Please read this document carefully before signing. By signing this document, you may be waiving certain legal rights.
Charter Company: ______________________________________
Captain: ______________________________________________
Charter Date: _________________________________________
Departure Location: ___________________________________
Destination: __________________________________________
Full Name: ____________________________________________
Date of Birth: _________________________________________
Address: ______________________________________________
Phone Number: _________________________________________
Email: ________________________________________________
Emergency Contact: ____________________________________
Emergency Phone: ______________________________________
I understand that participating in a recreational boat charter involves inherent risks that cannot be completely eliminated. These risks include, but are not limited to:
I voluntarily choose to participate despite these known and unknown risks.
I knowingly and voluntarily assume all risks associated with participating in this boat charter, whether foreseen or unforeseen.
I accept full responsibility for my own safety and agree to exercise reasonable care throughout the trip.
To the fullest extent permitted by applicable law, I release and hold harmless:
__________________________________________ (Company Name)
its owners, officers, employees, captains, crew members, agents, affiliates, volunteers, and contractors from any claims, demands, causes of action, damages, losses, liabilities, costs, or expenses arising from or related to:
except to the extent prohibited by law.
I certify that I am physically capable of participating in this excursion.
I have disclosed any medical conditions that may affect my participation.
In the event of a medical emergency, I authorize the captain or crew to obtain emergency medical treatment on my behalf. I understand that I am responsible for all medical expenses incurred.
I agree:
I agree to:
Failure to follow safety instructions may result in termination of my participation without refund.
If swimming, snorkeling, or wading is permitted during the excursion, I understand:
I understand that:
I understand that the charter company is not responsible for lost, stolen, or damaged personal property, including but not limited to:
☐ I authorize the charter company to use photographs or videos taken during the trip for promotional purposes.
☐ I do NOT authorize use of my image.
For passengers under 18 years of age:
I certify that I am the parent or legal guardian of the minor named below and consent to their participation under the terms of this waiver.
Minor's Name:
Parent/Guardian Name:
Signature:
This agreement shall be governed by the laws of the state in which the charter originates unless otherwise required by applicable federal maritime law.
If any provision of this agreement is determined to be unenforceable, the remaining provisions shall remain in full force and effect.
I certify that:
Printed Name: _______________________________________
Signature: __________________________________________
Date: _______________________________________________
Printed Name: _______________________________________
Signature: __________________________________________
Date: _______________________________________________
This is a general sample waiver and is not legal advice. Passenger liability waivers for boat charters may be subject to federal maritime law as well as state law. Before using this form for commercial operations, have it reviewed by an attorney familiar with maritime and admiralty law in the state where your charter business operates to help ensure it complies with applicable legal requirements and is appropriate for your specific services and insurance coverage.

BSL, Municipal Harbor
(228) 277-8596
info@YourBoatsConcierge.com