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Waiver of Liability and Acknowledgement

In order to complete your transaction and purchase a Prescription Medical Kit, you must read and acknowledge the content below. ALL FORM FIELDS and CHECKBOXES are required in order to submit this waiver. If you have any questions or concerns, you may reach us at 772.419.7199 or via email at admin@d-dey.com. Thank You.

Prescription Medical Kits from D-DEY Response Group

I hereby release D-DEY Response Group and its respective directors, officers, shareholders, employees, agents, contractors and their successors and assigns (collectively, the “Releasees”) from and against any and all liability for any loss, damage, injury, expense, demand or cause of action that I may suffer or cause to others with respect to personal injury, death, damage to or destruction of property, theft or otherwise, which may arise as a result of my decisions to use the training, equipment, or Prescription Medical Kits from D-DEY Response Group.

Name

Address

Phone Number

Click each checkbox to acknowledge that you have read and understand the following:

I am aware and acknowledge that injury or death may result from Ocean Voyages and from the use any equipment therein or thereon provided by D-DEY Response Group.

It is designed and intended for use at sea and where direct access to professional medical care is not an option. All medications, medical items and supplies are to be used under the direct supervision of the Captain / Skipper and / or the designated Medical Officer onboard. Whenever possible a physician should be consulted prior to the use of any prescription medication. Additional training may be required for the proper use of medical equipment and supplies. All prescription medications must be administered in accordance with the product literature and all printed instructions. Use of any medication must be terminated at the onset of any side effect or adverse reaction.

Prescription Medical Kits contain medications provided in anticipation of first aid or emergency medical situations that might arise and are not intended to replace any medications that might be prescribed by one's own personal physician. An individual should be fully informed by one's own personal physician with regard to any and all complications and contra-indications that might arise as the result of the use of those medications and in conjunction with the use of any other medication.

The Vessel, Managing Owner, and Captain/Crew have received training on ONLY the medications provided in D-DEY Response Group’s Prescription Medicine Kit. D-DEY Response Group cannot be held liable for the misuse, abuse, or complications for medicines it does not provide.

I will indemnify and hold harmless D-DEY Response Group, collectively and individually, from any and all losses, liabilities, damages, demands, costs and expenses that they may incur, for any reason whatsoever, which may arise as a result of my participation in the contemplated activity.

I acknowledge that I have read this Waiver of Liability, and have received the opportunity to discuss this with my legal counsel. Further, I acknowledge that I fully understand the terms of this Waiver of Liability and that I have signed it freely and voluntarily without any inducement, assurance, guarantee or oral representation being made.

Time Stamp

Vessel

Vessel Registration no.

Managing Captain or Owner> (noted on the vessel document or registration)

Captain or Medical Officer

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