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

I, __________________________________________________, understand that as a diver I should:

  1. Maintain good mental and physical fitness for diving. Avoid being under the influence of alcohol or dangerous drugs when freediving. Keep proficient in freediving skills, striving to increase them through continuing education and reviewing them in controlled conditions after a period of freediving inactivity.
  2. Be familiar with my dive sites. If not, obtain a formal site orientation from a knowledgeable, local source. If diving conditions are worse than those in which I am experienced, postpone freediving or select an alternate site with better conditions. Engage only in freediving activities consistent with my training and experience. Do not engage in cave, wreck or ice freediving.
  3. Use complete, well-maintained, reliable equipment with which I am familiar; and inspect it for correct fit and function prior to each dive.
  4. Listen carefully to freedive briefings and directions and respect the advice of those supervising my freediving activities.
  5. Never practice or take part in freediving activities without direct supervision of a buddy whether in open water or in confined water. Adhere to the buddy system throughout every freedive. Plan freedives – including communications, and emergency procedures – with my buddy.
  6. Have a means to monitor depth and time under water. Limit maximum depth and time to my level of training and experience.
  7. Wear appropriate amount of weight so that I am comfortably buoyant at the surface when at rest and without a full lung of air. Have weight system accessable for easy removal, and establish buoyancy when in distress.
  8. Take sufficient surface intervals to properly breathe between freedives. Avoid overexertion while in and under water and freedive within my limitations.
  9. Discontinue freediving activity for the day should any blackout or near-blackout (samba) occur.
  10. Know and obey local diving 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)

Updated 05 June 2002