Booking Request

    (any diver who has less than 40 logged dives or who has not dived in the last 6 months must carry out a refresh/check dive. Use the format: DayMonthYear example: 01012016. If the booking is for Discovery Scuba Dive or Beginner courses please type 0)

    (If the booking is for Discovery Scuba Dive or Beginner courses please type 0)

    Medical Statement

    Please answer the following questions on your past and 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.

    Do you have a history of ear disease, hearing loss? YesNo
    Are you suffering from sinusitis, otitis, cold, congestion? YesNo
    Do you have asthma, diabetes or hypertonia? YesNo
    Did you ever have major surgery (ear, sinus, lungs, heart etc)? YesNo
    Did you have behavioural disorders? YesNo
    Did you ever have panic attacks or claustrophobia? YesNo
    Are you suffering from epilepsy or other neurological disorders? YesNo
    Are you pregnant? YesNo
    Are you over 45 and have a family history of heart attack or stroke? YesNo
    Did you take any kind of medication recently? YesNo

    Liability Release and Assumption of Risk Agreement

    I, hereby affirm that I am aware that diving with compressed air involves certain inherent risks; decompression sickness, embolism or other hyperbaric injury can occur that requires treatment in a recompression chamber. Open water diving trips may be conducted at a site that is remote, either by time or distance or both, from such a recompression chamber. Scuba diving is a physically strenuous activity, therefore I must advise truthfully and fully inform the dive professional and Viking Diving Center of my medical history.

    I understand and agree that neither my instructors nor Aqualis Diving Center Hvar Croatia, may be held liable or responsible in any way for any injury, death or other loss suffered or caused by me or resulting from my own conduct or any matter or condition under my control that amounts to my own contributory negligence.

    In the absence of any negligence or other breach of duty by the dive professionals conducting this program or by Aqualis Diving Center Hvar Croatia, my participation in this scuba diving program is entirely at my own risk.

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

    I acknowledge receipt of this statement and have read all of the terms before signing this statement.