PRINT THIS FORM and attach it to your gear
Name:______________________________________________________
Complete Address:____________________________________________
City:_________________________________ State:_____ Zip:________
Phone Numbers: Day: __________________ Evening: ______________
E-mail address:_________________________________________________
EQUIPMENT REPAIR FORM
Please Check What You Would Like Serviced
___ B.C.D. ($16)
____Mares/Dacor HUB ($ Call)
___ Regulator 1st Stage And Primary 2nd Stage ($49)
___ Alternate Air Source (Octopus) ($14)
____ Please call/e-mail with a service quote if the service exceeds $__________
___ Integrated Alternate Air Source ($24)
___ Camera Housing Pressure Test ($40)
___ Battery Change ($9.95 Some Models May Need To Be Shipped To The Manufacturer)
Travel Departure/Need By Date:_____________ (If Applicable)
If you are shipping you’re gear to us, you will receive a confirmation call or e-mail when we receive your Equipment, and another call or e-mail
the day we ship it back to you. We can usually turn your equipment around within 2 weeks days.
Comments Or Requests:
_______________________________________________________________
_______________________________________________________________
By signing this Service Agreement, I hereby authorize Aquaventure Dive & Photo Center to perform the services that I have chosen. I recognize
that the prices quoted are for services only, and do not include parts, such as hoses, mouth pieces, repair kits and batteries.
Aquaventure Dive & Photo Center reserves the right to not service equipment that cannot reasonably be placed in a safe operating condition. All
equipment, unless specified otherwise, is only to be utilized with a gas mixture of 21% oxygen content up to approximately 40% oxygen content
compressed gas. O2 cleaning is available for use with higher PO2 gases upon request.
Aquaventure Dive & Photo Center recommends that all equipment be thoroughly inspected and tested for safety and proper operation prior to
each dive.
I understand and agree that Aquaventure Dive & Photo Center makes no guaranty, representation or warranty including any implied warranty of
merchantability or fitness for particular purpose with respect to the diving equipment serviced.
I hereby state I carefully reviewed this Service Agreement, and I acknowledge, recognize, appreciate, and assume all risks inherent in the sport
of scuba diving and in the use of scuba diving equipment and waive each and every claim for injuries, damages and losses, including claims for
negligence, which I may have against Aquaventure Dive & Photo Center and its employees, instructors, agents, and representatives, arising out
of services performed or not performed under this Service Agreement.
I understand that if Aquaventure Dive & Photo Center should be found liable for any injuries, damages and losses due from a failure to perform
any or all of its obligations or a failure of the equipment to properly operate, Aquaventure Dive & Photo Center’s liability shall be limited to a sum
equal to the total of the monies that were paid Aquaventure Dive & Photo Center for servicing and this liability shall be exclusive and apply if
loss or damage, irrespective of cause or origin, results directly or indirectly to persons or property from performance or non-performance of any
of Aquaventure Dive & Photo Center ’s obligations or from negligence, active or otherwise, of Aquaventure Dive & Photo Center, and its
employees, instructors, agents, and representatives. This Agreement shall be binding upon myself, heirs, and legal representatives.
__________________________
Signature
___________________
Date
Aquaventure Dive & Photo Center 10024 County Rd 81 Maple Grove, MN 55369 (763)-424-8717, fax: (763)-391-8000 [email protected]