PRINT THIS FORM and attach it to your gear

Name:______________________________________________________

Complete Address:____________________________________________

City:_________________________________ ST:_____ Zip:____________

Phone Numbers: Day: __________________  Evening: __________________

E-mail address:_________________________________________________

Please Check What You Would Like Serviced
___ B.C.D.
___ Regulator 1st Stage And Primary 2nd Stage
___ Alternate Air Source (Octopus)
___ Computer Or Depth Gauge Check 0-130 FT
___ Mouthpiece Replacement.
___ Battery Change (Some Models May Need To Be Shipped To The Manufacturer)

Travel Departure Date:_____________ (If Applicable)

Please Either Leave Credit Card Information Below Or Call Us (435) 752-1793 or toll free 1-888-71SCUBA

Credit Card:_______________________________________

We Can Usually Turn Your Equipment Around In Less Than One Week

You Will Receive A Confirmation Call or E-mail When We Receive Your Equipment, And One
More The Day We Ship It Back To You.

Comments Or Requests:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

By signing this Service Agreement, I hereby authorize Blue Water Scuba of Logan, Inc. 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 and batteries.

Blue Water Scuba of Logan 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 mixture of approximately 21 percent compressed air. Nitrox cleaning is available, if requested.

Blue Water Scuba of Logan recommends that all equipment be thoroughly inspected and tested
for safety and proper operation prior to each dive.

I understand and agree that Blue Water Scuba of Logan 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 Blue Water Scuba of Logan and its employees, instructors, agents, and representatives,
arising out of services performed or not performed under this Service Agreement.

I understand that if Blue Water Scuba of Logan 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, Blue Water Scuba of Logan's liability shall be limited to a sum equal to the total
of the monies that were paid Blue Water Scuba of Logan 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 Blue Water Scuba of Logan

obligations or from negligence, active or otherwise, Blue Water Scuba of Logan and its
employees, instructors, agents, and representatives. This Agreement shall be binding upon myself, heirs,
and legal representatives.

Thank You For Your Business!