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Participant Waiver & Release

CEBA Dive Tribe Scuba School · Puerto Plata, DR
1 Profile
2 Activities
3 Release
4 Medical
5 Photo & Insurance
6 Sign
👤

Participant Profile

Filled once — auto-populates all forms below.

🪪
Tap to upload or drag & drop
JPEG · PNG · PDF · Max 10MB
🏄

Select Your Activities

Select all that apply — waiver sections adjust automatically.

🤿 Which SCUBA Course(s) are you enrolling in?

🎓 Divemaster Program: The Divemaster program follows a separate enrollment and medical clearance process. Please contact us directly — do not use this form for Divemaster enrollment.

📧 info@cebascuba.com  |  📱 WhatsApp +1 849.507.3890
📋

Release & Waiver of Liability

Read carefully. This document affects your legal rights.

🏥

Medical Disclosure & Fitness

Confidential. Used only to assess fitness and plan emergency response. Handled per DR Law No. 172-13.

📸

Photo Release & Insurance

Two quick sections — both required.

⚠️ Minor Participant DetectedBased on the DOB provided, this participant is under 18. The event coordinator, group leader, or authorized adult must sign on the minor's behalf. No email will be sent to the minor.
✍️

Electronic Signature & Submission

Review, sign, and submit. A copy will be emailed to you.

Typing your name constitutes a valid electronic signature.

🔒 Audit Trail — Captured Automatically

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Document VersionBKB-WAIVER-v2026.02
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Waiver Submitted!

Your signed waiver has been received and recorded.

A copy has been sent to your email address.

BKB-XXXXXX

Please save this reference number and present it to your guide.


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