I ______________________________________________, In consideration of The Alter Ego Project LLC., doing business as a canopy piloting training organization shall, from this point out on this form be referred to as The Alter Ego Project. 1) Representations, Warranties, & Assumptions of Risk: I understand that by voluntarily attending a canopy training course for the purpose of progression and making myself a safer canopy pilot will expose me to the risk of personal injury, property damage and/or death. I understand that the successes of my jumps are dependent upon the perfect functioning of the airplane from which I intend to jump and the parachute system, and that neither the airplane nor the parachute system can be guaranteed to function perfectly. I understand that the airplane and the parachute system are both subject to mechanical malfunctions as well as operator error. I freely, voluntarily and expressly choose to assume all risks inherent in parachute jumping, including, but not limited to, risks of equipment malfunction and/or failure to function, including those which may result from some defect in design, assembly, and/or manufacture as well as those risks arising from improper and/or negligent operation and/or use of the equipment, for and in consideration of becoming a safer canopy pilot/parachutist, understanding full well that those risks may include personal injury, property damage, and/or death. I also understand that skydiving is an inherently dangerous sport and canopy piloting and canopy progression are highly dangerous if not done so with the greatest safety in mind. 2) Exemption and Release from Liability: I exempt and release the following persons and organizations: (A) The Alter Ego Project LLC and their directors, coaches, agents, servants, employees, sponsors and other representatives; (B) Manufacturers, designers, and suppliers of component equipment incorporated in the dual-container parachute pack assembly I will be using during my intentional parachute jumps; (C) Owners, suppliers, mechanics and operators of aircraft from which I am to make my intentional parachute jumps; (D) The owners and lessees, if any, of land upon and from which the parachute jumping and related aircraft operations are conducted; (E) If I am making my intentional parachute jump at or near a parachuting/skydiving facility, the owners and
Operators of that facility, as well as their officers, directors, agents, servants, employees, shareholders, sponsors and other representatives; (F) Any and all skydiving referral service, business entities, and/or owners of fictitious name entities which I may have used in locating and/or deciding upon a parachuting/skydiving facility or other location at which to perform your intentional parachute jumps; (G) Any other person and/or organization which is or may be liable for any loss or injury to me and or my property, or my death, arising out of my participation in any of the activities covered by this Agreement (as defined below); From any and all liability, claims, demands or actions or causes of action whatsoever arising out of any damage, loss or injury to me or my property, or my death, whether occurring while I am training and/or preparing for my intentional parachute jumps, while I am present in aircraft from which the jump is to be made, while I am making my intentional parachute jump, or while I am engaged in related activities (hereafter referred to as “activities covered by this Agreement”), whether such loss, damage, injury, or death results from the negligence and/or other fault, either active or passive of any of the persons and/or organizations described in paragraphs 2(A)-(G) above, or from any other cause; 3) Covenant Not to Sue: I agree never to institute any suit or action at law or otherwise against any of the organizations and/or persons described in paragraph 2(A) through (G) above, or to initiate or assist in the prosecution of any claim for damages or cause of action which I may have by reason of injury to my person or property, or my death, arising from the activities covered by this Agreement, whether caused by the negligence and/or fault, either active or passive, of any of the organizations and/or persons described in paragraph 2(A) through (G) above, or from any other cause. I further expressly agree that I will never raise any claim against any of the organizations and/or persons described in paragraph 2(A) through (G) above for product liability, failure to warn, negligence, breach of warranty, breach of contract, or strict liability, regardless of whether my claims for damages or injuries are alleged to result from the fault or negligence of the parties released or from myself. I further agree that my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf, shall not institute any suit or action at law or otherwise against any of the organizations and/or persons described in paragraph 2(A) through (G) above, nor shall they initiate or assist the prosecution of any claim for damages of cause of action which I, my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf may have by reason of injury to my person or property, or my death arises from the activities covered by this Agreement, whether caused by the negligence and/or fault, either active or passive, of any of the organizations and/or persons described in paragraph 2(A) through (G) above, or from any other cause, I hereby so instruct my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf. Should any suit or action at law or otherwise be instituted in violation of this Agreement against any of the organizations and/or persons described in paragraph 2(A) through (G) above, I agree that such organizations and/or persons shall be entitled to recover, in addition to any other damages which may be incurred, reasonable attorneys’ fees and costs incurred in defense of such suit or action, including any appeals there from. 1 4) Indemnity Against Claims: I will indemnify, defend, save and hold harmless the organizations and/or persons described in paragraph 2(A) through (G) above from any and all losses, claims, actions or proceedings of every kind and character, including attorneys’ fees and expenses, which may be presented or initiated by any persons and/or organizations and which arise directly or indirectly from my participation in the activities covered by the Agreement, whether resulting from the negligence and/or other fault, either active or passive, or any of the organizations and/or persons described in paragraph 2(A) through (G) above, or from any other cause. 5) Validity of Waiver: I understand that if I institute or anyone on my behalf institutes, any suit or action at law or any claim for damages or cause of action against any of the organizations and/or persons described in paragraph 2(A) through (G) above because of injury to my person or property, or my death, due to the activities covered by this Agreement, this Agreement can and will be used in court, and that such agreements have been upheld in courts in similar circumstances. 6) Representations and Warranties as to Medical Condition: I represent and warrant that (a) I have no physical infirmity that prevents me from participating in canopy coaching/training for the purpose of safe canopy progression. I am not under treatment for any other physical infirmity or chronic ailment or injury of any nature. (b) I am not under any medication of any kind at the present time. 7) Waiver of Jury Trial/Applicable Law/Venue/Headings: I agree that the law of the State of Florida shall apply to issues involving the construction, interpretation, and validity of this Agreement, and that Florida law shall govern any dispute between the parties arising from the activities covered by this Agreement. In the event this Agreement is violated and suit is brought against any of the organizations and/or persons described in paragraph 2(A) through (G) above, I waive my right to a jury trial, and agree that Volusia County, Florida shall be the sole venue for any suit or action arising from the activities covered by this Agreement. I agree that the headings and sub-headings used throughout this Agreement are for convenience only and have no significance in the interpretation of the body of this Agreement. 8) Severability/Multiple Waivers: I agree that should one or more provisions in this Agreement are judicially determined to be unenforceable, the remaining provisions shall continue to be binding and enforceable against me. If I have executed any other agreement containing provisions relating to the exemption and/or release from liability and/or covenant not to sue in connection with the activities covered by this Agreement, I agree that the agreement which provides the most protection from liability and/or suit for The Alter Ego Project LLC and any of the organizations and/or persons described in paragraph 2(A) through (G) above shall be enforceable against me by The Alter Ego Project LLC as well as it’s the organizations and/or persons described in paragraph 2(A) through (G) above. 9) Continuation of Obligations: I agree and acknowledge that the terms and conditions of this Agreement shall continue in force and effect now and in the future at all times during which I participate in the activities covered by this Agreement, and shall be binding upon my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf. This Agreement supersedes and replaces any prior such agreement I have signed. 10) I hereby agree and acknowledge that all of the information on this agreement and qualifications as to my abilities I have provided on this agreement to be truthful and accurate and failure to do so may result in my own serious injury or death. *Please read each paragraph carefully. Your initials indicate you understand and agree to all of the information and terms contained therein. I freely and voluntarily agree to all of the above by signing this contract on ___________ at ____________________. (Date) (Location) Age: _________ Birthdate: _____________________
Number of Jumps_________ Number of jumps in the past 12 Months__________
Size and type of canopy _______________________ Number of jumps on this canopy_________
Printed Name: _______________________________Signature: ______________________________ ***************************************To be filled out By The Alter Ego Project LLC representative only****************************************** Witness Printed Name: _________________________ Signature: ______________________________ |
