Participant: Course:

Please read carefully and fill all blanks before signing.

I, ____________________________________(participant Name), hereby affirm that I am aware that skin and scuba diving have inherent risks which may result in serious injury or death.

I understand that diving with compressed air involves certain inherent risks; including but not limited to decompression sickness, embolism or other hyperbaric/air expansion injury that require treatment in a recompression chamber. I further understand that the open water diving trips which are necessary for training and for certification may be conducted at a site that is remote, either by time or distance or both, from such a recompression chamber. I still choose to proceed with such instructional dives in spite of the possible absence of a recompression chamber in proximity to the dive site.

I understand and agree that neither my instructor(s), ____________________________________(instructor name(s)), the facility through which I receive my instruction, Huron Scuba Adventures, Inc., nor International PADI, Inc. nor its affiliate and subsidiary corporations, 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 this diving program or as a result of the negligence of any party, including the Released Parties, whether passive or active.

In consideration of being allowed to participate in this course (and optional Adventure Dive), hereinafter referred to as "program" I hereby personally assume all risks of this program, whether foreseen or unforeseen, that may befall me while I am a participant in this program including, but not limited to, the academics, confined water and/or open water activities.

I further release, exempt and hold harmless said program and Released Parties from any claim or lawsuit by me, my family, estate, heirs or assigns, arising out of my enrollment and participation in this program including both claims arising during the program or after I receive my certification.

I also understand that skin diving and scuba diving are physically strenuous activities and that I will be exerting myself during this program, and that if I am injured as a result of 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 further state that I am of lawful age and legally competent to sign this liability release, or that I have acquired the written consent of my parent or guardian. I understand the terms herein are contractual and not a mere recital, and that I have signed this Agreement 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 unenforceable provision had never been contained herein.

I 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, ________________________________(participant Name), BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE MY INSTRUCTORS,

______________________________________(instructor Name(s)), THE FACILITY THROUGH WHICH I RECEIVE MY INSTRUCTION,

Huron Scuba Adventures, Inc, AND PADI AMERICAS, INC., 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.

__________________________________________ ________________________________
Participant Signature Date (Day/Month/Year)

__________________________________________ ________________________________
Signature of Parent of Guardian (where applicable) Date (Day/Month/Year)

PRODUCT NO. 10072 (Rev. 3/06) Version 4.02

Participant: Course:

Participant Record (Confidential Information)

Please read carefully before signing.

This is a statement in which you are informed of some potential risks involved in scuba diving and of the conduct required of you during the scuba training program. Your signature on this statement is required for you to participate in the scuba training program offered

by ______________________________(instructor) and

Huron Scuba Adventures, Inc. located in the

city of Ann Arbor, state/province of Michigan.

Read this statement prior to signing it. You must complete this Medical Statement, which includes the medical questionnaire section, to enroll in the scuba training program. If you are a minor, you must have this Statement signed by a parent or guardian.
Diving is an exciting and demanding activity. When performed correctly, applying correct techniques, it is relatively safe. When established safety procedures are not followed, however, there are

increased risks.
To scuba dive safely, you should not be extremely overweight or out of condition. Diving can be strenuous under certain conditions. Your respiratory and circulatory systems must be in good health. All body air spaces must be normal and healthy. A person with coronary disease, a current cold or congestion, epilepsy, a severe medical problem or who is under the influence of alcohol or drugs should not dive. If you have asthma, heart disease, other chronic medical conditions or you are taking medications on a regular basis, you should consult your doctor and the instructor before participating in this program, and on a regular basis thereafter upon completion. You will also learn from the instructor the important safety rules regarding breathing and equalization while scuba diving. Improper use of scuba equipment can result in serious injury. You must be thoroughly instructed in its use under direct supervision of a qualified instructor to use it safely.
If you have any additional questions regarding this Medical Statement or the Medical Questionnaire section, review them with your instructor before signing.

Divers Medical Questionnaire

To the Participant:

The purpose of this Medical Questionnaire is to find out if you should be examined by your doctor before participating in recreational diver training. A positive response to a question does not necessarily disqualify you from diving. A positive response means that there is a preexisting condition that may affect your safety while diving and you must seek the advice of your physician prior to engaging in dive activities.

Please answer the following questions on your past or present medical history with a YES or NO. If you are not sure, answer YES. If any of these items apply to you, we must request that you consult with a physician prior to participating in scuba diving. Your instructor will supply you with an RSTC Medical Statement and Guidelines for Recreational Scuba Diver's Physical Examination to take to your physician.

____	Could you be pregnant, or are you attempting to become pregnant?
____	Are you presently taking prescription medications? (with the exception of birth control or anti-malarial)
____	Are you over 45 years of age and can answer YES to one or more of the following?
	___ currently smoke a pipe, cigars or cigarettes
	___ have a high cholesterol level
	___ have a family history of heart attack or stroke
	___ are currently receiving medical care
	___ high blood pressure
	___ diabetes mellitus, even if controlled by diet alone
Have you ever had or do you currently have...
____	Asthma, or wheezing with breathing, or wheezing with exercise?
____	Frequent or severe attacks of hayfever or allergy?
____	Frequent colds, sinusitis or bronchitis?
____	Any form of lung disease?
____	Pneumothorax (collapsed lung)?
____	Other chest disease or chest surgery?
____	Behavioral health, mental or psychological problems (Panic attack, fear of closed or open spaces)?
____	Epilepsy, seizures, convulsions or take medications to prevent them?
____	Recurring complicated migraine headaches or take medications to prevent them?
____	Blackouts or fainting (full/partial loss of consciousness)?

____	Frequent or severe suffering from motion sickness (seasick, carsick, etc.)?
____	Dysentery or dehydration requiring medical intervention?
____	Any dive accidents or decompression sickness?
____	Inability to perform moderate exercise (example: walk 1.6 km/one mile within 12 mins.)?
____	Head injury with loss of consciousness in the past five years?
____	Recurrent back problems?
____	Back or spinal surgery?
____	Diabetes?
____	Back, arm or leg problems following surgery, injury or fracture?
____	High blood pressure or take medicine to control blood pressure?
____	Heart disease?
____	Heart attack?
____	Angina, heart surgery or blood vessel surgery?
____	Sinus surgery?
____	Ear disease or surgery, hearing loss or problems with balance?
____	Recurrent ear problems?
____	Bleeding or other blood disorders?
____	Hernia?
____	Ulcers or ulcer surgery ?
____	A colostomy or ileostomy?
____	Recreational drug use or treatment for, or alcoholism in the past five years?

The information I have provided about my medical history is accurate to the best of my knowledge. I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health condition.

_______________________________________	_________________	_______________________________________	_________________
Signature	Date	Signature of Parent or Guardian	Date
PRODUCT No. 10063 (Rev. 06/07) Ver. 2.01

Please print legibly.

Name ________________________________________	Birth Date ________________	Age __________
First Initial Last	Day/Month/Year
Mailing Address ______________________________________________________________________
City ______________________________	State/Province/Region ____________________
Country _________________________________________	Zip/Postal Code ____________________
Home Phone (_______) ______________________________	Business Phone (______) ____________________
Fax (______) ____________________	Email ________________________________________
Name and address of your family physician
Physician _________________________________________	Clinic/Hospital _________________________________________
Address __________________________________________________________________________________
Date of last physical examination _________________________________________
Name of examiner _________________________________________	Clinic/Hospital _________________________________________
Address __________________________________________________________________________________
Phone (______) ____________________	Email _________________________________________
Were you ever required to have a physical for diving? [ ] Yes [ ] No	If so, when? _________________________________________

This person applying for training or is presently certified to engage in scuba (self-contained underwater breathing apparatus) diving. Your opinion of the applicant's medical fitness for scuba diving is requested. There are guidelines attached for your information and reference.

Physician's Impression

[ ] I find no medical conditions that I consider incompatible with diving.

[ ] I am unable to recommend this individual for diving.

Remarks _________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

_______________________________________________________________	Date _________________________________________
Physician's Signature or Legal Representative of Medical Practitioner	Day/Month/Year
Physician _________________________________________	Clinic/Hospital _________________________________
Address __________________________________________________________________________________
Phone ( ) ____________________	Email _________________________________________

Participant: Course:

Please read carefully before signing.

This is a statement in which you are informed of the established safe diving practices for skin and scuba diving. These practices have been compiled for your review and acknowledgement and are intended to increase your comfort and safety in diving. Your signature on this statement is required as proof that you are aware of these safe diving practices. Read and discuss the statement prior to signing it. If you are a minor, this form must also be signed by a parent or guardian.

I, __________________________________________________(Print Name), understand that as a diver I should:

Maintain good mental and physical fitness for diving. Avoid being under the influence of alcohol or dangerous drugs when diving. Keep proficient in diving skills, striving to increase them through continuing education and reviewing them in controlled conditions after a period of diving inactivity, and refer to my course materials to stay current and refresh myself on important information.
Be familiar with my dive sites. If not, obtain a formal diving orientation from a knowledgeable, local source. If diving conditions are worse than those in which I am experienced, postpone diving or select an alternate site with better conditions. Engage only in diving activities consistent with my training and experience. Do not engage in cave or technical diving unless specifically trained to do so.
Use complete, well-maintained, reliable equipment with which I am familiar; and inspect it for correct fit and function prior to each dive. Deny use of my equipment to uncertified divers. Always have a buoyancy control device and submersible pressure gauge when scuba diving. Recognize the desirability of an alternate air source and a low-pressure buoyancy control inflation system.
Listen carefully to dive briefings and directions and respect the advice of those supervising my diving activities. Recognize that additional training is recommended for participation in specialty diving activities, in other geographic areas and after periods of inactivity that exceed six months.
Adhere to the buddy system throughout every dive. Plan dives - including communications, procedures for reuniting in case of separation and emergency procedures - with my buddy.
Be proficient in dive table usage. Make all dives no decompression dives and allow a margin of safety. Have a means to monitor depth and time underwater. Limit maximum depth to my level of training and experience. Ascend at a rate of not more than 18 metres/60 feet per minute. Be a SAFE diver - Slowly Ascend From Every dive. Make a safety stop as an added precaution, usually at 5 metres/15 feet for three minutes or longer.
Maintain proper buoyancy. Adjust weighting at the surface for neutral buoyancy with no air in my buoyancy control device. Maintain neutral buoyancy while underwater. Be buoyant for surface swimming and resting. Have weights clear for easy removal, and establish buoyancy when in distress while diving.
Breathe properly for diving. Never breath-hold or skip-breathe when breathing compressed air, and avoid excessive hyperventilation when breath-hold diving. Avoid overexertion while in and underwater and dive within my limitations.
Use a boat, float or other surface support station, whenever feasible.
Know and obey local dive laws and regulations, including fish and game and dive flag laws.

I have read the above statements and have had any questions answered to my satisfaction. I understand the importance and purposes of these established practices. I recognize they are for my own safety and well-being, and that failure to adhere to them can place me in jeopardy when diving.

____________________________________________________________ ________________________
Participant's Signature Date (Day/Month/Year)

____________________________________________________________ ________________________
Signature of Parent or Guardian (where applicable) Date (Day/Month/Year)

PRODUCT NO. 10060 (Rev. 11/05) Version 1.05

PADI Open Water Diver Course Record & Referral Form

Student Name____________________________________
Birth Date __________ Day/Month/Year Sex M F

Mailing address____________________________________

City____________________________________ State/Province__________________
Country_________________ Zip/Postal Code____________
Phone Home (____)____________ Business (____)____________
Fax (____)__________________
Email ____________________________________

A. Confined Water Dives
	Date Completed	Instructor
	Day/Month/Year	Initials**	PADI #

CW 1*	____/____/____	______	#__________
CW 2	____/____/____	______	#__________
CW 3	____/____/____	______	#__________
CW 4	____/____/____	______	#__________
CW 5	____/____/____	______	#__________

Watermanship Assessment
Date Completed	Instructor
Day/Month/Year	Initials**	PADI #

200 metre/yard Swim OR 300 metre/yard Mask/Snorkel/Fin Swim
____/____/____	______	#___________
10 Minute Survival Float
____/____/____	______	#___________
Skin Diving Skills
____/____/____	______	#___________
Dry Suit Orientation
____/____/____	______	#___________

*DSD with all CW Dive 1 skills = Open Water Diver CW Dive 1
(Note: If all Confined Water Dives and Watermanship Assessment have been completed by one instructor, only one signature required.)
All Confined Water Dives listed above and the Watermanship Assessment have been completed.

Instructor Signature ______________________ PADI #________
Date ____/____/____ Day/Month/Year
**I certify that this student has satisfactorily completed this skill/module/dive as outlined in the PADI Instructor Manual. I am a PADI Instructor renewed in Teaching status for the current year.

B. Knowledge Development

	Date Completed	Completed	Passed	Viewed	Instructor
	Day/Month/Year	KR	Quiz/Exam	Video	Initials**	PADI #
Mod 1	____/____/____	[ ]	________	[ ]	________	#_______
Mod 2	____/____/____	[ ]	________	[ ]	________	#_______
Mod 3	____/____/____	[ ]	________	[ ]	________	#_______
Mod 4	____/____/____	[ ]	________	[ ]	________	#_______
Mod 5	____/____/____	[ ]	________	[ ]	________	#_______

(Note: If all above Knowledge Development sessions have been completed by one instructor, only one signature required)
All Knowledge Development sessions listed above have been completed, Quizzes/Exams passed.

Instructor Signature _______________________________ #___________
Date ____/____/____ Day/Month/Year

All PADI Instructors who initial this document must complete identification section below.

PADI Instructor_______________________________PADI No.___________
Signature____________________________Date_________ Day/Month/Year
Dive Center/Resort No._______________Phone No. (____)_____________ Fax No. (____)_______________ Email ___________________________

When referring a PADI Scuba Diver/Open Water Diver student:
a. Fill in the diver and PADI Instructor information and note appropriate areas of training completed.
b. Attach a copy of the diver's PADI Medical Statement to this form.
c. Advise the diver of the need for a photo for certification card processing.
d. Encourage the diver to complete training as soon as possible and explain that this form is only valid for one year from the last training module completion date.

Dive Flexible Skills These skills may be completed during any Open Water Training Dive.	Completed on	Instructor Initials**	PADI#
1. Cramp Removal	Dive #____	________	#________
2. Tired Diver Tow	Dive #____	________	#________
3. Surface Swim with Compass	Dive #____	________	#________
4. Snorkel/Regulator Exchange	Dive #____	________	#________
5. Remove /Replace Scuba (surface)	Dive #____	________	#________
6. Remove/Replace Weights (surface)	Dive #____	________	#________
7. CESA (Dive 2, 3 or 4)	Dive #____	________	#________
8. UW Compass Navigation (Dive 2, 3 or 4)	Dive #____	________	#________

(Note: If all above Dive Flexible Skills have been completed by one instructor, only one signature is required)
All Dive Flexible Skills listed above have been completed.

Instructor Signature __________________________ #_________
Date ____/____/____ Day/Month/Year

Huron Scuba's reformatted version of Product No. 10056 (Rev. 9/06) Version 3.05

C. Open Water Dives

Date Completed Day/Month/Year	Instructor Initials**	PADI #	Date Completed Day/Month/Year	Instructor Initials**	PADI #
Dive 1 ____/____/____	______	#_______	Dive 3 ____/____/____	______	#_______
Dive 2 ____/____/____	______	#_______	Dive 4 ____/____/____	______	#_______

Student Statement: I understand the training requirements for this course and have successfully completed all certification requirements. I am adequately prepared to dive in areas and under conditions similar to those in which I was trained. I realize that additional training is recommended for participation in specialty diving activities, in other geographical areas, and after periods of inactivity that exceed six months. I agree to abide by PADI's Standard Safe Diving Practices.
Student Signature _____________________________________________
Date ____/____/____ Day/Month/Year
All requirements for certification as a PADI Scuba Diver have been met (completion of Knowledge Development sessions 1, 2, 3 Confined Water Dives 1, 2, 3 Open Water Dives 1, 2).

Instructor Signature _______________________________ #___________
Date ____/____/____ Day/Month/Year
All requirements for certification as a PADI Open Water Diver have been met.

Instructor Signature _______________________________ #___________
Date ____/____/____ Day/Month/Year

Trip/Class: ______________________________

Rental Reservation for Dates:____________________________

Huron Scuba Adventures, Inc.

4816 Jackson Road #D, Ann Arbor MI 48103

Phone 734-994-3483

dive@huronscuba.com

NAME:	BEST PHONE:	ALT. PHONE:

CREDIT CARD #	EXP:	CVV:

CERTIFICATION LEVEL:	CERT #:	INSTRUCTOR:

Rental fees are non-refundable.
You are renting a type of equipment, not a specific item. An exact piece of equipment may not be available for the time period of your rental because it may not have been returned by another customer, it may have been replaced, or it may be in the process of maintenance or repair.
Inspect your rental equipment, including setting it up on a cylinder and testing its functions, before you leave Huron Scuba. You rent this equipment "AS IS."
You must be certified and have adequate and current knowledge and training in the use of any scuba equipment (or be in scuba training). By renting scuba equipment, you are representing that those things are true.
You agree that you will not loan this equipment to anyone.
If this equipment is damaged or lost during your rental you will pay for its repair or replacement by Huron Scuba at current retail pricing.
After 7 days late, you will be charged for late fees plus replacement by Huron Scuba at current retail pricing.
You agree to pay a cleaning/service fee of up to $20 for each and every item returned in poor condition.
You agree to indemnify and hold harmless HURON SCUBA, its agents, officers, directors and shareholders, from any claim, loss or liability related to his equipment.

Qty	Item	Size	#	Daily	Wknd	Week	Amount
	BCD (standard)			$15	$25	$40
	BCD (wt-integrated)			$20	$30	$55
	Wetsuit (5mm-7mm)			$12	$20	$40
	Wetsuit (tropical)			$8	$12	$24
	Drysuit & hose kit			$70	$95	$140
	Drysuit boots & insulation			(Included with suit)
	Weight belt			$4	$6	$12
	Weight bag with 30 lbs			$15	$20	$30
	Hood			$5	$7	$10
	Regulator system			$18	$28	$50
	Dive computer			$15	$23	$40
	Computer manual			$20 if damaged
	Gear bag			$2	$3	$6
	Air cylinder up to 80 cu. ft.			$15	$20	$30
	Nitrox cylinder @32% 80 cu. ft.			$23	$28	$38
	Air High-capacity cylinder 95+ cu ft			$20	$30	$40
	Nitrox High-capacity cylinder @32%			$28	$38	$48
	Doubles (Nitrox 32% adds $16)			$50	$75	$100
	Dive light (batteries not included)			$7	$10	$15
	PADI Open Water Diver DVD			n/a	n/a	$7
	Spare Air with holster & fill adapter			$12	$25	$50
Subtotal rental
Students in our classes and customers on trips paid through Huron Scuba (25% off)
Total

Must be returned by:

Or additional fees will be due.

to be filled out by staff:

RESERVED BY: __________

PACKED BY: __________

Checked out and
all inventory verified by: ________

DATE RETURNED: __________

RECEIVED BY: __________

Late fees paid, if owed: ________

DVDs not returned within 7 days of Due Date incur a charge of $47.29.

I authorize, by my signature below, Huron Scuba's charge to my credit card for all late fees, items not returned within 7 days of the due date, and any necessary cleaning, repair and/or replacement of these items rented by me.

RENTED BY ____________________________________________________________ DATE______________________