SirenYoga™ Participant Statement

Read the following paragraphs carefully. SirenYoga™ follows the Professional Association of Diving Instructors (PADI) medical, safety and liability practices.

This statement, which includes a Medical Questionnaire, a Liability Release and Assumption of Risk Agreement (Statement of Risks and Liability), and the Safety Knowledge Review, informs you of some potential risks involved in underwater exercise and of the conduct required of you during the SirenYoga™ underwater program. If you are a minor under 18, please read and have your parent or guardian read and sign.

You will also need to learn and review important safety rules regarding breathing and equalization while underwater from the SirenYoga™ Instructor. Any form of scuba diving and the use of hookah scuba equipment without proper supervision or instruction can result in serious injury or death. You must be instructed in its use under the direct supervision of a qualified instructor.


SirenYoga™ Medical Questionnaire

Hookah scuba diving is an exciting and relaxing activity. To participate, you must not be extremely overweight or extremely out of condition. Diving can be strenuous under certain conditions. Your respiratory and circulatory systems must be in good health. All body air spaces must be normal and healthy. A person with heart trouble, a current cold or congestion, epilepsy, asthma, a severe medical problem, or who is under the influence of alcohol or drugs, should not dive. If taking medication, consult your doctor before participating in this program.

The purpose of the Medical Questionnaire is to find out if you should be examined by a physician before participating in recreational hookah scuba diving. A positive response to a question does not necessarily disqualify you from practicing SirenYoga™. A positive response means that there is a preexisting condition that may affect your safety while diving and you must seek the advice of a physician.

Please answer the following questions on your past and present medical history with a YES or NO. If you are not sure, answer YES. If any of these items apply to you, we must request that you consult with a physician prior to participating in SirenYoga™. Your SirenYoga™ Instructor will supply you with a Medical Statement and Guidelines for Recreational Scuba Diving Physical Examination to take to a physician.

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To continue your SirenYoga™ experience, you must complete this review under the direction of your SirenYoga™ Instructor BEFORE getting in the water. Check the appropriate box in response to each question:
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