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CUSTOMER’S RELEASE OF LIABILITY

DECLARATION OF FITNESS TO OPERATE PERSONAL WATERCRAFT

I hereby declare that I am physically fit to operate a vessel. I do not, and have not, suffered from any of the following conditions, which I understand may lead to a dangerous situation with regard to other persons or myself during operation of rental PWC or rental vessel.

Epilepsy fits, severe head injury, recurrent blackouts or giddiness, disease of the brain or nervous system, high blood pressure, lung or heart disease, recurrent weakness or dislocation of any limb, diabetes, mental illness, drug or alcohol addiction, recent back injury, arthritis or severe joint sprains, chronic bronchitis, asthma, rheumatic fever, thyroid adrenal or other glandular disorder, recent blood donation, or any condition that requires the regular use of drugs.

I hereby declare that I have no physical or mental condition that should preclude me from participating in my chosen activity, that I am not participating against medical advice or treatment, and that I have not been diagnosed by a registered doctor as having a terminal illness.

Even if I have a health condition as state above of which I may be unaware, by signing this form, I still choose to participate in the activity with the rental property and agree to waive all responsibilities to all above-mentioned parties concerning any consequences that would result from my actions.

I further declare that in the event before, during, or after renting a PWC or rental vessel that I feel ill or unwell, have any physical complaints whatsoever or if any injury is sustained of any kind during the course of PWC rental, I will notify the Renal Operation Manager at Pure Florida immediately.

I HAVE READ THE ABOVE DELCARATIONS, UNDERSTAND THEM, AND I AGREE TO BE BOUND TO THEM

PRINT NAME * Please enter your name.

Phone Number: * Please enter your phone number.

Address: *

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Email: * Please enter your email.

SIGNATURE OF PARTICIPANT *

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Date *

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PARENT'S OR GUARDIAN'S ADDITIONAL INDEMNIFICATION

(Must be completed for participants under the age of 18)

In consideration of the "Minor" being permitted by PF to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless PF from any and all claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.

PARENT'S OR GUARDIAN'S SIGNATURE

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PRINT NAME Please enter your name.

Date

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RENTAL AGREEMENT: Any questions while going over the rules/regs please ask.

A five-minute grace period is given thereafter we will bill in 15-minute increments ($45 every 15 minutes) * Please check it here.

A Fuel-Surcharge was billed prior to your rental ($10 per hour per rental) * Please check it here.

I accept responsibility for all damages to the rental or third parties assessed as follows:

Jet Ski/Boat: Fiberglass damage assessed at $50/inch cosmetic, $100/inch structural, including but not limited to bumpers, mirrors, lost keys, engine damage, ect… * Please check it here.

Boat: Propeller damage asses at $100 for boat blades, $200 for replacement (Broken blades) included but not limited to lost anchors, boat key, motor damage, ect… * Please check it here.

Areas on the map are the limits of where the rental may go. If I choose to go outside the mapped area there will be a $50.00 surcharge * Please check it here.

In the Pure Naples staff is dispatched due to operator error or a late return a fee of $105/hour will be assessed * Please check it here.

In the event your vessel becomes beached and you find yourself stranded SEA TOW would need to be contacted at renters expense * Please check it here.

I am born prior to January 1st 1988: *

Yes

No

Please select at least one choice above.

If no do you have a boaters license

Yes

No

Please select at least one choice above.

Number of people aboard the jet ski or boat * Please enter your answer here.

Do you have anyone 6 or younger aboard the vessel? *Anyone 6 and younger must wear life vest at all times on boat rental *

YES

NO

Please select at least one choice above.

Local Regulations: The following will help prevent you from getting a ticket: Failure to follow any of the below will result in a minimum fine of $100, Escort back to the dock and a loss of rental at renters expense

Red and Green signs designate the channel and imaginary lines extend from red to red and green to green markers * Please check it here.

To marker 32/33 and marker 10-7A is always slow speed no wake (No throttle/minimum steerage) * Please check it here.

The designated manatee zone is always slow speed (No throttle minimum steerage) * Please check it here.

You can operate anywhere on the bay, but be aware it is slow speed at all times when operating outside of the channel. * Please check it here.

No quick changes in the channel. Drive with the flow of traffic and be aware of other vessels near you. * Please check it here.

Keep a good distance away from others and anything else on the waterway including other vessels in case you have to turn quickly to avoid a collision. * Please check it here.

No limbs over side of vessel or bow of boat. * Please check it here.

Any one on a jet-ski must keep their PWC life jacket on at all times. Operating without a PWC lifejacket will result in a fine and immediate termination of rental. This will result in a Pure Naples Staff member being dispatched(See above for rate) * Please check it here.

Do not jump wakes of other boats it is illegal and you will get ticketed * Please check it here.

Operation of the vessel is not recommended for the Gulf of Mexico, however if you do find yourself out there be sure to maintain a distance of 500 feet from the shore. * Please check it here.

Careless operation is defined as operating a vessel recklessly upon the water of Florida. I shall operate the vessel in a responsible manor, having regard to other waterborne traffic, posted speed and wake restrictions, and all other attendant circumstances so as not to endanger the life, limb, or property of any persons. * Please check it here.