DEFINITIONS:
In this agreement the term "Ship" means [name of ship], and "Owners" includes Shipowners, Disponent, Owners, Managers, Characters, Agents, Master, Mariner or other Servants of the Ship. The Term "Beneficiary" includes the person signing this hold harmless agreement, minor children accompanying the person so signing, and, insofar as concerns dispares in relation to loss of life, the dependents and/or legal representatives of the deceased.

To the Master of the [Name of ship]: In consideration of allowing the Beneficiaries, [Name of Beneficiary in capital letters] to follow the Ship from [port and/or date of embarkation] to [port and/or date of disembarkation] the following conditions are hereby accepted:

1. This agreement is in every respect, including questions of Owners' liability, governed by the [applicable law] law. Any dispute arising out of this agreement is to be decided by the proper [country of jurisdiction] Courts to the exclusion of the courts or tribunals of any other jurisdiction. Should for any reason proceedings in relation to this agreement and/or to the passage agreed herein be instituted elsewhere, whether in rem or in personam, then such proceedings shall be stayed pending a final and unappealable decision of the proper [country of jurisdiction] Courts.
2. This clause serves to give explicit notice to the Beneficiary that the Ship is not a passenger ship. No warranty whatsoever is given by the Owners that the Ship is fit for the carriage of passengers. Any undertaking as to seaworthiness that might otherwise exist is hereby expressely waived.
3. The Beneficiary expressely agrees that Owners shall be under no liability whatsoever to the Beneficiary in respect of loss of live, illness, injury or loss of or damage to personal effects, luggage or other property, by reason of having allowed the Beneficiary to follow the Ship as agreed above. The Owners shall be exonerated from such liability even if the loss of live, illness, injury or loss of or damage to personal effects, luggage or other property is caused by the Owners negligence. Accordingly the Beneficiary expressely agrees to assume any and all risks concerning loss of live, illness, injury or loss of or damage to personal effects, luggage or other property whilst on board and during embarkation and disemarkation.
4. Insofar as concerns loss of live, illness, injury whether or not caused by negligence of the Owners, the Beneficiary undertakes to pay any and all expences for medical treatment, maintenance, transportation, repatriation, burial and/or other expenses incurred reason thereof. To the extent that Owners nevertheless are hold liable by any third party to pay for any or all such expenses, the Beneficiary expressely undertakes to the indemnity Owners for all such expenses.
5. This clause serves to give explicit notice to the Beneficiary that, in view of the fact that the Beneficiary has assumed any and all risks as expressed under (3) and (4) above, it may in the best interest of the Beneficiary to purchase travel insurance which provides adequate cover for such risks.
6. The Beneficiary warrants compliance with all quarantine, passport and other regulations for all ports of call at all times and undertakes to indemnify Owners for all additional expenses which they may incur by reason of non-compliance on the part of the Beneficiary, whether negligent or not, including but nor limited to additional harbour, tonnage and light dues, fines and expenses arising out of delay or detouration of the Ship.
7. This clause serves to give explicite notice to the Beneficiary that the Ship is at all times at liberty to deviate from the advertised route for commercial or other reasons, and as a consequence the Ship may not proceed to the intended port(s) of destination mentioned above. If the Ship does not call the intended port(s) of destination, Owners are under no obligation whatsoever to transport the Beneficiary to the intended port(s) or to pay for such transpotation, and the Beneficiary hereby expressely waives any and all rights to claim damages, refund of expences or any other kind of compensation as a consequence thereof. Any money paid by the Beneficiary on signing this contract is to be considered as fully earned by Owners and non-returnable.
8. If Owners are held legally liable to the Beneficiary by virtue of rules of law which supersede or set aside the proceding provisions of this agreement, such liability shall be based on the provisions contained in the 1974 Athens Convention on Carriage of Passengers and Their Luggage by Sea.