Thank you for Choosing Triton Adventures 🔱

First Name:*

Surname:*

Date of Birth:*

Date of Birth:

Home Address:*

E-mail:*

Contact Phone Number:*

Emergency Contact: (Name and Phone and Relationship)*

SSI Responsible Diver Code

Scuba diving is an adventure activity that requires the use of specialized life support equipment in an underwater environment where humans could not otherwise exist. As with other adventure activities, scuba diving has elements of risk that cannot be totally eliminated regardless of the amount of training, care, caution or expertise. SSI believes these risks may be reduced through the SSI Diver Diamond - development of proper Knowledge, Skills, Equipment and Experience. Ultimately it is up to each individual diver to assume the inherent risk associated with scuba diving and each diver's responsibility to minimize the risk through exercising good judgment, common sense, respect and personal awareness during all diving activities. SSI has developed a Responsible Diver Code to remind divers of your responsibilities for each dive. As a Responsible Diver - I pledge to: 1. DIVE COMPETENTLY - Always dive within my training, certification, experience, comfort and ability. 2. MAINTAIN APPROPRIATE DIVER HEALTH - Including appropriate fitness, physical health and mental awareness to dive. 3. UTILIZE A DIVE PLAN - Plan my dive and dive my plan. Listen to and follow dive briefings. - 4. BE A RESPONSIBLE DIVE PARTNER - Remain with my dive partner from start to finish of my dive. Know our plan to reunite if separated underwater. 5. INSPECT MY DIVE EQUIPMENT - Before each dive, I will inspect my equipment and make sure everything is working properly. I will confirm my cylinder valve is completely open. When using blended gas (i.e., Enriched Air Nitrox) – I shall analyze my gas and know its limitations. I will establish proper weighting, know how to release my weights, and verify my buoyancy compensator (BC) and inflator are connected and functioning properly. I will secure my submersible pressure/depth gauge and/or dive computer where it is easily accessible, and know how to use each. 6. DIVER AWARENESS - Monitor my cylinder pressure; making sure to surface with reserve gas and never run out of gas. Monitor my depth and time, respect no decompression limits, perform controlled ascents, safety stops, and monitor my dive partner. — 7. MAINTAIN PROFICIENT SCUBA SKILLS - I understand scuba skills and knowledge are perishable. If it has been more than six months since my last dive, I understand the importance of taking a Scuba Skills Update course. I will maintain proper buoyancy throughout my dive, ascend slowly, and breathe properly to avoid overexpansion injuries. 8. RESPECT THE ENVIRONMENT - Be aware of currents, waves, visibility, temperature, weather, boat traffic, slippery, uneven and unstable surfaces, overhead environments, entanglements, and hazardous marine life. I understand boats are unsteady surfaces and will always use one hand to stabilize myself. I understand the importance of taking an orientation dive with a local professional when diving in unfamiliar environments. I will obey all diving and applicable regulations, statutes and codes. 9. PLAN FOR EMERGENCIES - In addition to inspecting all of my dive equipment, I will verify my dive partner's equipment is functioning properly, configured appropriately and that I know how to remove our weights in case of an emergency. I will make sure our alternate air sources are properly secured and easily accessible in case of a low air or out of air emergency. I will know scuba hand signals and how to alert others in case of an emergency. I will have an emergency action plan in case my dive partner or I have an emergency. 10. ACCEPT RESPONSIBILITY - I am ultimately responsible for my safety during all diving activities. Failure to comply with these responsibilities will increase my risk of serious injury or death. Accidents can happen even when all safety guidelines are followed, therefore I should obtain personal dive accident insurance. I understand the importance of being a responsible diver and I pledge to abide by the SSI Responsible Diver Code. I understand failure to abide by the SSI Responsible Diver Code will jeopardize my safety and well-being.

I FULLY UNDERSTAND AND AGREE

Privacy Policy This Privacy Policy explains why SSI Training Centers obtain your personal data for the purposes of conducting your training, issuing certifications, administration of your private information and any other necessary specifics regarding the performance of this agreement. By registering in MySSI, you are consenting to share your personal data: Name (First and Last), Address (Postbox), Postcode (Zip), City, State, Country, Email Address, Telephone Numbers (optional), Date of Birth, Photo, Language, Gender, SSI Master ID, Course Type, Course Progress and Certification Information (Name, SSI Training Center, Certifying Instructor, Year You Started Diving, Level of Experience, Number of Dives and Issue Date), plus your training center Affiliation. By giving your consent, SSI Training Centers may subsequently access your personal data described above in order to identify you, verify or confirm the status of your training and certifications and to offer you continued training and services based on your diving experience. For more information you may go to the SSI Privacy Policy at https://my.divessi.com/myssi_privacy.

I FULLY UNDERSTAND AND AGREE

Hotel or Villa Name:*

Room Number/ Villa Number:*

Approx Jacket Size:*

Shoe Size:

Diver Medical | Participant Questionnaire

Recreational scuba diving and freediving requires good physical and mental health. There are a few medical conditions which can be hazardous while diving, listed below. Those who have, or are predisposed to, any of these conditions, should be evaluated by a physician. This Diver Medical Participant Questionnaire provides a basis to determine if you should seek out that evaluation. If you have any concerns about your diving fitness not represented on this form, consult with your physician before diving. If you are feeling ill, avoid diving. If you think you may have a contagious disease, protect yourself and others by not participating in dive training and/or dive activities. References to "diving" on this form encompass both recreational scuba diving and freediving. This form is principally designed as an initial medical screen for new divers, but is also appropriate for divers taking continuing education. For your safety, and that of others who may dive with you, answer all questions honestly. Directions Complete this questionnaire as a prerequisite to a recreational scuba diving or freediving course. Note to women: If you are pregnant, or attempting to become pregnant, do not dive.

I UNDERSTAND

I have had problems with my lungs, breathing, heart and/or blood affecting my normal physical or mental performance.

YES
NO

I am over 45 years of age.

YES
NO

I struggle to perform moderate exercise (for example, walk 1.6 kilometer/one mile in I minutes or swim 200 meters/yards without resting), OR I have been unable to participate in a normal physical activity due to fitness or health reasons within the past 12 months.

YES
NO

I have had problems with my eyes, ears, or nasal passages/sinuses.

YES
NO

I have had surgery within the last 12 months, OR I have ongoing problems related to past surgery.

YES
NO

I have lost consciousness, had migraine headaches, seizures, stroke, significant head injury, or suffer from persistent neurologic injury or disease.

YES
NO

I am currently undergoing treatment (or have required treatment within the last five years) for psychological problems, personality disorder, panic attacks, or an addiction to drugs or alcohol; or, I have been diagnosed with a learning or developmental disability.

YES
NO

I have had back problems, hernia, ulcers, or diabetes.

YES
NO

I have had stomach or intestine problems, including recent diarrhea.

YES
NO

l am taking prescription medications (with the exception of birth control or anti-malarial drugs other than mefloquine (Lariam).

YES
NO

If you answered NO to all 10 questions above, a medical evaluation is not required. Please read and agree to the participant statement below by signing and dating it. Participant Statement: I have answered all questions honestly, and understand that I accept responsibility for any consequences resulting from any questions I may have answered inaccurately or for my failure to disclose any existing or past health conditions. If you answered [YES] to any of these questions, then you must additionally complete the Diver Medical Participation Questionnaire. The Diver Medical Participation Questionnaire is a more thorough medical screening form used to determine if you need to be evaluated by a physician prior to any in-water diving activities. PLEASE UPLOAD IT HERE:

Participant's Signature and Agreement (By checking this box is agreed as a digital Signature and is usable in a court of law)

Today's Date*

Today's Date

BASIC DIVER REGISTRATION

SSI Responsible Diver Code

Diver Medical | Participant Questionnaire