper Fit |
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$5.00 |
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Fins |
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Fit-Straps-Match |
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$5.00 |
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Boots |
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Fit-Zipper-Match |
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$5.00 |
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Hood |
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Proper Fit |
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$5.00 |
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Gloves |
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Fit & Match |
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$5.00 |
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Wet Suit |
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Fit & No Tears |
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$15.00 |
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Tank |
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VIP Hydro PSI |
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$15.00 |
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Tank - Nitrox |
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VIP Hydro PSI & Mix check |
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$25.00 |
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Regulator |
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Hoses-Mouthpiece-Breathes-All OK |
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$20.00 |
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BCD |
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Fit-Usage-No Leaks |
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$20.00 |
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Weight Belt |
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Fit & Weight |
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$10.00 |
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Dive Light |
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Switch-Bulb-Batteries OK |
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$15.00 |
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Dry Suit |
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Fit-Zipper-Seals |
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$40.00 |
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Dry Suit
Undies |
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Fit & Thickness |
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$15.00 |
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Dive Flag |
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Flag Float & Line |
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$7.00 |
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Dive Computer |
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Battery is good & Understand usage |
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$25.00 |
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Gear Bag |
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Holds gear OK |
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$5.00 |
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DPV |
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Runs/Battery |
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$40.00 |
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Speargun |
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Tip/Shockcord |
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$25.00 |
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Sub-Total |
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R.I. Tax 7% |
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Total |
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| I, |
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HAVE CAREFULLY READ AND |
| UNDERSTAND
THE ABOVE AGREEMENT. BY SIGNING THIS AGREEMENT, I EXEMPT AND |
| RELEASE
THE NEWPORT DIVING CENTER, AND ALL RELATED ENTITIES AS DEFINED ABOVE, |
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ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY |
| DAMAGE,
OR WRONGFUL DEATH AS A RESULT OF RENTING AND/OR USING THE EQUIPMENT, |
| HOWEVER
CAUSED, INCLUDING, BUT NOT LIMITED TO PRODUCT LIABILITY OR THE |
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| NEGLIGENCE
OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. |
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| Participant's
Signature |
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Date (Day/Month/Year) |
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| Signature of
Parent/Guardian (where applicable) |
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Date (Day/Month/Year) |
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