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Skydive Allegan (Skydive Inc.) Release of Liability Waiver

This is a legally binding document and MUST be filled out, in its entirety, in order for you to skydive! In addition to providing the necessary information about yourself, you will be required to read and sign ALL of the agreements. Ensure that you thoroughly read ALL of the paragraphs in these agreements because they MUST be individually initialed as well. Please enter ALL information by carefully and legibly printing, except where your signature is required

 

!WARNING!

Skydiving, Parachuting, Flying and all similar and related activities are DANGEROUS AND THERE ARE RISKS INVOLVED IN YOUR PARTICIPATION. You may be SERIOUSLY AND PERMANENTLY INJURED AND/OR KILLED as a result of your participation. Each participant, regardless of experience has final responsibility for his or her own safety.


Statement of Medical Fitness:

a) I, the participant, represent and warrant that I have NO physical infirmities, except as listed below; I am not under treatment for any other physical infirmity or chronic ailment or injury of any nature, and have never been treated for or diagnosed to have any of the following: Cardiac or pulmonary conditions or diseases, diabetes, fainting spells or convulsions, nervous or mental disorders, kidney or related diseases, high or low blood pressures, or any other disability which might in any way affect my ability to participate in skydiving, parachuting, flying, or all similar and related activities.


b) I am not taking any medications of any kind which might in any way affect my ability to participate in skydiving, parachuting, flying, or any and all similar or related activities.

c) I am not under the influence of any alcohol or drugs.

d) I am not pregnant nor do I suspect that I am pregnant.

e) List all infirmities (medical conditions, physical ailments, etc) below. If you do not have any, write NONE.

f) I hereby certify that the personal information I have given above is true and accurate.

 

AGREEMENT, RELEASE OF LIABILITY & ASSUMPTION OF RISK

In consideration for being permitted to utilize the facilities and to participate and engage in, ground instruction, flying, skydiving, and any or all related parachuting or airport activities hereinafter collectively referred to as "Skydiving Activities" conducted by Aerial Delivery Inc., Parachutes LLC, Skydive Inc., Skydive Allegan or any associated entities, I HEREBY AGREE AS FOLLOWS:

PARTIES INCLUDED. I understand that this Agreement, Release of Liability & Assumption of Risk includes and covers Aerial Delivery Inc, Skydive Inc, Skydive Allegan, Parachutes LLC, and any of its agents, officers, employees, volunteers, pilots, instructors, jumpmasters, and contractors, and additionally including but not limited to, Allegan City Airport (Padgham Field), the City of Allegan, Michigan, the owners of any land utilized for Skydiving Activities, adjacent property owners, the United States Parachute Association and its members, any manufacturer, distributor or dealer of any gear or equipment utilized in Skydiving Activities, and anyone directly or indirectly involved in any manner in my Skydiving Activities, specifically including but not limited to tandem skydiving and sport skydiving, hereinafter collectively referred to in this Agreement, Release of Liability and Assumption of Risk as "Covered Parties."


DURATION OF RELEASE. It is my understanding and intention that this Release and Agreement be effective not only for my first skydive but for any subsequent skydives or activities in any way associated with Aerial Delivery Inc, Parachutes LLC, Skydive Inc, and/or Skydive Allegan or any other Covered Parties.


AGREEMENTS. I understand it is agreed between the parties that Skydiving Activities are inherently dangerous and may result in injury or death. It is further agreed between the parties that the unforeseen may happen and that no one may delineate all risks or possibilities of error. Therefore, I specifically include in the Release, any injury resulting from any occurrence, whether foreseen or unforeseen, and whether contemplated or not contemplated, which is in any way connected with my Skydiving Activities or presence at the Allegan City airport or any other place, venue, or entity connected with the Covered Parties.


COVENANT NOT TO SUE. I further agree that I WILL NOT SUE OR MAKE CLAIM against ANY of the Covered Parties for ANY damages or other losses or injuries sustained as a result of my Skydiving Activities even if caused by negligence or other fault of the Covered Parties.


RELEASE OF LIABILITY. I hereby release the Covered Parties, from any and all liability, claims, demands, actions, and causes of actions whatsoever arising out of or related to any loss, damage, or injury, up to and including DEATH, that may be sustained, even if caused by negligence or other fault of the Covered Parties while engaged in any Skydiving Activities, vehicle operations, rescue operations or any and all related but unidentified activities.


ASSUMPTION OF RISKS. I realize and understand the scope, nature, and extent of the risks involved in Skydiving Activities, including the foreseen and the unforeseen, which shall include but not be limited to parachute jumping, tandem or experimental test parachute jumping, ground instruction, flying and related activities, the exit, skydiving, freefall, time under the canopy, the landing, any rescue operations or attempts by the Covered Parties, whether on or off the designated landing area, or any facilities used by Aerial Delivery Inc, Parachutes LLC, Skydive Inc, and/or Skydive Allegan. This agreement shall also include any ground transportation provided to me by any entity in any way associated with Aerial Delivery Inc, Parachutes LLC, Skydive Inc, and/or Skydive Allegan and its operations.


INDEMNIFICATION AND HOLD HARMLESS. I also agree to indemnify, save, and hold the Covered Parties, harmless from all claims, judgments, costs, losses or proceedings of every kind and character specifically including, but not limited to, actual attorney fees and expenses, and to reimburse the Covered Parties for any and all expenses whatsoever incurred in connection with any action brought as a result, either directly or indirectly, of my participation in any Skydiving Activities, including but not limited to, actions brought on by myself, my estate, or on behalf of myself or my estate.  I further agree that, as part of my obligation to indemnify and hold the Covered Parties harmless from all claims, judgments and costs, I and/or anyone who brings an action on my behalf shall post a bond in the amount of $10,000.00 in favor of the Coverd Parties. 


PARTIES BOUND BY THIS AGREEMENT. It is my understanding and intention that this Agreement, Release of Liability & Assumption of Risk be binding not only on myself, but on anyone or any entity, including but not limited to my estate and my heirs, that or who 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 Covered Parties, from any and all claims or obligations, foreseen and unforeseen, contemplated and not contemplated, whatsoever arising in any way from my participation in Skydiving Activities, even if caused by the negligence or other fault of the Covered Parties.


DUTY OF CARE. I hereby 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 Covered Parties.


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 or law, that only the portion found to be unenforceable shall fail and that all remaining portions shall remain in effect and be valid and enforceable, and 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.


FAVOR AGREEMENT. It is my intention and my agreement that in all cases, this document be broadly construed in favor of the Covered Parties and against me and that any and all ambiguities or questions are resolved in favor of the Covered Parties.


IMAGE REPRODUCTION. I hereby authorize Aerial Delivery Inc, Parachutes LLC, Skydive Inc, Skydive Allegan, or its assignees to take any photographs or videos as they may deem appropriate, of myself, or of any parties associated with me, and to use those photographs in such a manner as they see fit and may deem appropriate and specifically waive any interest, proprietary or otherwise, I may have in such photographs or videos.


LEGAL RIGHTS. It has been explained to me, and I understand, that by signing this document I am giving up important legal rights and it is my voluntary intention to do so. I also understand that, if I wish, I may to have my own attorney review this document before I sign it.  Upon its execution, this Agreement, Release of Liability & Assumption of Risk shall be binding against me in favor of the Covered Parties. 


DAMAGE AGREEMENT. I hereby agree to be responsible and to pay for damages to any and all equipment, parachutes, aircraft, supplies or airport properties, which are caused, in whole or in part, by my actions or the actions of any parties associated with me during my Skydiving Activities.


AIRPORT RULES. I understand that this is a working airport with active and ongoing flight operations and I will abide by any rules and regulations set forth pertaining to the airport and airport property. There is no smoking in any building, around any skydiving operations, or in any other areas posted as such. No alcoholic beverages or drugs of any kind are allowed during skydiving operations. No pets are allowed. All children must be under DIRECT adult supervision at all times. I understand that I am responsible for following these rules along with any other rules put in place by any of the Covered Parties and that I am also responsible for any injury or damage caused by the failure to follow these rules either by myself or by any parties associated with me.


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.


First Jumper's Name

First Name*

Middle Name

Last Name*

Phone*
First Jumper's Date of Birth*
First Jumper's Signature*
Second Jumper's Name

First Name*

Middle Name

Last Name*
Second Jumper's Date of Birth*
Third Jumper's Name

First Name*

Middle Name

Last Name*
Third Jumper's Date of Birth*
Fourth Jumper's Name

First Name*

Middle Name

Last Name*
Fourth Jumper's Date of Birth*
Fifth Jumper's Name

First Name*

Middle Name

Last Name*
Fifth Jumper's Date of Birth*
Sixth Jumper's Name

First Name*

Middle Name

Last Name*
Sixth Jumper's Date of Birth*
Seventh Jumper's Name

First Name*

Middle Name

Last Name*
Seventh Jumper's Date of Birth*
Eighth Jumper's Name

First Name*

Middle Name

Last Name*
Eighth Jumper's Date of Birth*
Ninth Jumper's Name

First Name*

Middle Name

Last Name*
Ninth Jumper's Date of Birth*
Tenth Jumper's Name

First Name*

Middle Name

Last Name*
Tenth Jumper's Date of Birth*
Jumper'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*

Confirm Email*
Check to receive information, events, and special offers via email.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
List all infirmities (medical conditions, physical ailments, etc...) below.

If you do not have any, write "NONE". *
USPA Membership and License(s)

USPA Membership Number *

Membership Expiration Date *

License Number
Jump History

Date of Last Skydive *

Total Number of Skydives *
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.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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