Enroll With the Marine Vocational Program

Applicant Information

Full Name

Date of Birth

Address (Street/City/State/Zip)

Phone Number

Parent Contact

Full Name (Mother)

Address (Street/City/State/Zip)

Phone Number

Full Name (Father)

Address (Street/City/State/Zip)

Phone Number

Emergency ContactsPlease list 2 emergency contacts

Full Name

Relationship

Address (Street/City/State/Zip)

Phone Number

Full Name

Relationship

Address (Street/City/State/Zip)

Phone Number

Health

Allergies

Declaration of Fitness to Participate in Water Activities

Release and Waiver of Claims: Assumption of Risk: Indemnification Agreement

In consideration of being allowed to use the facilities and vessels and participate in fishing, snorkeling, boating, and other activities (collectively, the "Activities") provided by the Marine Vocational Program (MVP) (collectively the "Host"), the Participant, and the Participant's parent(s) or legal guardian(s) if the Participant is a minor, do hereby agree, to the fullest extent permitted by law, as follows:

TO WAIVE ALL CLAIMS that they have or may have against the Host arising out of the Participant's participation in the Activities or the use of any equipment provided by the Host ("Equipment"), including while receiving instruction or training.
TO ASSUME ALL RISKS of participating in the activities and using the equipment, even those caused by the negligent acts or conducts of the Host, its owners, affiliates, operators, employees, agents, and/or officers. The Participant and his/her parent(s) or legal guardian(s) understand that there are inherent risks of participating in the Activities and using the Equipment, which may be both foreseen and unforeseen and include serious physical injury and death.
TO RELEASE the Host, its owners, affiliates, operators, employees, agents, and officers from all liability for any loss, damage, injury, death, or expense that the Participant (or his/her next of kin) may suffer, arising out of his/her participation in the Activities and/or use of the Equipment, including while receiving instruction and/or training. The Participant and his/her parent(s) or legal guardian(s) specifically understand that they are releasing any and all claims that arise or may arise from any negligent acts or conduct of the Host, its owners, affiliates, operators, employees, agents, and/or officers, to the fullest extent permitted by law. However, nothing in this Agreement shall be construed as a release for conduct that is found to conssitute gross negligence or intentional conduct; and
TO INDEMNIFY the Host, its owners, affiliates, operators, employees, agents, and/or officers, from all liability for any loss, damage, injury, death, or expense that the Participant (or his/her next of kin) may suffer, arising out of participation in the Activities and/or use of the Equipment, including while receiving instruction and/or training.

Personal Responsibility

The Participant and his/her parent(s) or legal guardian(s) certify that Participant has no physical or mental condition that precludes him/her from participating in the Activities and that he/she is not participating against medical advice.

The Participant and his/her parent(s) or legal guardian(s) understand that Participant's participation in the Activities is voluntary and further understand that they have the opportunity to inspect the Host's equipment, vessels, and facilities before any participation.

The Participant and his/her parent(s) or legal guardian(s) understand that the Host's vessels have limited medical facilities and that in the event of illness or injury, appropriate medical care must be summoned by radio, and so treatment may be significantly delayed until Participant can be transported to a proper medical facility.

The Participant and his/her parent(s) or legal guardian(s) understand that Participant is obligated to follow the rules of the Activities, and that he/she can minimize his/her risk of injury by doing so and through the exercise of common sense and by being aware of his/her surroundings.

If, while participating in the Activities, the Participant or his/her parent(s) or legal guardian(s) observe any unusual hazard or condition, which they believe jeopardizes Participant's personal safety or that of others, Participant and/or his parent(s) or legal guardian(s) will remove Participant from participation in the Activities and immediately bring said hazard or condition to the attention of the Host.

To the extent that any portion of this Agreement is deemed to be invalid under the law of applicable jurisidction, the remaining portions of the Agreement shall remain binding and available for use by the Host and its counsel in any proceeding.

The Marine Vocational Program or activity may involve certain inherent risks, including death or personal injury. In consideration for participating in this Program or activity, I hereby irrevocably and permanently release any and all claims of any kind of nature whatsoever, including but not limited to claims for personal injury, death, loss damage or delay, against the Marine Vocational Program in this Activity. I and everyone involved meet the required age or health restrictions for this Activity. The host reserves the right to refusse any access to this Activty.

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Checking this box constitutes a signature

Date

Permission to Use Pictures

The Participant and his/her parent(s) or legal guardian(s) agree to allow the Marine Vocational Program (herein known as "Host") to utilize pictures taken during and for the purposes of instruction, training, and other official activities on the Host's website and social media accounts. Pictures will not be taken or used for any purpose that is not an official activity conducted by the Host.

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Checking this box constitutes a signature

Date

Disclaimer and SignatureI certify that my answers are true and correct to the best of my knowledge. I understand that false or misleading information may result in his or her termination from the program.

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Checking this box constitutes a signature

Date

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