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Cleveland Skydiving Center Waiver 

Warning!

By completing and signing this agreement, the release of the liability and assumption

of risk document, you are giving up important legal rights.

Skydiving, parachuting, and all its related activities can be dangerous, and there

are risks involved in your participation. You can be seriously injured or even

killed as a result of your participation in skydiving or its related activities.


Today's Date: April 19, 2024

 

The length of this document reflects its seriousness.

Carefully read every single word on every single page.

 

CONTRACT

AGREEMENT, RELEASE OF LIABILITY AND ASSUMPTION OF RISK

IN CONSIDERATION of being permitted to utilize the facilities and equipment of CLEVELAND SKYDIVING CENTER, (and its associated entities and facilities) to engage in parachuting activities, ground instruction, flying and related activities, skydiving, freefall, static line jumping, instructor assisted-freefall skydiving, tandem jumping or canopy flying hereinafter collectively referred to as "skydiving activities," as defined in this contract, I HEREBY AGREE AS FOLLOWS:

PARAGRAPH HEADINGS: The headings to the paragraphs to this Agreement are solely for convenience and have no substantive effect on the Agreement, nor are they to aid in the interpretation of the Agreement.

I understand I am not required to make a skydive, but if I desire to do so, I am not required to jump at CLEVELAND SKYDIVING CENTER. I understand there are other businesses and persons offering skydiving within a 150-mile radius of CLEVELAND SKYDIVING CENTER. Those businesses and persons may be listed in the phone book or can be located online.

I Agree

I further understand that I may take this document to my personal attorney for review. I elect not to take this document to my personal attorney for review.

I Agree

PARTIES INCLUDED: I understand that this Agreement, Release of Liability and Assumption of risk includes, but is not limited to CLEVELAND SKYDIVING CENTER - an uninsured corporation, Marcie Smith, an individual; and any partners, officers, board members, club members, agents, associated entities, employees, volunteers, drivers, pilots, parachute riggers, instructors, jumpmasters, the owners of the aircraft (which shall also include, but not limited to airfoils and balloons); the owner of any land utilized for "skydiving activities," including, but not limited to any adjacent property owners, the Gates Airport, and its employees; the United States Parachute Association, and its members; any independent contractor and/or any manufacturer of, owner or entity charged with the maintenance of any piece of equipment which I may use or am using, or is in any way, shape or form being used in connection with my "skydiving activities" at the time of my INJURY or DEATH and anyone involved in any way, shape or form or manner in my "skydiving activities" and specifically included but not limited to tandem, static line, Instructor Assisted Freefall or experimental test parachute jumping to include tandem parachute jumping, hereinafter collectively referred to in this Agreement, Release of Liability and Assumption of Risk as "SKYDIVE".

I Agree

This entire Contract, Release of Liability and Assumption of Risk is expanded to include all parties mentioned anywhere in the body of this document by name or by category, all vendors or suppliers or owners of the materials or equipment used for "skydiving activities," including but not limited to the manufacturer of the equipment, its employees, independent contractors and all other persons or entities in any way associated with any entity mentioned, either specifically or by implication, in the body of this document whom are referred to herein as "SKYDIVE."

I Agree

I understand that this document is a binding contract between myself and the entities described herein as "SKYDIVE" and certify that I am of legal age and under no legal disability that would prevent me from entering into a binding contract

I Agree
 

By signing this document, I acknowledge that I understand and accept that tandem masters, jumpmasters, instructors, parachute packers, load organizers, those charges with the maintenance of the parachutes and the parachute equipment, the maintenance of the aircraft, and the pilots are independent contractors. As independent contractors, no other entity, including but not limited to those coming under the heading of "SKYDIVE" can be held responsible for the independent contractors actions, including but not limited to gross negligence, ordinary negligence and willful and/or wanton misconduct. I accept this limitation.

I Agree

RISKS CONTEMPLATED: This Agreement is made in contemplation of all "skydiving activities," which for the purposes of this agreement shall include but not limited to all occurrences contemplated or not contemplated, foreseen and unforeseen, likely or unlikely to occur, including but not limited to instruction, parachute jumping, tandem or experimental test parachute jumping, ground instruction, flying and related activities, the exit from the aircraft, skydiving, freefall, static line parachuting, Instructor Assisted Freefall skydiving, canopy opening, time under canopy or not, inside or outside the aircraft, equipment malfunctions of any kind, any rescue operation of attempts by "SKYDIVE," whether on or off the designated landing area, or any facilities used by "SKYDIVE," ground transportation provided to me by any entity in any way associated with "SKYDIVE" and any activity whatsoever in any way, shape or form or manner connected with my "skydiving activities" or my presence on or near the facilities and grounds of "SKYDIVE," including my INJURY or DEATH, even if caused directly or indirectly by negligence of other fault which term shall include but not limited to gross negligence and ordinary negligence on the part of "SKYDIVE." These risks shall be referred to for the purposes of this Agreement as "skydiving activities."

I Agree

NEGLIGENCE: The term negligence as used anywhere in the body of this document shall include, but not limited to gross negligence, ordinary negligence and or willful, wanton or reckless conduct.

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 eliminate or delineate all risks or possibilities or error. therefore, I specifically include in this Release, any INJURY or my DEATH resulting from any occurrence, whether foreseen or unforeseen, and whether contemplated or not contemplated, which is in any way connected with my "skydiving activities" and /or presence on the premises commonly known as Cleveland Skydiving Center and Gates Airport or any other place or entity connected with "SKYDIVE" even if caused by negligence or other fault of "SKYDIVE."

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, including but not limited to my estate and my heirs and any one of any entities that may be able to do or does 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 "SKYDIVE" from any and all claims or obligations whatsoever, foreseen and unforeseen, contemplated and not contemplated, arising out of my participation in "skydiving activities," even if caused by negligence or other fault of "SKYDIVE."

I Agree

RELEASE OF LIABILITY: I hereby release and discharge "SKYDIVE" from any and all liability, claims, demands, or causes of action that I or any person or entity may have for my INJURY or DEATH or other damages arising out of my participation in "skydiving activities" even if caused by negligence or other fault of "SKYDIVE."

I Agree

COVENANT NOT TO SUE: I further agree that I WILL NOT SUE OR MAKE CLAIM against "SKYDIVE" for damages or other loses, including my INJURY or DEATH sustained as a result of my "skydiving activities" even if caused by negligence or other fault of "SKYDIVE."

I Agree

INDEMNIFICATION AND HOLD HARMLESS: I also agree to INDEMNIFY AND HOLD "SKYDIVE" 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 or lawsuit brought as a result of my participation in "skydiving activities," including but not limited to actions brought by myself on behalf of myself or my estate, including but not limited to repayment to "SKYDIVE," even if "SKYDIVE" is claimed or found to be negligent or otherwise at fault.

I Agree
 

ASSUMPTION OF RISK: I understand and acknowledge that "skydiving activities" are inherently dangerous and I EXPRESSLY AND VOLUNTARY 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 NEGLIGENCE OR OTHER FAULT OF "SKYDIVE" including but not limited to equipment malfunction from whatever cause, inadequate training, any deficiencies in the landing area, rescue attempts, the weather, (including but not limited to wind conditions) bad landings, inadequate training, rescue attempts, or any other causes whatsoever, including but not limited to those set forth in other paragraphs of this document, even if those INJURIES or my DEATH are caused by negligence or any fault of "SKYDIVE."

I Agree

I hereby agree to waive and do waive any and all duty of care, whether by omission or commission, or any other duty, which may be owed to me by "SKYDIVE."

I Agree

LIMITATIONS OF WARRANTY: "SKYDIVE" hereby warrants that the equipment provided by "SKYDIVE" has been previously used for "skydiving activities." This warranty is the only warranty made and is made in lieu of any other warranties, expresses or implied, including but not limited to warranty of the merchantability or fitness for particular purpose. In accepting this limitation of warranty, I specifically waive any claim I may make for defect in design, manufacture, workmanship or any other defect in equipment and waive any claim I may have that an alternate design was available and would have been safer or in any way better, or that the design employed failed to comply with industry standards. I have read the above paragraph, acknowledge that I understand it and accept the limitations of warranty.

I Agree

In the event an agent of or claimed agent, independent contractor, or employee of "SKYDIVE" is guilty of willful and/or wanton conduct or misconduct, or any conduct claimed to be or deemed to be outside the scope of this contract/document, by action or law or for any other reason, I agree that the entity's actions shall be beyond the scope of his/her or its employment and not attributable to "SKYDIVE" or any other entity, on any agency theory, or any other theory. this shall also apply to any acts which are alleged to be or are deemed to be willful and wanton on the part of the agent, employee, or any person or entity acting on behalf of or instead of any entity included in the definition of "SKYDIVE."

I Agree

I hereby agree to pay for damages I may cause, to any and all equipment, parachutes, aircraft, grounds or airport properties which may occur during my "skydiving activities".

I Agree

OTHER RECREATIONAL ACTIVITIES: This Agreement shall also be effective for and include any recreational activity which is organized, provided by or in any way associated with "SKYDIVE" or takes place on the grounds of "SKYDIVE," or the property owned by any entity in any way associated with, organized for provided by "SKYDIVE."

I Agree

I hereby authorize "SKYDIVE" or its assigner to take any photographs and videos as they may deem appropriate of myself and to use those photos in such a manner, as they may deem appropriate and specifically waive any interest, propriety 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

In the event it is found that any one portion of this document conflict with any one or more other portion in this document, the interpretation of that portion which is most favorable to "SKYDIVE" shall control.

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. EVEN THOUGH I MAY HAVE FAILED TO CHECK 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.

I Agree

I ELECT NOT TO ATTEMPT TO NEGOTIATE A CHANGE IN THIS AGREEMENT

I Agree

THIS WAIVER MEANS THAT IF YOU SIGN, YOU ARE BOUND BY THIS ENTIRE DOCUMENT. IT MEANS IN THE BROADEST GENERAL TERMS THAT IF YOU SUE "SKYDIVE" YOU CANNOT WIN AND, FURTHER, YOU WILL OWE "SKYDIVE" MONEY, INCLUDING, BUT NOT LIMITED TO ATTORNEY'S FEES, REPAYMENT OF ANY JUDGEMENT OBTAINED AND OTHER EXPENSES INCURRED BY "SKYDIVE" IN DEFENDING YOUR LAWSUIT AND YOU WILL HAVE TO REIMBURSE "SKYDIVE." FOR ANY JUDGEMENT YOU MIGHT GET AGAINST "SKYDIVE" EVEN IF YOUR INJURY OR DEATH IS CAUSED BY THE NEGLIGENCE OF "SKYDIVE." I UNDERSTAND AND AGREE TO BE BOUND BY THIS PARAGRAPH AND ALL OTHERS IN THIS DOCUMENT.

I Agree

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

I Agree

DURATION OF RELEASE: It is my understanding and intention that this Release and Agreement be effective not only for my first jump, but for all subsequent jumps or "skydiving activities" and shall be in full force and effect from the signing of this Agreement until such time as it is cancelled by "SKYDIVE" or myself by certified mail, returned receipt requested, mailed to and received by "SKYDIVE" or myself at least 180 days before cancellation becomes effective.

I Agree

I further agree that any subsequent release signed by me shall include the terms of this release to the extent they are not inconsistent with the subsequent release and that any and all inconsistencies be decided in favor of "SKYDIVE."

I Agree
 

ENFORCEABILITY: I agree that if any portions of this Agreement, Release of Liability and Assumption of Risk are found to be against public policy or unenforceable for any reason, 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 my behalf of myself, my estate, or by anyone or entity who could or does sue because of my INJURY or DEATH.

I Agree

DOCUMENT BROADLY CONSTRUED AND AMBIGUITIES CONSTRUED AGAINST ME. I am, by reading this paragraph, being made aware that the general rule is that this type of document is to be narrowly construed and ambiguities are to be decided against the person or entity preparing the document. I EXPRESSLY WAIVE that rule and I specifically agree that this document be broadly construed in favor "SKYDIVE" and against me AND THAT ALL AMBIGUITIES BE RESOLVED IN FAVOR OF "SKYDIVE."

I Agree

It is further agreed between the parties that no matter where venue lies, any lawsuits shall be filed in the State of Ohio, or such other location as "SKYDIVE" shall specify, on Motion of and at the option of "SKYDIVE." I further agree that at the option of "SKYDIVE" State of Ohio law will control no matter where a case may be filed or my INJURY or DEATH may occur.

I Agree

I GIVE CLEVELAND SKYDIVING CENTER THE AUTHORITY TO USE ANY PHOTOS TAKEN OF ME TO BE USED FOR ANY MARKETING OR ADVERTISING PURPOSES. I UNDERSTAND THAT THESE PHOTOS TAKEN COULD BE POSTED ON SOCIAL MEDIA OR PRINTED IN ANY FORMAT INCLUDING FLIERS, BILLBOARDS AND MAGAZINE PHOTOS. I UNDERSTAND THAT IF I PURCHASE A VIDEO AND OR PHOTO PACKAGE IT COULD TAKE AT LEAST A WEEK TO ARRIVE.

I Agree

I HAVE BEEN GIVEN THE OPPORTUNITY TO READ THIS DOCUMENT. I HAVE DONE SO. I UNDERSTAND ITS CONTENTS. I INTEND THAT I AND MY HEIRS, MY FAMILY AND ANYONE WHO MIGHT ACT ON MY BEHALF IN ANY CAPACITY WHATSOEVER BE BOUND BY ITS TERMS.

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 ANY WAY, SHAPE OR FORM ASSOCIATED WITH MY SKYDIVE, EVEN IF THE ENTITY I INTEND TO SUE HAS CAUSED MY INJURY OR DEATH BY THEIR NEGLIGENCE OR OTHER FAULT.

I Agree
 

TODAY'S DATE: April 19, 2024

Additional Parties Included: I understand that this Agreement, Release of Liability, and Assumption of Risk includes Cabair LLC, Win Win Aviation Inc., Try Skydiving LLC, Eagle Air Transport, Direct Action Aviation, Sky Team Aviation, their owners, agents, associated entities, officers, mechanics, aircraft or other contractors or providers, manufacturers of any and all equipment or parts, an individual, association and its members, all hereinafter to be included in the collectively referred to as Released Parties.

I Agree


First Jumper's Name

First Name*

Last Name*

Phone*
First Jumper's Date of Birth*
First Jumper's Information

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
First Jumper's Signature*
Second Jumper's Name

First Name*

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

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
Third Jumper's Name

First Name*

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

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
Fourth Jumper's Name

First Name*

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

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
Fifth Jumper's Name

First Name*

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

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
Sixth Jumper's Name

First Name*

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

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
Seventh Jumper's Name

First Name*

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

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
Eighth Jumper's Name

First Name*

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

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
Ninth Jumper's Name

First Name*

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

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
Tenth Jumper's Name

First Name*

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

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
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, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
NOTIFY IN CASE OF ACCIDENT, INJURY OR DEATH:

NAME (required): *

RELATIONSHIP (required): *

ADDRESS (required): *

HOME PHONE:

WORK PHONE:

CELL PHONE (required): *
Where did you hear about us?
Experienced Jumpers Only:

USPA Membership Number:

USPA License Number:

USPA Membership Expiration:
Jump Info
Are you here for a tandem skydive?*
No
Yes
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*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

STATEMENT OF MEDICAL FITNESS

"I, the participant, represent and warrant that I have no physical infirmities, except as listed; 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 disease, diabetes, fainting spells or convulsions, nervous disorders, kidney or related disease, 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.  I am not under the influence of any narcotics, alcohol or any other type of medications that could alter or affect my ability to skydive.  If necessary, I have been cleared by a medical professional to skydive and do not have any current injuries that could lead to any further injuries by making a skydive."


WEIGHT (required): *

Infirmities (if none say none) *
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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