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VOLUNTEER PARACHUTE JUMPER

ASSUMPTION OF RISK AGREEMENT

IMPORTANT - READ BEFORE YOU SIGN.

YOU ARE GIVING UP IMPORTANT

LEGAL RIGHTS

 

VOLUNTEER JUMPER AGREEMENT, RELEASE OF LIABILITY & ASSUMPTION OF RISK

IN CONSIDERATION of being permitted to utilize the facilities and equipment of the uninsured “Tennessee Skydiving, LLC.”, and its associated entities, to engage in parachute activities, ground instruction, flying and related activities, skydiving, freefall and tandem jumping, hereinafter collectively referred to as “skydiving activities,” as defined in paragraph 6 in this contract. I HEREBY AGREE AS FOLLOWS:

 

I understand that I am not required to make a skydive, but if I desire to do so, I am not required to jump at the uninsured “Tennessee Skydiving, LLC.”  I understand there are other drop zones within a 300 mile radius of the city of Tullahoma, TN. 

I Agree

 

I understand that this document is a binding contract between myself and the entities described herein as “Tennessee Skydiving, LLC.” and certify that I am of legal age and under no legal disability which would prevent me from entering into a binding contract.  

I Agree

 

I am aware that “skydiving activities” are INHERENTLY DANGEROUS AND MAY RESULT IN INJURY OR DEATH and agree that the unforeseen may happen and no one can delineate all risk or possibilities of error.  Therefore, I specifically include in this release, any injury resulting from any occurrence, whether foreseen or unforeseen, and whether contemplated which is in any way connected with my “skydiving activities” and/or on presence of the premises commonly know as the Tullahoma Airport or any other place or entity connected with the uninsured “Tennessee Skydiving, LLC.”.   

I Agree

 

PARTIES INCLUDED: I understand that this Agreement, Release of liability & Assumption of Risk includes but is not limited to the uninsured “Tennessee Skydiving, LLC.”, and any of its officers, board members and shareholders, its or their agents, customers, associated entities, employees, volunteers, pilots, instructors, videomen, other jumpers, jumpmasters, the owner of the aircraft, (which shall also include but is not limited to airfoils and balloons), the owner of any land utilized for “skydiving activities”, adjacent property owners,  Tullahoma Regional Airport, City of Tullahoma, the United States Parachute Association and its members, anyone working with or for the uninsured “Tennessee Skydiving LLC.”, any manufacturer of any piece of equipment or gear which I may use or am using at the time of my INJURY OR DEATH and anyone involved in any way, shape, form or manner in my “skydiving activities” and specifically including but not limited to tandem or experimental test parachute jumping to include tandem parachute jumping, hereinafter collectively referred to in this Agreement, Release of liability & Assumption of Risk as “Tennessee Skydiving, LLC.”.  

I Agree

 

This entire CONTRACT, Release of liability & Assumption of Risk is expanded to included all parties mentioned anywhere in the body of the document by name or by category, all vendors or suppliers of materials or equipment for “skydiving activities”, including but not limited to the manufacturer of the equipment, its employees, directors, officers and shareholders, and all associated entities, shareholders, partners, employees and all other persons in any way associated with any entity mentioned, either specifically or by implications, in the body of this document.  

I Agree

 

RISK CONTEMPLATED: This agreement is made in contemplation of all “skydiving activities,” which for purposes of this agreement shall include but not be limited to all occurrences contemplated or not contemplated, foreseen and unforeseen, instruction, parachute jumping, tandem or experimental test parachute jumping, ground instruction, flying and related activities, the exit from the aircraft, skydiving freefall, time under the canopy, the landing, any rescue operations or attempts by the uninsured “Tennessee Skydiving LLC.”, whether on or off the designated landing area, or facilities used by the uninsured “Tennessee Skydiving LLC.”, ground transportation provided to me by any entity in any way associated with the uninsured “Tennessee Skydiving LLC.” and any activity whatsoever in any way, shape or form or manner connected with my “skydiving activities” or my presence on or near the facility and grounds of the uninsured “Tennessee Skydiving LLC.”, and/or the airport which is used for my “skydiving activities”.  These risks shall be referred to for purposes of this agreement as “skydiving activities”.

I Agree

 

PARTIES BOUND BY THIS AGREEMENT: It is my understanding and intention that this Agreement, Release of Liability and Assumption of Risk be BINDING not only on myself, but on anyone or any entity that may be able to or do sue because of my INJURY OR DEATH.  It is further my understanding and agreement that this Release is intended to and does in fact release the uninsured “Tennessee Skydiving LLC.” as defined in paragraph 3 from any and all claims or obligations whatsoever, foreseen and unforeseen, contemplated or not contemplated, arising in any way from my participation in “skydiving activities” even if caused by the negligence or other fault of the uninsured “Tennessee Skydiving LLC.”.  

I Agree

 

RELEASE OF LIABILITY: I herby release and discharge the uninsured “Tennessee Skydiving LLC.” from any and all liability, claims, demands or causes of action that I may hereafter have for injuries or damages arising out of my participation in “skydiving activities” even if caused by negligence or other fault of the uninsured “Tennessee Skydiving LLC.”.  

I Agree

 

COVENANT TO SUE: I further agree that I WILL NOT SUE OR MAKE CLAIM against the uninsured “Tennessee Skydiving LLC.”, for damages or other losses sustained as a result of my “skydiving activities” even if caused by negligence or other fault of the uninsured “Tennessee Skydiving LLC.”.  

I Agree

 

INDEMNIFICATION AND HOLD HARMLESS: I also agree to INDEMNIFY AND HOLD “Tennessee Skydiving LLC.” HARMLESS from all claims, judgments and costs, including but not limited to reasonable attorney’s fees and to reimburse them for any expenses whatsoever incurred in connection with any action brought as a result of my participation in “skydiving activities”, including but not limited to actions brought by myself or on behalf of myself or my estate.  

I Agree

 

ASSUMPTION OF RISK: I understand and acknowledge that “skydiving activities” are inherently dangerous and I EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF DEATH OR PERSONAL INJURY SUSTAINED WHILE PARTICIPATING IN “SKYDIVING ACTIVITIES” WHETHER SUCH RISK IS FORESEEN OR UNFORESEEN, CONTEMPLATED OR NOT CONTEMPLATED, AND WHETHER OR NOT CAUSED BY THE NEGLIGENCE OR OTHER FAULT OF THE UNINSURED “Tennessee Skydiving LLC.” including but not limited to equipment malfunction from whatever cause, inadequate training, any deficiencies in the landing area, rescue attempts, bad landings or any other cause whatsoever, including but not limited to those set forth in paragraph 5, even if those injuries are caused by negligence or any other fault of the uninsured “Tennessee Skydiving LLC.”  

I Agree

 

LIMITATION OF WARRANTY: the uninsured “Tennessee Skydiving LLC.” hereby warrants that the equipment provided by the uninsured “Tennessee Skydiving LLC.” has been previously used for “skydiving activities”.  This warranty is the only warranty made and is made in lieu of any other warranties, express or implied, including but not limited to warranty of merchantability or fitness for a particular. I have read that above paragraph, acknowledge that I understand it and accept the limitation of warranty. 

I Agree

 

In the event any agent of the uninsured “Tennessee Skydiving LLC.” is guilty of willful and wanton, or any conduct outside the scope of this contract, I agree that the agent’s action shall be beyond the scope of his/her employment and not attributed to anyone on any agency theory, or any other theory.  

I Agree

 

If I am making a student jump, I understand that I will be wearing a harness which will need to be adjusted by the jumpmaster. If my jump is a tandem jump, I understand that the tandem master will attach my harness to his and that this will put my body in close proximity to that of the tandem master. I specifically agree to this physical contact between the tandem master and myself. 

I Agree

 

OTHER RECREATIONAL ACTIVITIES: This Agreement shall be effective for and include any recreational activity which takes place on the grounds of “Tennessee Skydiving LLC.”, or the property owned by any entity in any way associated with the uninsured “Tennessee Skydiving LLC.”.  

 

DURATION OF RELEASE: It is my understanding and intention that this Release and Agreement be effective not only for my first jump but for any subsequent jumps or “skydiving activities” and shall be in full force and effect from the signing of this agreement until such time it is cancelled by the uninsured “Tennessee Skydiving LLC.”.  

I Agree


I herby agree to waive any and all duty of care, whether by omission or commission, or any other duty which may be owed to me by the uninsured “Tennessee Skydiving LLC.”.    

I Agree

 

ENFORCEABILITY: I agree that if any portions of this Agreement, Release of Liability and Assumption of Risk are found to be unenforceable or against public policy, that only that portion shall fall, but I specifically waive any unenforceability or any public policy argument that I may make or that may be made on behalf of my estate or by anyone who would sue because of my injury or death.   

I Agree
 

 

I am reading this paragraph being made aware that the general rule is that this type of document is to be narrowly constructed and ambiguities are to be decided against the person or entity preparing the document. I expressly waive that rule and specifically agree that this document be broadly constructed and that it be constructed in favor of the uninsured “Tennessee Skydiving LLC.”, and against me and that all ambiguities be resolved in favor of the uninsured “Tennessee Skydiving LLC.”.    

I Agree

 

It is further agreed between the parties that no matter where venue lies, any lawsuits shall be filed in State Court of Cullman County, Alabama. It is further agreed that in the event any lawsuit is filed in other than the State Court of Cullman County, Alabama, such lawsuit shall be moved to Cullman County, Alabama or such other locations as the uninsured “Tennessee Skydiving LLC.” shall specify, on motion and at the option of the uninsured “Tennessee Skydiving LLC.”. Such move shall be at my expense.    

I Agree

 

I hereby agree to reimburse the uninsured “Tennessee Skydiving LLC.” for loss or damage to any equipment of any kind whatsoever caused by my personal negligence or wrong doing.    

I Agree

 

I hereby authorize the uninsured “Tennessee Skydiving LLC.” or its assignee to take any photographs and videos as they may deem appropriate of myself or my party and to use those photographs in such a manner as they deem appropriate and specifically waive any interest, proprietary or otherwise, I may have in such photographs.    

I Agree

 

I GIVE UP LEGAL RIGHTS: I understand, that by signing this document I am giving up important legal rights and it is my intention to do so.    

I Agree

 

Even though I may have failed to initial some or all of the paragraphs of this document, I still intend to be bound by all paragraphs. I further understand that this document can only be amended in writing, with the amendment signed by the attorney for the drop zone and myself.    

I Agree

 

UNDERSTANDING OF AGREEMENT: I HEREBY CERTIFY THAT I HAVE READ AND UNDERSTAND THE CONTENTS OF THIS DOCUMENT AND I WISH TO BE BOUND BY ITS TERMS AND I UNDERSTAND THAT BY SIGNING THIS, I HAVE FOREVER GIVEN UP IMPORTANT LEGAL RIGHTS.    

I Agree

 

I UNDERSTAND THAT WHEN I SIGN THIS DOCUMENT, I WILL BE GIVING UP ANY AND ALL RIGHTS I OR MY HEIRS MAY HAVE TO SUE ANYONE IN ANYWAY, SHAPE OR FORM ASSOCIATED WITH MY SKYDIVE, EVEN IF THE ENTITY I INTEND TO SUE HAS CAUSED MY INJURY OR DEATH BY THEIR NEGLIGENCE.   

I Agree

 

I HAVE BEEN GIVEN AN OPPORTUNITY TO READ THIS DOCUMENT. I HAVE DONE SO. I UNDERSTAND ITS CONTENTS. I INTEND THAT NOT ONLY I, BUT MY HEIRS, MY FAMILY AND ANYONE WHO MIGHT ACT ON MY BEHALF IN ANY CAPACITY WHATSOEVER BE BOUND BY ITS LEGAL TERMS.

READ THE ENTIRE DOCUMENT BEFORE YOU SIGN 

YOU ARE GIVING UP IMPORTANT LEGAL RIGHTS

 

I Agree

 

STATEMENT OF MEDICAL FITNESS:

“I, the participant, represent and warrant that I have no physical or mental infirmities, am not under treatment for any other physical or mental infirmity or chronic ailment or injury of any nature, and have been treated for or diagnosed to have any of the following: mental illness or depression, cardiac or pulmonary conditions or disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related diseases, high or low blood pressure, or any other disability which might in any way affect my ability to participate in skydiving, parachuting, flying or related activities”. If unsure of medical fitness for skydiving I will consult a doctor.  

I Agree
                   

 

WARNING!

SKYDIVING, PARACHUTING, FLYING AND ALL OF ITS RELATED ACTIVITIES ARE DANGEROUS AND THERE ARE RISK INVOLVED IN YOUR PARTICIPATION.  YOU CAN BE SERIOUSLY AND PERMANENTLY INJURED OR EVEN KILLED AS A RESULT OF YOUR PARTICIPATION IN SKYDIVING, PARACHUTING FLYING OR ALL OF ITS RELATED ACTIVITIES.  EACH INDIVIDUAL PARTICIPANT, REGARDLESS OF EXPERIENCE, HAS FINAL RESPONSIBILITY FOR HIS/HER OWN SAFTEY.  

I Agree

 

I have read the attached AGREEMENT named (Tennessee Skydiving LLC. Release of Liability and Assumption of Risk), I understand that it is a legal contract binding on me. I understand what it says. I intend to be bound by what it says and know that when I sign it, I give up important legal rights.

 

 

UNINSURED UNITED PARACHUTE TECHNOLOGIES
TANDEM PARACHUTE JUMPER AGREEMENT

This is an important legal document. Allow yourself sufficient time to carefully read and
understand the entire document, because by signing it, you are agreeing to give up
certain legal rights. 

I Agree
 

In consideration of the Uninsured United Parachute Technologies LLC, doing business as United
Parachute Technology and Skydive Taft, hereinafter referred to as “Corporation”, allowing me the
privilege of utilizing a dual-harness, dual container parachute pack assembly (also known as a “tandem
parachute system”), designed, manufactured and/or assembled by the Uninsured United Parachute
Technologies LLC, Inc., d/b/a United Parachute Technology, for the purpose of performing an intentional
parachute jump, 
I Agree
 

I agree that:
1) Representations, Warranties, & Assumptions of Risk: I understand that parachute jumping will expose
me to the risk of personal injury, property damage and/or death. I understand that the success of my
jump is 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 an/or negligent operation and/or use of the equipment, for
and in consideration of the thrill of participation in this activity, understanding full well that those risks may
include personal injury, property damage, and/or death. 

I Agree
 

2) Exemption and Release from Liability: I exempt and release the following persons and organizations:

 (A) The Corporations and their officers, directors, agents, servants, employees, shareholders,
and other representatives; 

I Agree
 

(B) Manufacturers, designers, and suppliers of component equipment incorporated in the dual-
harness, dual-container parachute pack assembly to which I will be attached during my intentional
parachute jump; 

I Agree
 

(C) Owners, suppliers, and operators of aircraft from which I am to make my intentional parachute
jump; 

I Agree
 
(D) The owner of the dual-harness, dual-container parachute pack assembly, and any of its
components, to which I will be attached during my intentional parachute jump; 
I Agree
 
(E) The operator (“parachutist in command”) of the dual-harness, dual-container parachute pack
assembly to which I will be attached during my intentional parachute jump; 
I Agree
 

(F) 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, and other representatives; 

I Agree
 

(G) The owners and lessees, if any, of land upon and from which the parachute jumping and
related aircraft operations are conducted; and 

I Agree
 

(H) The Toll-Free Skydiving Network, Inc., Uninsured (800) Skydive Leasing Corp., Uninsured
(888) Skydive Leasing Corp., Uninsured (877) Skydive Leasing Corp., 1-800 FREEFALL, and any and all
other 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 an intentional parachute jump. 

I Agree
 
(I) 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); 
I Agree
 

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 jump, 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)-(I) above, or from any other cause. 
I Agree
 

 

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 (I) 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 (I) 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 (I) 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. 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 (I) 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 an/or fault, either active or
passive, of any of the organizations and/or persons described in paragraph 2(A) through (I) 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 (I) 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 therefrom. 

I Agree
 

4) Indemnity Against Claims: I will indemnify, defend, save and hold harmless the organizations
and/or persons described in paragraph 2(A) through (I) 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 (I) above, or from any other cause. 

I Agree
 
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 (I) 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. 
I Agree
 
6) Representations and Warranties as to Medical Condition: I represent and warrant that (a) I
have no physical infirmity, except those listed below, am not under treatment for any other physical
infirmity or chronic ailment or injury of any nature, and have never been treated for any other of the
following: cardiac or pulmonary conditions or diseases, diabetes, fainting spells or convulsions, nervous
disorder, kidney or related diseases, high or low blood pressure; (b) I am not under any medication of any
kind at the present time; and (c) I do/do not (circle one) wear corrective lenses. If I am prescribed
corrective lenses, I agree to wear them during my intentional parachute jump.  
I Agree
 

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 (I) 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. 

I Agree
 
8) Severability/Multiple Waivers: I agree that should one or more provisions in this Agreement be
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 to the Uninsured United Parachute Technologies, LLC, d/b/a United Parachute Technology
shall be enforceable against me by the Uninsured United Parachute Technologies, LLC d/b/a United
Parachute Technology. 
I Agree
 
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. 
I Agree
 

10) Viewing of Videotape: I have viewed and I warrant that I fully understand the accompanying
“Tandem Vector Waiver” video tape. 

I Agree
 

I freely and voluntarily agree to all of the above by signing this
contract on May 28, 2020 at Skydive Tullahoma, Tennessee.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
Second Participant's Signature*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
Third Participant's Signature*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Medical/Physical Conditions

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Tenth Participant's Signature*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Medical/Physical Conditions

Please list any medical or physical conditions that we should be aware of, if none, leave blank
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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