LETTER OF INDEMNITY FOR VISITORS

TO THE OWNERS, MANANERS, AGENTS AND MASTER OF THE ________________________

DEAR SIRS,

IN CONSIDERATION OF YOUR AGREEMENT THAT I MAY BOARD THE ABOVE VESSEL FOR THE PURPOSE OF

__________________________________ FROM THE TIME AND PLACE OF EMBARKATION TO THE TIME AND PLACE OF

DISEMBARKATION ENTERED BELOW, I,_______________________________, HEREBY AGREE AS FOLLOWS;

1. THAT I ASSUME ALL RISKS OF WHATSOEVER NATURE AND HOWSOEVER ARISING, EXPRESSLY INCLUDING RISKS

WHICH MAY RESULT FROM YOUR, YOUR SERVANTS’ OR AGENTS’ NEGLIGENCE OR ANY DEFECTS IN THE VESSEL,

DURING THE PERIOD THAT I AM ABOARD THE VESSEL, INCLUDING, BUT NOT LIMITED TO ILLNESS, INJURY, DEATH,

LOSS OF OR DAMAGE TO MY PROPERTY AND PERSONAL EFFECTS, AND FURTHER EXPRESSLY ASSUME

RESPONSIBILITY FOR ANY AND ALL COSTS, CHARGES OR EXPENSES WHICH MAY ARISE WHETHER DIRECTLY OR

INDIRECTLY IN CONSEQUENCE OF SUCH MATTERS.

2. THAT I SHALL HOLD YOU HARMLESS AND INDEMNIFY YOU, AND EACH OF YOU, IN RESPECT OF ANY LOSSES,

DAMAGES, CLAIMS, LIABILITIES, FINES, COSTS, CAHRGES OR EXPENSES WHETHER MEDICAL OR OTHERWISE,

INCLUDING THOSE ASSOCIATED WITH ANY DEVIATION OF THE VESSEL OR ANY NEED TO REPATRIATE ME FROM

THE VESSEL, WHICH YOU MAY SUFFER OR INCUR WHETHER DIRECTLY OR INDIRECTLY IN CONSEQUENCE OF OR

IN CONNECTION WITH MY BEING ABOARD THE VESSEL AND WHETHER OR NOT SUCH MAY ARISE IN

CONSEQUENCE OF ANY NEGLIGENT ACT OR OMISSION ON MY PART OR ON THE OTHER PART OF YOU, YOUR

SERVANTS OR AGENTS OR ANY DEFECTS IN THE VESSEL.

3. THAT SHOULD THE VESSEL FOR ANY REASON WHATSOEVER NOT BE ABLE TO RETURN ME TO THE PLACE OF

DISEMBARKATION ENTERED BELOW, IT IS UNDERSTOOD THAT I MUST PROVIDE MYSELF WITH A PASSAGE HOME

OR ELSEWHERE AND THAT YOU SHALL BE UNDER NO RESPONSIBILITY WHATSOEVER IN CONSEQUENCE OF SUCH

MATTERS.

4. THAT I SHALL AND IN ANY EVENT BE PROPERLY DEEMED TO HAVE TAKEN OUT ADEQUATE PERSONAL INSURANCE

COVER WITH REPUTABLE INSURANCE COMPANY TO COVER THE PERSONAL RISKS AND LIABILITIES ASSUMED BY

ME UNDER THIS AGREEMENT.

EMBARKATION : ____________________ DISEMBARKATION: ____________________

PORT/PLACE : ______________________ PORT/PLACE : ____________________

TIME : ______________________ TIME : ____________________

SIGNATURE : _____________________________ FULL NAME: _____________________________

COMPANY : _______________________________ DATE : ______________________________