Infoelba srl
Registered office:Viale Teseo Tesei, 12, 57037 Portoferraio
Phone 0565 918864
Email. info@infoelba.it
Vat code 01130150491 and Fiscal code 01130150491

Manleva Standard ENG

en

    Declarative

    SAMPLE WAIVER FORM

    I, the undersigned,

    Name:  

    Surname:  

    Place of birth:  

    Date of birth:  

    Address:

    House number:  

    Postal code:  

    City:  

    Province:  

    Phone:  

    Email:  

     

    HEREBY DECLARE UNDER MY OWN RESPONSIBILITY the following:

    1. That I am voluntarily taking part in the scuba diving activity organized by our diving center.
    2. That I am aware of the risks associated with scuba diving, including possible physical and psychological consequences, even serious ones, resulting from illness, accidents, improper use of equipment, or unforeseen environmental conditions.
    3. I hold a scuba diving certification of level , under the training agency  
    4. I have completed a total of dives, the last of which took place on  , at a  depth of meters.
    5. That I am in good health and have no medical conditions or take any medication that could impair my ability to dive safely.
    6. That I agree to follow all instructions and safety procedures given by instructors, guides, or the diving staff.
    7. That I release and hold harmless the diving center AcquaViva, its owners, collaborators, employees, and/or agents from any civil or criminal liability for physical, material, moral, or financial damages that may occur during or as a result of the activity, except in cases of willful misconduct or gross negligence.
    8. That I authorize the processing of my personal data in accordance with EU Regulation 2016/679 (GDPR) and applicable Italian privacy laws, for administrative and organizational purposes related to the activity.

    Date: 21-11-2025 
    Participant’s signature:

     
    Consent to personal data processing:
     
    Statement of awareness and assumption of responsibility: