SDI Instructor Manual - Part 5

SDI Instructor Manual Part 5 Appendix Forms

All Rights Reserved, 1999 © By Scuba Diving International (SDI)

Copyright 1999 © by Scuba Diving International (SDI). All rights reserved. Printed in the United States of America. Except as permitted under the Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher.

Scuba Diving International 18 Elm Street, Topsham, ME 04086 Phone: Toll Free: Fax: Web site: E-mail:

207-729-4201 888-778-9073 207-729-4453 www.tdisdi.com [email protected]

Business hours: Monday - Friday, 8:00 AM to 6:00 PM Eastern time

Table of Contents 1. 

SDI Forms Overview ............................................................................................ 3 

1.1  1.2  1.3  1.4  1.5  1.6  1.7  1.8  1.9  1.10  1.11  1.12 

2. 

SDI – Scuba Diver Registration Form ............................................................................................ 3  SDI – Medical Information Form..................................................................................................... 3  SDI – General Liability Release And Express Assumption Of Risk Forms .................................... 3  SDI – Divemaster or Assistant Instructor Registration Form.......................................................... 3  SDI – Scuba Diving Instructor Registration Form .......................................................................... 3  SDI – Specialty Upgrade Form for Instructors ............................................................................... 3  SDI – Open Water Global Referral Form ....................................................................................... 3  SDI – Solo Release Form ............................................................................................................... 4  SDI – Accident / Incident Report Form ........................................................................................... 4  SDI – Academic Presentation Form ............................................................................................... 4  SDI – In-Water Presentation Form ................................................................................................. 4  SDI /TDI/ERDI – Member Update Form ......................................................................................... 4 

Forms .................................................................................................................... 5 

Revision History Revision Number

Date

2.0

05/27/01

2.1 3.0 3.1 5.0 6.0 7.0 9.0

10/10/02 08/15/03 12/23/03 11/19/04 10/13/2005 10/27/2006 12/01/2008

10.0

12/31/2009

Sections Changed

The Manual has been completely restructured and updated to reflect latest changes and additions. Updated with latest Training Updates. Updated with latest Training Updates. 2004 Renewal update. Major update, changes on most forms. Minor changes and updates to forms Minor corrections and updated forms Correction to Medical History form and minor edits to several general liability releases 2009 Updates included. Minor edits. Inclusion of Member Update Form

1.

SDI Forms Overview

1.1

SDI – Scuba Diver Registration Form Use this form for the following 1. Open Water Scuba Diver 2. Junior Open Water Scuba Diver 3. Advanced Scuba Diver 4. Master Scuba Diver 5. CPROX, CPR1st and CPROX1stAED Administrator 6. Rescue Diver 7. Specialty (Remember to specify which specialty)

1.2

SDI – Medical Information Form Use this form to obtain medical information from the Students. Make sure to review the contents before starting

on a course or specialty.

1.3

SDI – General Liability Release And Express Assumption Of Risk Forms Use this form to obtain the General Liability Release from the Students. Make sure to review the contents before

starting on a course or specialty to ensure it has been completed and signed – including the signature of a witness. ONE FORM PER COURSE. 1. General Liability Release And Express Assumption Of Risk – for Teaching 2. General Liability Release And Express Assumption Of Risk - For Guided Scuba Tours For Certified Divers 3. General Liability Release And Express Assumption Of Risk - For Guided Snorkeling Tours 4. General Liability Release And Express Assumption Of Risk - For Unguided & Unsupervised Boat Dives For Certified Divers

1.4

SDI – Divemaster or Assistant Instructor Registration Form Use this form to file for Divemaster or Assistant Instructor rating.

1.5

SDI – Scuba Diving Instructor Registration Form Use this form to file for Instructor rating.

1.6

SDI – Specialty Upgrade Form for Instructors Use this form to file for specialty upgrades – for Instructors ONLY.

1.7

SDI – Open Water Global Referral Form Use this form to when a student is traveling to another facility for the Open Water certification. The procedure is

covered in Part 2 – Open Water Instructor Manual.

1.8

SDI – Solo Release Form Use this form as the Solo Diver Liability Release.

1.9

SDI – Accident / Incident Report Form Use this form to file information regarding an accident or incident with SDI Headquarter.

1.10

SDI – Academic Presentation Form Use this form when preparing for the academic portion of a class. An example of its usage can be found in the

Academic portion of the Open Water Instructor Manual.

1.11

SDI – In-Water Presentation Form Use this form when preparing for the confined portion of a class. An example of its usage can be found in the In-

Water portion of the Open Water Instructor Manual.

1.12

SDI /TDI/ERDI – Member Update Form Use this form when renewing after membership or teaching status has lapsed after 2 years. Use in conjunction

with Two Year Renewal/Refresher Policy in General Standards.

2.

Forms

Scuba Diver Registration Form 18 Elm St, Topsham, Maine 04086 Phone: 207-729-4201 Fax: 207-729-4453 Email [email protected]

www.tdisdi.com

Method of Payment AMEX

, MasterCard

, Visa

, Check

or Money Order

(Make Checks Payable to SDI) Exp. Date:

Signature:

Course:

Check only ONE course per diver registration form

Open Water Scuba Diver

Junior Open Water Scuba Diver

Specialty (Please specify): Advanced Scuba Diver

Rescue Diver Master Scuba Diver

(list four specialties below)

___________,

____________,

CERTIFICATION FEE:

C-Card Only*

____________,

(list four specialties below)

____________

C-Card & Certificate* (refer to current price list)

All diver c-cards & certificates are sent directly to the facility or student

Print Name as it is to appear on C-Card

Complete Mailing Address (include City, State and Zip Code)

Phone Number E-mail Address

DOB (mm/dd/yyyy):

DOB (mm/dd/yyyy):

DOB (mm/dd/yyyy):

DOB (mm/dd/yyyy): Course Completion Date (mm/dd/yy):

Freshwater Max training depth: Saltwater Metres Feet : Instructor’s SDI #: Instructor Name: I certify that the above named students have completed the SDI training course indicated and have reached the proficiency level required by SDI Standards before issuing these certifications. In addition, I agree to void all cards not issued within six months.

Copyright © 2002, 2006 by Scuba Diving International (SDI)

nd

2 Inst./Asst. by:

#:

Facility Name: Facility Number: Ship To Address:

Facility

Student (s)

Instructor Signature (Required on each Form)

Date Signed

Revision 7.0, 10/27/06

Scuba Diving International Medical Statement Participant Record (Confidential Information)

18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453 ---- Please read carefully before signing ---This is a statement in which you are informed of some potential risks involved in scuba diving and of the conduct required of you during the scuba-training program. Your signature on this statement is required for you to participate in the scuba training program offered by

_____________________________________ and Instructor

______________________________ located in the Facility City of ____________________ and State of _______ Read and discuss this statement prior to signing it. You must complete this Medical Statement, which includes the medicalhistory section, to enroll in the scuba-training program. If you are a minor, you must have this statement signed by a parent. Diving is an exciting and demanding activity. When conducted correctly, applying accepted techniques, this sport has very acceptable risks.

When established safety procedures are not followed, however, there are dangers. To scuba dive safely, you must not be extremely overweight or out of condition. Diving can be strenuous under certain conditions. Your respiratory and circulatory systems must be in good health. All body air spaces must be normal and healthy. A person with heart trouble, a current cold or congestion, epilepsy, asthma, a severe medical problem or who is under the influence of alcohol or drugs should not dive. If taking medication, consult your doctor and the instructor before participation in this program. You will also need to learn from the instructor the important safety rules regarding breathing and equalization while scuba diving. Improper use of scuba equipment can result in serious injury. You must be thoroughly instructed in its use under direct supervision of a qualified instructor to use it safely. If you have any additional questions regarding this Medical Statement or the Medical History section, review them with your instructor before signing.

MEDICAL HISTORY - To the Participant The purpose of this medical questionnaire is to find out if your doctor should examine you before participating in recreational dive training. A positive response to a question does not necessarily disqualify you from diving. A positive response means that there may be a possible preexisting condition that could affect your safety while diving and you must seek the advice of your physician. Please answer EACH ONE of the following questions on your past or present medical history with a YES or NO. If you are not sure, answer YES. If any of those items apply to you, we must request that you consult with a physician prior to participating in scuba diving. ___ History of diving accidents or decompression sickness? ___ Are you pregnant? ___ History of recurrent back problems? ___ History of back surgery? Have you ever had or do you currently have: ___ Inability to perform moderate exercise (example: walk one ___ Do you have active asthma or history of emphysema or mile within 12 minutes)? tuberculosis? ___ History of high blood pressure or take medicine to control ___ Frequent or severe attacks of hay fever or allergy? blood pressure? ___ Do you currently have a cold, sinusitis or bronchitis? ___ History of any heart disease? ___ Any form of lung disease? ___ History of heart attacks? ___ Have you had a Pneumothorax (collapsed lung)? ___ Angina or heart surgery or blood vessel surgery? ___ History of chest surgery? ___ History of ear disease, hearing loss or problems with ___ Claustrophobia or agoraphobia (fear of closed or open balance? spaces)? ___ History of drug or alcohol abuse? ___ Epilepsy, seizures, convulsions or take medications to ___ Do you currently have an ear infection? prevent them? ___ Are you currently taking medication that carries a warning ___ Recurring migraine headaches or take medications to about any impairment of your physical or mental abilities? prevent them? ___ Do you have a history of bleeding or other blood ___ Do you have a history of diabetes? disorders? ___ History of blackouts or fainting (full/partial loss of ___ Any other current medical condition that you feel could consciousness)? contradict participation in an active demanding sport such as scuba diving?

The information I have provided about my medical history is accurate to the best of my knowledge.

________________________________________________ Signature

_________________ Date

________________________________________________

_________________

Signatures of Parents or Guardians (Where Applicable)

Date

Copyright © 2002 by Scuba Diving International (SDI)

Revision 7.0, 12/01/08

STUDENT Please print legibly Name:______________________________________________________ Birth Date:____________ Age:______ First

Initial

Last

Mailing Address:_____________________________________________________________________________ _____________________________________________________________________________ City:___________________________________________ State/ Province:_______________________________ Country:_______________________________________ Zip / Postal Code:______________________________ Phone: (_______)_______________________________ Fax: (_______)_________________________________ Name and address of your family or primary care physician Physician:__________________________________________ Clinic/ Hospital:___________________________ Address:____________________________________________________________________________________ City

State

Zip

Phone: (____)______________________________________ Date of last physical examination: ____ /____/____ mm / dd

/ yy

Name of examiner:__________________________________ Clinic/ Hospital:____________________________ Address:_____________________________________________________ Phone: (______)_________________ Were you ever required to have a physical for diving? Yes

No

If so, when? _________________________

PHYSICIAN This person is an applicant for training or is presently certified to engage in scuba (self contained underwater breathing apparatus) diving. Your opinion of the applicant’s medical fitness for scuba diving is requested. Physician’s impression: ____ I find no medical conditions that I consider incompatible with diving. ____ I am unable to recommend this individual for diving. Remarks: __________________________________________________________________________________ __________________________________________________________________________________ Physician:___________________________________________ Clinic/ Hospital:__________________________ Address:____________________________________________________________________________________ City

State

Zip

Phone: (________)__________________________ Fax: (________)________________________________ Physician's Signature:_______________________________________________ Date ______/______/______ mm /

dd

International Training, Inc.● 18 Elm Street ● Topsham ME 04086 Phone: (207) 729-4201● Fax: (207) 729-4453

/

yy

General Liability Release And Express Assumption Of Risk 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453 For _____________________________________________ (specify Course or Specialty) training program under sanction through SDI. Please read carefully, fill in all blanks and initial each paragraph before signing at bottom. I, ______________________________, hereby affirm that I have been advised and thoroughly informed of the inherent hazards of scuba diving activities ________ Further, I understand that diving with compressed air or oxygen enriched air (nitrox) involves certain inherent risks including decompression sickness, embolism, oxygen toxicity, inert gas narcosis, marine life injuries or other barotrauma/hyperbaric injuries can occur that require treatment in a recompression chamber. I further understand that the open water diving trips, which are necessary for training and certification, may be conducted at a site that is remote, either by time of distance or both, from such a recompression chamber. I still choose to proceed with such instructional dives in spite of the possible absence of a recompression chamber in proximity to the dive site. ________ I understand and agree that neither my Instructor(s) ___________________________________, the facility through which I received my Instruction, ________________________________________, International Training and Scuba Diving International, nor the officers, directors, shareholders, affiliated companies, employees, agents, or assigns of the above listed entities and/or individuals, nor the authors of any materials including texts and tables expressly used for training and certification (hereinafter referred to as "Released Parties") may be held liable or responsible in any way for any injury, death, or other damages to me or my family, heirs, or assigns that may occur as a result of my participation in this diving class or as a result of the negligence of any party, including the Released Parties, whether passive or active. ________ In consideration of being allowed to enroll in this course, I hereby personally assume all risks in connection with said course, for any harm, injury, or damage that may befall me while I am enrolled as a student of this course, including all risks connected therewith, whether foreseen or unforeseen. ________ I further agree to save, defend, indemnify, and hold harmless said course and Released Parties from any claim or lawsuit by me, anyone purporting to act on my behalf, my family, estate, heirs or assigns, arising directly or indirectly out of my enrollment and participation in this course including both claims arising during the course or after I receive my certification even if such claims may be groundless, false or fraudulent. ________ I also understand that diving activities are physically strenuous and that I will be exerting myself during this diving course, and that if I am injured as a result of heart attack, panic, hyperventilation, oxygen toxicity, inert gas narcosis, drowning, etc. that I expressly assume the risk of said injuries and that I will not hold the above listed individuals or companies responsible for the same, and I agree to defend, indemnify, and hold harmless said course and Released Parties for any such injuries incurred by me. ________ I understand that these activities may place me deeper than I am able to safely execute a free (without breathing gas) ascent from. ________ I understand that I may be required to furnish my own equipment and that I am responsible for its operating condition and maintenance. ________ I further state that I am of lawful age and legally competent to sign this liability release, or that I have acquired the written consent of my parent or guardian. ________ I understand that the terms herein are contractual and not a mere recital, and that I have signed this document of my own free act. Further that I understand and agree that, in the event that one or more of the provisions of this agreement, for any reason, is held by a court of competent jurisdiction to be invalid or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision hereof, and this agreement shall be construed as if such invalid, illegal or unenforceable provision or provisions had never been contained herein. IT IS THE INTENTION OF ____________________________________ BY THIS INSTRUMENT TO EXEMPT AND RELEASE MY INSTRUCTORS, _________________________ (AND OTHERS, _________________________), THE FACILITY THROUGH WHICH I RECEIVED MY INSTRUCTION ______________________________, THE TRAINING AGENCY _________________________ AND INTERNATIONAL TRAINING AND SCUBA DIVING INTERNATIONAL, AND ALL OTHER RELATED ENTITIES AND RELEASED PARTIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, OR ARISING OUT OF, DIRECTLY OR INDIRECTLY, INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS LIABILITY RELEASE AND EXPRESS ASSUMPTION OF RISK BY READING IT BEFORE SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS. This document is required for all courses and Specialties taught under sanction by Scuba Diving International. No alterations, changes, omissions or revisions may be made.

_______________________________ Signature of Student/Participant / Date

___________________________ Signatures of Parents or Guardians / Date (where applicable)

_______________________________ Witness / Date Copyright© 2002 by Scuba Diving International (SDI)

Revision 6.1, 12/01/08

General Liability Release And Express Assumption Of Risk 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

For Guided Scuba Tours For Certified Divers Please read carefully, fill in all blanks and initial each paragraph before signing at bottom. I, ______________________________, hereby affirm that I have been advised and thoroughly informed of the inherent hazards of scuba diving activities and participation in a guided tour as a diver. ________ Further, I understand that diving with compressed air, oxygen enriched air (Nitrox), and trimix supplied by standard open circuit scuba or with semi-closed circuit or closed circuit rebreathers involves certain inherent risks including decompression sickness, embolism, oxygen toxicity, inert gas narcosis, hypoxia, hypercapnia, marine life injuries or other barotrauma or hyperbaric injuries. Such injuries can occur that require treatment in a recompression chamber or medical facility. I further understand that dive activities can be at remote sites, and isolated by time and distance, from such a recompression chamber or medical facility. I still choose to proceed with such dives in spite of the absence of a recompression chamber in proximity to the dive site. ________ I understand and agree that neither the instructor/guide ___________________________________, nor any of the respective employees, officers, agents or assigns of ________________________________________, (hereinafter referred to as "Released Parties") may be held liable or responsible in any way for any injury, death, or other damages to me or my family, heirs, or assigns that may occur as a result of my participation in this diving activity or as a result of the negligence of any party, including the Released Parties, whether passive or active. ________ In consideration of being allowed to participate in this activity I hereby personally assume all risks in connection with said trip, for any harm, injury, or damage that may befall me while I am a diving participant including all risks connected therewith, whether foreseen or unforeseen. ________ I further agree to save, defend, indemnify, and hold harmless said Released Parties from any claim or lawsuit by me, anyone purporting to act on my behalf, my family, estate, heirs or assigns, arising directly or indirectly out of my participation and diving activities including claims arising during this activity even if such claims may be groundless, false or fraudulent. ________ I also understand that diving activities are physically strenuous and that I will be exerting myself during this diving trip and that if I am injured as a result of heart attack, panic, hyperventilation, oxygen toxicity, inert gas narcosis, drowning, etc. that I expressly assume the risk of said injuries and that I will not hold the above listed individuals or companies responsible for the same, and I agree to defend, indemnify, and hold harmless said Released Parties for any such injuries incurred by me. ________ I understand that these activities may place me deeper than I am able to safely execute a free ascent (without breathing gas)from. ________ I understand that I may be required to furnish some of my own equipment and that I am responsible for its operating condition and maintenance. ________ I understand that I may be supplied with certain items of scuba equipment and that I am responsible for reviewing its proper function and operating condition prior to using it. ________ I further state that I am of lawful age and legally competent to sign this liability release, or that I have acquired the written consent of my parent or guardian. ________ I further state that I am already a qualified and certified scuba diver from the following training agencies: ______________________, and that I hold training to the level of ________________________. I am aware of the required certification level and/or experience necessary and recommended to enroll in this diving activity and I stipulate that I meet requirements for prior certification or equivalent experience. I have been a certified diver since ______ and have been diving for _____ years for a total of ______ dives to a maximum depth of ____ ft. _______ I understand that the terms herein are contractual and not a mere recital, and that I have signed this document of my own free act. Further that I understand and agree that, in the event that one or more of the provisions of this agreement, for any reason, is held by a court of competent jurisdiction to be invalid or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision hereof, and this agreement shall be construed as if such invalid, illegal or unenforceable provision or provisions had never been contained herein. IT IS THE INTENTION OF ____________________________________ BY THIS INSTRUMENT TO EXEMPT AND RELEASE MY INSTRUCTORS DIVEMASTER/GUIDE, _________________________ THE BUSINESS, _________________________), AND ALL OTHER RELATED ENTITIES AND RELEASED PARTIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, OR ARISING OUT OF, DIRECTLY OR INDIRECTLY, INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS LIABILITY RELEASE AND EXPRESS ASSUMPTION OF RISK BY READING IT BEFORE SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS.

_______________________________ Signature of Student/Participant / Date

___________________________ Signatures of Parents or Guardians / Date (where applicable)

_______________________________ Witness / Date Copyright © 2002 by Scuba Diving International (SDI)

Revision 6.0, 11/01/05

General Liability Release And Express Assumption Of Risk 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

For Guided Snorkeling Tours Please read carefully, fill in all blanks and initial each paragraph before signing at bottom. I, ______________________________, hereby affirm that I have been advised and thoroughly informed of the inherent hazards of snorkeling activities and participation in a guided tour as a snorkeler. ________ Further, I understand that snorkeling involves certain inherent risks including marine life injuries, drowning, slipping & falling on either a vessel or a beach entry point, possible hazards from other watercraft or vessels in the area or other barotrauma injuries such as ear or mask squeezes, etc. Such injuries can occur that may require treatment in a medical facility. I further understand that snorkeling activities can be at remote sites, and isolated by time and distance, from such a medical facility. I still choose to proceed with such snorkeling activities in spite of the absence of a medical facility in proximity to the snorkeling site. ________ I understand and agree that neither the instructor/guide ___________________________________, nor any of the respective employees, officers, agents or assigns of ________________________________________, (hereinafter referred to as "Released Parties") may be held liable or responsible in any way for any injury, death, or other damages to me or my family, heirs, or assigns that may occur as a result of my participation in this snorkeling activity or as a result of the negligence of any party, including the Released Parties, whether passive or active. ________ In consideration of being allowed to participate in this activity I hereby personally assume all risks in connection with said trip, for any harm, injury, or damage that may befall me while I am a snorkeling participant including all risks connected therewith, whether foreseen or unforeseen. ________ I further agree to save, defend, indemnify, and hold harmless said Released Parties from any claim or lawsuit by me, anyone purporting to act on my behalf, my family, estate, heirs or assigns, arising directly or indirectly out of my participation and snorkeling activities including claims arising during this activity even if such claims may be groundless, false or fraudulent. ________ I also understand that snorkeling activities are physically strenuous and that I will be exerting myself during this snorkeling trip and that if I am injured as a result of heart attack, panic, hyperventilation, drowning, etc. that I expressly assume the risk of said injuries and that I will not hold the above listed individuals or companies responsible for the same, and I agree to defend, indemnify, and hold harmless said Released Parties for any such injuries incurred by me. ________ I understand that I may be required to furnish some of my own equipment and that I am responsible for its operating condition and maintenance.. ________ I understand that I may be supplied with certain items of snorkeling equipment and that I am responsible for reviewing its proper function, fit, and operating condition prior to using it. ________ I further state that I am of lawful age and legally competent to sign this liability release, or that I have acquired the written consent of my parent or guardian. ________ I understand that the terms herein are contractual and not a mere recital, and that I have signed this document of my own free act. Further that I understand and agree that, in the event that one or more of the provisions of this agreement, for any reason, is held by a court of competent jurisdiction to be invalid or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision hereof, and this agreement shall be construed as if such invalid, illegal or unenforceable provision or provisions had never been contained herein. IT IS THE INTENTION OF ____________________________________ BY THIS INSTRUMENT TO EXEMPT AND RELEASE MY INSTRUCTORS DIVEMASTER/GUIDE, _________________________ THE BUSINESS, _________________________), AND ALL OTHER RELATED ENTITIES AND RELEASED PARTIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, OR ARISING OUT OF, DIRECTLY OR INDIRECTLY, INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS LIABILITY RELEASE AND EXPRESS ASSUMPTION OF RISK BY READING IT BEFORE SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS.

_______________________________ Signature of Student/Participant / Date

___________________________ Signatures of Parents or Guardians / Date (where applicable)

_______________________________ Witness / Date Copyright © 2002 by Scuba Diving International (SDI)

Revision 6.0, 11/01/05

General Liability Release And Express Assumption Of Risk 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

For Unguided & Unsupervised Boat Dives For Certified Divers Please read carefully, fill in all blanks and initial each paragraph before signing at bottom. I, ______________________________, hereby affirm that I have been advised and thoroughly informed of the inherent hazards of scuba diving activities and participation in a unguided unsupervised tour as a certified diver. ________ Further, I understand that diving with compressed air, oxygen enriched air (Nitrox), and trimix supplied by standard open circuit scuba or with semi-closed circuit or closed circuit rebreathers involves certain inherent risks including decompression sickness, embolism, oxygen toxicity, inert gas narcosis, hypoxia, hypercapnia, marine life injuries or other barotrauma or hyperbaric injuries. Such injuries can occur that require treatment in a recompression chamber or medical facility. I further understand that dive activities can be at remote sites, and isolated by time and distance, from such a recompression chamber or medical facility. I still choose to proceed with such dives in spite of the absence of a recompression chamber in proximity to the dive site. ________ I understand and agree that neither the captain and crew ___________________________________, nor the vessel_______________________, nor any of the respective employees, officers, agents or assigns of ________________________________________, (hereinafter referred to as "Released Parties") may be held liable or responsible in any way for any injury, death, or other damages to me or my family, heirs, or assigns that may occur as a result of my participation in this diving activity or as a result of the negligence of any party, including the Released Parties, whether passive or active. ________ In consideration of being allowed to participate in this activity I hereby personally assume all risks in connection with said trip, for any harm, injury, or damage that may befall me while I am a diving participant including all risks connected therewith, whether foreseen or unforeseen. ________ I further agree to save, defend, indemnify, and hold harmless said Released Parties from any claim or lawsuit by me, anyone purporting to act on my behalf, my family, estate, heirs or assigns, arising directly or indirectly out of my participation and diving activities including claims arising during this activity even if such claims may be groundless, false or fraudulent. ________ I also understand that diving activities are physically strenuous and that I will be exerting myself during this diving trip and that if I am injured as a result of heart attack, panic, hyperventilation, oxygen toxicity, inert gas narcosis, drowning, etc. that I expressly assume the risk of said injuries and that I will not hold the above listed individuals or companies responsible for the same, and I agree to defend, indemnify, and hold harmless said Released Parties for any such injuries incurred by me. ________ I understand that these activities may place me deeper than I am able to safely execute a free ascent (without breathing gas) from. ________ I understand that I may be required to furnish some of my own equipment and that I am responsible for its operating condition and maintenance. ________ I understand that I may be supplied with certain items of scuba equipment and that I am responsible for reviewing its proper function and operating condition prior to using it. ________ I further state that I am of lawful age and legally competent to sign this liability release, or that I have acquired the written consent of my parent or guardian. ________ I further state that I am already a qualified and certified scuba diver from the following training agencies:__________________________, and that I hold training to the level of _____________________________________. I am aware of the required certification level and/or experience necessary and recommended to enroll in this diving activity and I stipulate that I meet those requirements for prior certification or equivalent experience. I have been a certified diver since ________ and have been diving for _____ years for a total of ______ dives to a maximum depth of ____ ft. ________ I understand that the terms herein are contractual and not a mere recital, and that I have signed this document of my own free act. Further that I understand and agree that, in the event that one or more of the provisions of this agreement, for any reason, is held by a court of competent jurisdiction to be invalid or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision hereof, and this agreement shall be construed as if such invalid, illegal or unenforceable provision or provisions had never been contained herein. IT IS THE INTENTION OF ____________________________________ BY THIS INSTRUMENT TO EXEMPT AND RELEASE THE CAPTAIN/CREW___________________________________________, THE VESSEL ______________________________THE BUSINESS_________________________________ AND ALL OTHER RELATED ENTITIES AND RELEASED PARTIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, OR ARISING OUT OF, DIRECTLY OR INDIRECTLY, INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS LIABILITY RELEASE AND EXPRESS ASSUMPTION OF RISK BY READING IT BEFORE SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS.

_______________________________ Signature of Student/Participant / Date

___________________________ Signatures of Parents or Guardians / Date (where applicable)

_______________________________ Witness / Date Copyright © 2002 by Scuba Diving International (SDI)

Revision 6.1, 12/01/08

Divemaster or Assistant Instructor Registration Form 18 Elm St, Topsham, Maine 04086 Phone: 207-729-4201 Fax: 207-729-4453 Email [email protected]

www.tdisdi.com

Method of Payment AMEX

, MasterCard

, Visa

, Check

or Money Order

(Make Checks Payable to SDI) Exp. Date:

Signature: Certificates & cards are sent directly to the instructor or facility.

Certification Fee: Refer to current price list Please Check One Only:

DIVEMASTER

ASSISTANT INSTRUCTOR

Print Name As It Is To Appear On Certification Card DOB (mm/dd/yyyy):

Complete Mailing Address (including City, State and Zip Code)

Phone Number

E-mail Address Course Completion Date (mm/dd/yy):

Freshwater Max training depth: Saltwater Metres Feet : Instructors SDI #: Instructor Name: I certify that the above named students have completed the SDI training course indicated and have reached the proficiency level required by SDI Standards before issuing these certifications. In addition, I agree to void all cards not issued within six months. Copyright© 2002, 2006 by Scuba Diving International (SDI)

nd

2 Inst./Asst. by:

#:

Facility Name: Facility Number: Ship To Address:

Facility

Instructor

__________________________________________ _ Instructor Signature (Required on each Form) Date Signed Revision 7.0, 10/27/06

Scuba Diving Instructor Registration Form 18 Elm St, Topsham, Maine 04086 Phone: 207-729-4201 Fax: 207-729-4453 Email [email protected]

Note

www.tdisdi.com

The Instructor Application must accompany this form Method of Payment

AMEX

, MasterCard

, Visa

, Check

or Money Order

(Make Checks Payable to SDI) Exp. Date:

Signature: Other Instructor Ratings:

ANDI #

PADI #

PSA #

IANTD #

YMCA #

NAUI #

SSI #

NASDS #

Other (Specify): # Certificates & cards are sent directly to the instructor trainer or facility.

Certification Fee: * * Refer to current price list

Print Name As It Is To Appear On Certification Card DOB (mm/dd/yyyy):

Current SDI DM or AI #

Complete Mailing Address (including City, State and Zip Code)

Phone Number

E-mail Address Course Completion Date (mm/dd/yy):

Freshwater Max training depth: Saltwater Meter Feet : Instructor’s SDI #: Instructor Trainer Name:

nd

2 Inst./Asst. by:

#:

Facility Name: Facility Number: Ship To Address:

Facility

Instructor Trainer

I certify that the above named students have completed the SDI training course indicated and have reached the proficiency level required by SDI Standards before issuing these certifications. In addition, I agree to void all cards not issued within six months.

____________________________________________________ Instructor Trainer Signature (Required on each Form) Date Signed

Copyright © 2002, 2006 by Scuba Diving International (SDI)

Revision 7.0, 10/27/06

Specialty Upgrade Form For Instructors Only 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

Method of Payment AMEX

, MasterCard

, Visa

, Check

or Money Order

(Make Checks Payable to SDI) Exp. Date:

Signature: Certificates & cards are sent directly to the instructor or facility.

Certification Fee: * Refer to current price list

Please Check Only One Course Per Form Advanced Buoyancy Control Altitude Boat Computer Diver Computer Nitrox Diver CPROX Administrator CPR1st Administrator Deep Diving (130 ft Max) Diver Propulsion Vehicle Drift Diver Dry Suit

Equipment Specialist Ice Marine Ecosystems Awareness Night /Limited Visibility Research Search & Recovery Shore/Beach U/W Hunter & Collector U/W Navigation U/W Photography U/W Video

Underwater Video VIP Wreck Other: (Specify)

Current Instructor Number:

Print Name As It Is To Appear On Certification Card

Complete Mailing Address (including City, State and Zip Code)

Phone Number

E-mail Address

Please fill out the appropriate section on Page 2 BEFORE submitting the form to SDI Specialty Upgrade Form – For Instructors Only Copyright © 2002 by Scuba Diving International (SDI)

Page 1 of 2 Revision 6.0, 11/01/05

Specialty Procedure #1 Participation in an Instructor Specialty Class A SDI Instructor has completed an SDI Specialty Instructor Course.

Instructor Requirements: A. B.

I agree to adhere to the SDI Specialty Course standard and outline provided by SDI Headquarters. Documentation of 10 dives in that particular specialty course.

Course Location: _____________________________ Course Completion Date: ___/___/___ Instructor Trainer Signature: ____________________ SDI #________ Date: ___/___/__ Instructor Signature: ___________________________________________ Date: ___/___/___

Specialty Procedure # 2 Administrative Specialty Instructor Upgrade An instructor who wishes to crossover his/her specialty instructor rating from another certification agency to SDI.

OR An instructor who feels his/her experience in a particular specialty meets the requirements to teach a SDI specialty course.

Instructor Requirements: A. B.

I agree to adhere to the SDI Specialty Course standard and outline provided by SDI Headquarters. Documentation of 25 dives in that particular specialty course.

Instructor Signature: ________________________________________

Date: ___/___/___

Specialty Procedure #3 Request for a Specialty Instructor Upgrade An instructor who has a specialty rating that is not listed as one of the SDI Specialty courses, can apply for specialty course recognition.

Instructor Requirements: A. B.

I agree to provide SDI Headquarters with the specialty course outline Complete Documentation of dive history plus documentation of 20 dives in that particular specialty course.

Instructor Signature: ________________________________________

Date: ___/___/___

Dive History:

Specialty Upgrade Form – For Instructors Only Copyright © 2002 by Scuba Diving International (SDI)

Page 2 of 2 Revision 6.0, 11/01/05

Open Water Global Referral Form 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

Student Information: Name: Address:

City:

State:

Zip:

Country:

Phone:

Fax:

Email:

Birth Date:

Age:

Sex:

M

F

Original Instructor: Facility:

Phone:

Instructor’s Name: Address:

City:

State:

Zip:

Country:

Phone:

Fax:

Email:

SDI Instructor #:

I agree that the above named student has successfully fulfilled all of the academic and confined water requirements for SDI’s Open Water Scuba Diving course. As indicated by the signature below I believe the student is mentally and physically prepared to participate in open water training. Instructor Signature: _____________________________

Completion Date: ____/____/____

Check List for Original Instructor: ____ ____ ____

A Copy of the student’s Medical History must accompany this referral form. A Signed and Completed SDI Scuba Diver Referral Form. Remind student to take along his/her diver logbook and dive computer. Expiration Date: Valid for 6 Months from completion date

Open Water Global Referral Form Copyright © 2002 by Scuba Diving International (SDI)

Page 1 of 3 Revision 6.0, 11/01/05

Open Water Global Referral Form 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

Î

EVALUATING OPEN WATER INSTRUCTOR

Í

Dear evaluating instructor,

The SDI referral program is designed to allow ANY active instructor to evaluate the Open Water skills and performance of a referring student. An active instructor refers to any instructor that is affiliated with an international recognized dive training agency. We appreciate your assistance with my student referral. Please review the list of required student skills, dives and instructor pre-requisites before the start of the open water evaluating process.

Evaluating Instructor must: ____ Be an Active Instructor with an internationally recognized training agency. ____ Review students’ Medical History Form. ____ Have referring student sign your facility’s waiver and release form. ____ Evaluate & initial all the required open water skills and dives listed on the back on this form. ____ Sign this referral form. ____ Give the original referral form to student, and retain a copy of this referral form for your records.

Thank you for your professional expertise and cooperation.

Open Water Global Referral Form Copyright © 2002 by Scuba Diving International (SDI)

Page 2 of 3 Revision 6.0, 11/01/05

Open Water Global Referral Form 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

Skill Performance Record Evaluating Open Water Instructor Must Initial Each Skill When Completed • • • • • • •

• Buoyancy Control ____ Hovering ____ Controlled Ascents ____ Controlled Descents • Weight System Adjustment ____ Removal & Replacement • Out of Air Emergencies ____ Alternate Air Source ____ Share Air with Buddy while making a controlled ascent ____ Swimming ascent • Rescue Techniques ____ Tired Diver Tow ____ Cramp Relief

Scuba System ____ Assembly & Disassembly Pre-Dive Check ____ Self & Buddy ____ Underwater Communication Computer Use ____ Reading & Understanding Gauges Regulator Use ____ Clearing & Recovery Mask Clear at Depth ____ Partial ____ Full BCD ____ Auto & Oral Inflation Entries (Demonstrate 2 types of entries) List type of entries: Open Water Training

Dive 1

Dive 2

Dive 3

Dive 4

Date (mm/dd/yy) Performance Student Initials Instructor Initials PASS: I _______________________________, verify that all of the required open water dives and skills ( Print Name of Evaluating Instructor ) for SDI’s Open Water Scuba Diving Course have been successfully performed by the student. _______________________________________________________, #__________________ (Signature of Evaluating Instructor)

Instructor #

_________________________________________, Date: _______/________/________ Agency

Month

Day

Year

INCOMPLETE. Reason:_____________________________________________________ Î

THE ORIGINAL FORM IS TO BE GIVEN BACK TO THE STUDENT, IN ORDER FOR THE Í Î STUDENT TO RECEIVE THE FINAL CERTIFICATION FROM THEIR INSTRUCTOR Í

Open Water Global Referral Form Copyright © 2002 by Scuba Diving International (SDI)

Page 3 of 3 Revision 6.0, 11/01/05

Solo Diving Liability Release And Assumption Of Risk Agreement 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

THIS IS A RELEASE OF YOUR RIGHTS TO SUE! READ IT CAREFULLY. FILL IN ALL BLANKS. INITIAL EACH PARAGRAPH BEFORE SIGNING. I, _______________________, hereby affirm that I have been advised of the inherent hazards of solo scuba diving. Further, I understand that such diving involves certain inherent risks including, but not limited to, drowning, decompression sickness, embolism, oxygen toxicity, inert gas narcosis, marine life injuries and other types of barotrauma and/or hyperbaric injuries. I further understand that by diving alone, I may not have a dive buddy to assist me should any of these, or any other, diving malady or accident occur while I am solo diving. I, _____________________, understand and agree that neither my instructor(s): ________________, the facility __________________ through which I receive my instruction, nor SDI,nor any of their respective employees, officers, agents or assignees, nor the dive vessel, nor the dive operation through which I am granted the privilege of solo diving, nor my dive buddy, nor other participants in this solo diving activity (hereinafter referred to as Released Parties) may be held liable or responsible in any way for any injury, death or other damages to me or my family, heirs or assignees that may occur as a result of my participation in solo diving as a result of the negligence of any party, including the Released Parties, whether passive or active. I, _______________________, in consideration for being allowed to solo dive, hereby personally assume all risks in connection with this activity for any harm, injury, or damage that may befall me while I am solo diving, including all risks connected therewith, whether foreseen or unforeseen, even if caused by the negligence of the Released Parties. I, _______________________, further save and hold harmless the Released Parties from any claim or lawsuit by me, my family, estate, heirs or assignees arising out of my enrollment and participation in solo diving, including all claims arising before, during, and after this solo diving activity, even if caused by the negligence of the Released Parties. I, _______________________, further state that I am already a certified diver and have been truthful in stating my qualifications as a certified scuba diver, and have the following certifications from the following training agencies: ______________________ that I am aware of the required certification for solo scuba diving, and that I meet all requirements. I have been a certified scuba diver since: ______, and have been diving for: ______ years for a total of: _____ dives to a maximum depth of: _____ feet/meters (Circle either feet or meters). Solo Diving Liability Release and Assumption of Risk Agreement Copyright © 2002 by Scuba Diving International (SDI)

Page 1 of 2 Revision 6.1, 12/01/08

I, _______________________, understand that the terms herein are contractual and not a mere recital, and that I have signed this document of my own free act and will. I, ______________________, further state that I am of lawful age and legally competent to sign this liability release, or that I have acquired the written consent of my parent or guardian. 1. PLEASE COPY THE FOLLOWING STATEMENT (IN ITS ENTIRETY) ON THE BLANK LINES PROVIDED BENEATH THIS PARAGRAPH.

2.

PLEASE SIGN, DATE AND WITNESS THE FORM WHERE INDICATED.

STATEMENT: IT IS MY INTENTION, BY SIGNING THIS INSTRUMENT, TO EXEMPT AND RELEASE THE RELEASED PARTIES FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. COPY HERE:

I have fully informed myself of the contents of this liability release and express assumption of risk agreement by reading it before I signed it on behalf of myself and my heirs. I understand this liability release and express assumption of risk agreement expresses the complete and whole agreement between me and the Released Parties as it relates to the issues set forth herein. __________________________________ Signature of Diver

Date

Solo Diving Liability Release and Assumption of Risk Agreement Copyright © 2002 by Scuba Diving International (SDI)

_______________________________ Witness

Date

Page 2 of 2 Revision 6.0, 11/01/05

Diving Accident / Incident Report 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453 The information contained within all of the pages that make up this document is CONFIDENTIAL and PRIVILEGED. Said information is intended solely for the use of the individual to whom it is directed. If the recipient is a person / business other than those listed, you are hereby notified that any dissemination, copying, or other use of this communication is strictly prohibited. If you have received this document in error, please notify SDI (Scuba Diving International) immediately at (207) 729-4201 and destroy this document immediately thereafter. Thank you for your cooperation and courtesy in relation to this matter.

Please print or type clearly. It is extremely important that you fill in this form COMPLETELY! Date of Accident:

Name of Victim:

Location of Accident: Address of Victim: Sex:

Age:

Check all items applicable.

Was this an Instructional or Supervised Dive?

Fatality: ___

Bodily Injury: ____

Bends: ____ Embolism: ____

Non-Injury: ____

Other (describe): Describe the diving experience of the victim; was he or she a student? Novice diver? Experienced diver?

Describe the injuries suffered by the victim:

Please provide all details regarding weather conditions (water, visibility, wind, waves etc.):

Please provide details of any equipment failure:

Please describe any rescue or emergency procedures used and first aid given:

Please list any other emergency personnel / Agencies that attended:

Narrative Report: Describe the accident and the events leading up to it with your best overview, including the roles of the participants. Use additional pages if needed to give a complete account:

Your Name:

Your SDI Number:

Your Address:

Your Telephone Number.

Day:

Evening:

Please describe your current diving status (i.e. Active Instructor, Divemaster etc.):

Describe your personal participation in the incident (i.e. were you instructing the victim, a witness, called on to assist, etc.):

Please list the names, addresses and phone numbers of all other participants, witnesses. Use additional sheets if needed:

Copyright © 2002 by Scuba Diving International (SDI)

Revision 6.0, 11/01/05

Academic Presentation 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

Topic: Introductions:

(Put your Name and Cert # SDI – xx, on the white board) – let students introduce themselves)

Time for presentation itself, Hours:

Minutes:

1. Objective: How do I get the Attention of the student?

2. Value / Importance / Objective / Outline / Key-points: Organization and make sure the Information is correct

3. Re-State: Review Key Points, Restate Importance

4. Challenge:

Copyright © 2002 by Scuba Diving International (SDI)

Revision 6.0, 11/01/05

In-Water Presentation 18 Elm Street, Topsham, Maine 04086 Phone: (207) 729-4201 Fax: (207) 729-4453

Introductions (Your Name, Your Divemaster’s Name – Dive Teams) Time for presentation itself, Hours:

Minutes:

1.

Do a Surface Demonstration (to illustrate the skill(s)

2.

Review Signs (for example: “OK”, “Go Down”, “Your turn to do the skill”, “Stop”, “Re-do”, “Surface”, “I Have a Problem”, “Equalize Ear Problem”)

3.

Go down together == Students on their knees == Get an “OK” sign from each student == Watch Me Demo!

4.

Demonstrate the Skill(s) == Remember, Slow & Exaggerated.

5.

Evaluate each student performing the skill(s) == Get an OK from the student == Shake Their Hand

6.

Surface With Students

7.

Re-state the Skill(s) == Discuss Problems and Solutions == Praise and Critique == Challenge

8.

Thank the Divemaster

#

Skill

Value / Importance / Objective / Outline / Key-points

1 2 3 4 5 6 7 8 9 10 11 12 13 14 Re-State: (Praise, Review Key Points (“You are now able to”), Re-state importance, Discuss possible problems, Answer questions students may have.) Challenge: (Ask questions to ensure comprehension, Challenge the Student.) Copyright © 2002 by Scuba Diving International (SDI)

Revision 6.0, 11/01/05

Member Update Form (P1 of 2) To be used by inactive members and/or Instructor Trainers to verify renewal or update requirements First

Middle

Last

Member Name: Address: City:

State:

Zip:

Phone: (H) Birth date (mm/dd/yyyy):

Country:

(W)

(M)

E-mail:

SDI/TDI/ERDI Member Number (REQUIRED): Date last Renewed with SDI/TDI/ERDI: SDI/TDI/ERDI Facility Affiliation: Highest SDI/TDI/ERDI Professional Rating: Date of Last SCUBA Diving Medical:

(attach copy)

Date of last CPR & First Aid Certification:

(attach copy)

Other Agency Membership(s) (List of any other Agency Memberships and current status. Include student count for past 2 years) Certification: Current Status:

Agency:

Certification: Current Status:

Agency:

Certification #: Date Last Active:

/

/

Certification #: Date Last Active:

/

/

Level of Rating(s) Being Updated 1: 2: 3:

Instructor Trainer Details Name:

E-mail:

Copyright ® 2009 by International Training

Member #:

Phone:

Revision 1.0 07/10/09

Member Update Form (P2 of 2) Location of Update:

Update Components (ITs must initial the relevant subject line(s) as verifying that the updating member has completed, for an update after two (2) or more years inactivity, all the necessary skill performance and graduation requirements for the applicable instructor level course(s). Attach notes if necessary.

IT’s Initials

Subjects: • Online Professional Familiarization Program • SDI Standards & Procedures Review • TDI Standards & Procedures Review • ERDI Standards & Procedures Review • Current Training Updates Review • SDI Instructor Evaluation Course (required for SDI instructors updating) • Classroom Presentation • Confined Water Lesson • Open Water Lesson • Written Exam Completed (with 100% remediation as required) • SDI CPROX* CPR1st* CPROX1stAED* • TDI Open Circuit Instructor Course (specify) • TDI SCR Instructor Course (specify) • TDI CCR Instructor Course (specify) • TDI Overhead Environment Instructor Course (specify) • ERDI Instructor Course Skill Performance Requirements • Other (specify) • Other (specify) • Other (specify)

Number of Academic Presentations Completed: Number of Confined Water Dives Completed: Number of Open Water Dives Completed:

Max Depth:

Date Update Completed: Declaration by Member: I fully understand and have completed all the requirements for this instructor update and am in possession of current Student Manuals and Instructor Guides for the ratings I hold. I also understand that this update does not guarantee Renewal of Membership or Active Teaching Status and I am not authorized to teach SDI/TDI/ERDI programs until I have received approval from the HQ Training Department. I certify that I have no outstanding Quality Assurance issues with any SCUBA certifying agency and know of no reason that my status may not be renewed. Signature:

Date:

Declaration by Instructor Trainer: I verify that the member has satisfactorily completed all the requirements of this instructor update to the level required by current SDI/TDI/ERDI Standards.

Signature: Copyright ® 2009 by International Training

Date: Revision 1.0 07/10/09