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 or Octopus
___ Battery Change (Some Models May Need To Be Shipped To The Manufacturer)

Date Needed:_____________ (If Applicable)

Please allow 7 days from the time Underwater World receives your equipment until the time we ship it back to you. 


You will receive a confirmation phone call or email on the day we receive your equipment and the day we ship it back to you. 

Comments or Additional Requests 








By signing this Service Agreement, I hereby authorize Underwater World, Inc. to perform the services that I have chosen. I am aware that the prices quoted are for services only and do not include parts, such as hoses, mouth pieces, or batteries.

Underwater World, Inc. 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 40 percent compressed air. 02 cleaning is available, if requested.

Underwater World, Inc. recommends that all equipment be thoroughly inspected and tested for safety and proper operation prior to each dive.

I understand and agree that Underwater World, Inc. 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 Underwater World, Inc. and its employees, instructors, agents, and representatives, arising out of services performed or not performed under this Service Agreement.

I understand that if Underwater World, Inc. 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, Underwater World, Inc.’s liability shall be limited to a sum equal to the total of the monies that were paid Underwater World, Inc. 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 Underwater World, Inc.’s obligations or from negligence, active or otherwise, of Underwater World, Inc., and its employees, instructors, agents, and representatives. This Agreement shall be binding upon myself, heirs, and legal representatives.