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SKYDIVE MIDWEST SKYDIVING CENTER, INC.,
dba SKYDIVE MIDWEST

Skydive Midwest
PO Box 733
Sturtevant, WI 53177
1-877-DIVE-OUT

RELEASE AND WAIVER OF LIABILITY, COVENANT
NOT TO SUE, AND INDEMNIFICATION AGREEMENT

I UNDERSTAND THAT THE FOLLOWING DOCUMENT IS A RELEASE AND WAIVER OF LIABILITY, COVENANT NOT TO SUE, AND INDEMNIFICATION AGREEMENT ("AGREEMENT"), WHICH I AGREE TO CAREFULLY READ IN ITS ENTIRETY, FULLY STUDY, AND AGREE TO BE BOUND BY ITS CONTENTS.  I AM AWARE OF THE POTENTIAL AND THE REAL DANGERS INCIDENTAL TO ENGAGING IN SKYDIVING, PARACHUTE JUMPING AND RELATED ACTIVITIES, INCLUDING THE RISK OF SERIOUS AND PERMANENT INJURIES AND DEATH.  I AM AWARE THAT BY SIGNING THIS DOCUMENT, I AM ENTERING INTO A BINDING CONTRACT, AND I AM THEREBY GIVING UP IMPORTANT LEGAL RIGHTS, AND IT IS MY INTENTION TO DO SO.  I UNDERSTAND THAT THE FOLLOWING DOCUMENT WILL CONTRACTUALLY BIND ME TO THE TERMS I AGREE TO BELOW.

By my signature below, I indicate that I have read and fully understand the above acknowledgment, and I agree that I will carefully read the following Agreement.

Signature:


Date: May 6, 2025

IT IS RECOMMENDED AND HIGHLY ENCOURAGED THAT YOU SEEK COMPETENT LEGAL COUNSEL BEFORE INITIALING OR SIGNING THIS RELEASE AND WAIVER OF LIABILITY, COVENANT NOT TO SUE, AND INDEMNIFICATION AGREEMENT. 

1.    THIS IS A LEGAL DOCUMENT

       My initials or signatures, where indicated, are my acknowledgment of the contents of the paragraph preceding my initials or signature, and by said initials or signature I am indicating that I have read the subject preceding paragraph, and that I fully understand, and agree to be bound by the contents of this Release and Waiver of Liability, Covenant Not to Sue, and Indemnification Agreement (hereinafter referred to in this document as the “Agreement”).

 

2.    FAMILIARITY WITH THE ENGLISH LANGUAGE

       I know how to read, write, and understand the English language, or have used the services of a competent translator, sufficiently to understand this document and to fully appreciate its nature and the consequences of each and every provision contained in this Agreement and the consequences of my consent thereto.

 

3.    DEFINITION: “SKYDIVING, PARACHUTE JUMPING AND RELATED ACTIVITIES.”  As used in this Agreement, the term “Skydiving, Parachute Jumping and Related Activities”, whenever and wherever used, shall be deemed to include, but not to be limited to, all activities in any way related to skydiving, parachuting, parachute packing, parachute use, freefall, wingsuit use, canopy flight, aircraft passenger operations, aircraft flight and ground operations, motor vehicle operations and any and all activities occurring on or about any location from which, or to which, skydiving or parachute jumping is taking place, has taken place, is contemplated or is intended to take place, or may, unintentionally, take place, and including but not limited to Skydiving, Parachute Jumping and Related Activities at or in the area at, around and/or above the Sylvania Airport. I agree that it is difficult to describe all activities that may be included in the term “Skydiving, Parachute Jumping and Related Activities” and that this term shall, therefore, be interpreted broadly and inclusively and not be limited to the above-stated activities.

 

4.    DEFINITION:  “RELEASED PARTIES”.  As used in this Agreement, the term “Released Parties,” whenever and wherever used in this document, shall be deemed to include, individually and collectively, the following parties: Skydive Midwest Skydiving Center, Inc., dba Skydive Midwest, Keith George, AGL Services LLC, Direct Action Aviation LLC, Direct Action Aviation Management and Logistics, Inc., and the United States Parachute Association, and any and all directors, officers, owners, shareholders, members, volunteers, employees, agents, independent contractors, heirs, representatives, successors and assigns of the aforementioned persons and entities.    
                                                           


5.    DEFINITION:  “AFFILIATES”.  As used in this Agreement, the term “Affiliates”, whenever and wherever used in this document, shall be deemed to include, individually and collectively, the following parties who or which have business affiliations with the Released Parties: Sylvania Airport, LLC, Sun Path Products, Inc., Aerodyne Research, LLC, Skydiving Services, LLC, Win Win Aviation, Inc., Win Aviation Maintenance, Inc., Performance Designs, Inc., Uninsured United Parachute Technologies, LLC, and United Parachute Technology, Inc., all other similarly situated parties which have business affiliations with the Released Parties, and any and all directors, officers, owners, shareholders, members, volunteers, employees, agents, independent contractors, heirs, representatives, successors and assigns of the aforementioned persons and entities. 

 

6.    CONSIDERATION
        For and in consideration of my being permitted by the hereinbefore defined Released Parties to make one or more jumps and to participate in the hereinbefore defined Skydiving, Parachute Jumping and Related Activities, involving one or more of the hereinbefore defined Released Parties, and the use of the associated facilities and equipment, and for other good and valuable consideration the receipt and sufficiency of which is hereby acknowledged, I hereby agree to be bound by all of the provisions of this Agreement, except to the extent that I have purchased relief from some provisions herein pursuant to Section 14 hereof.

 

7.    NATURE OF THE ACTIVITY AND ASSOCIATED RISKS

       I UNDERSTAND THAT SKYDIVING, PARACHUTE JUMPING AND RELATED ACTIVITIES ARE DANGEROUS ACTIVITIES WHICH CAN AND SOMETIMES DO RESULT IN BODILY INJURY OR DEATH TO PARTICIPANTS.  I UNDERSTAND THAT I WILL BE PARACHUTING FROM AN AIRCRAFT IN FLIGHT, WHICH IS A DANGEROUS THING TO DO.  I UNDERSTAND THAT I MAY BE INJURED OR KILLED, EVEN IF I DO EVERYTHING I WAS TRAINED TO DO, through my own fault or negligence, or through the fault or negligence of others, or through the failure of a component or components of the parachute systems, which I may from time to time use in Skydiving, Parachute Jumping and Related Activities, to function properly. The risks involved include, but are not limited to:

  • partial or complete failure of the parachute system, or any of its components, 
  • partial or complete failure of the airplane, and/or of other equipment utilized for Skydiving, Parachute Jumping and Related Activities, 
  • hard parachute openings, inadvertent or premature parachute openings,
  • improper parachute packing,
  • falling out of the harness in the air,
  • hard landings,
  • mid-air collisions between participants,
  • mid-air collisions between a participant and an aircraft,
  • mid-air collisions between a participant and another parachute canopy or associated components,
  • collisions between a participant and a person or object on the ground,
  • risks arising because of air to ground or air to air communication failures, or wind and/or weather changes,
  • the negligence of pilots, instructors, parachute packers, other parachutists, other parachutist students, spectators, rescue personnel, and others in any way involved with my Skydiving, Parachute Jumping and Related Activities, or any of them, or of others who are present at the location where my Skydiving, Parachute Jumping and Related Activities occur,    
  • equipment which has previously been used for skydiving,
  • weather related causes,
  • negligent rescue causes, and
  • any and all other causes which may or may not be known at this time but which may become known  in the future and which may cause, directly or indirectly, my injury or death.    

                                            

8.    AWARENESS OF RISKS INVOLVED

a.    I realize that I can die as a result of my participation in any and all phases of Skydiving, Parachute Jumping and Related Activities.    
                                         

b.    I realize that minor and major injuries can result from my participation in any and all phases of Skydiving, Parachute Jumping and Related Activities.    
                                             

c.    I am willing to risk my life while participating in Skydiving, Parachute Jumping and Related Activities, regardless of fault from causes, including, but not limited to, negligence of one or more of the persons involved in these activities.    
                                           

d.    I am willing to risk major or minor injury to any or all parts of my body, or death, while participating in Skydiving, Parachute Jumping and Related Activities, regardless of fault, including, but not limited to, negligence of one or more of the persons or entities involved in these activities.

               

e.    I understand that there is not now, nor will there ever be, a perfect parachute system, a perfect airplane, a perfect pilot, a perfect parachute packer, a perfect instructor, or a perfect student, and that each of the foregoing and others involved in the process of enabling me to make a parachute jump can, and possibly will, fail to perform as intended.  

 

f.    I understand that the aircraft which is used for my Skydiving, Parachute Jumping and Related Activities may be operated under FAA regulations which permit its engines to be operated in excess of the manufacturer’s recommendations of time between overhauls (“TBO”) and that the aircraft’s engine or engines may, in fact, exceed the manufacturer’s recommended TBO.                                                                      

9.    ASSUMPTION OF RISK

       I KNOW AND FULLY APPRECIATE THAT SKYDIVING, PARACHUTE JUMPING AND RELATED ACTIVITIES EXPOSE ME TO THE RISK OF PERSONAL INJURY AND EVEN DEATH. I FULLY APPRECIATE THE DANGERS, AND I VOLUNTARILY, EXPRESSLY, ASSUME THESE RISKS.  With full knowledge and understanding of the foregoing, and with full understanding of the potential dangers and possible consequences of my participation in Skydiving, Parachute Jumping and Related Activities, I hereby, of my own free will and without inducements, promises or statements other than those contained in this Agreement, expressly assume all risks of any nature whatsoever for any death, injury, or other damages to myself, my property, and the person and the property of others, which may arise out of my involvement in Skydiving, Parachute Jumping and Related Activities, or from my use of the above-mentioned facilities, or equipment, or which may be caused, directly or indirectly, by any persons whomsoever or any cause whatsoever, except as otherwise provided in Section 10 hereof.      
                                        

10.    LIMITATION AND DISCLAIMER OF WARRANTIES

        THE RELEASED PARTIES HEREBY WARRANT that, to the best of their knowledge and belief, the equipment provided by the Released Parties, and any of them, meets and/or complies with applicable Federal Aviation Administration (“FAA”) Regulations and Standards for equipment to be used for skydiving, parachute jumping, and related 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 PURPOSE, WHICH THE RELEASED PARTIES SPECIFICALLY DISCLAIM.    
                                                 

11.    RELEASE AND WAIVER OF ALL CLAIMS

         I, FOR MYSELF AND FOR MY SPOUSE, HEIRS, REPRESENTATIVES, ASSIGNS, SUCCESSORS, AND ADMINISTRATORS, HEREBY EXPRESSLY RELEASE AND WAIVE ANY AND ALL CLAIMS RELATED TO SKYDIVING, PARACHUTE JUMPING, AND RELATED ACTIVITIES FOR NEGLIGENCE, PRODUCTS LIABILITY, STRICT LIABILITY, BREACH OF IMPLIED WARRANTIES OF FITNESS FOR USE AND MERCHANTABILITY, AND FOR, (WHETHER IN CONTRACT OR IN TORT, OR OTHERWISE) WHICH I MAY PRESENTLY OR HEREAFTER HAVE, INCLUDING, BUT NOT LIMITED TO, ANY AND ALL CLAIMS FOR NEGLIGENCE, WHETHER PASSIVE OR ACTIVE, AND INCLUDING, WITHOUT LIMITATION, NEGLIGENT RESCUE OPERATIONS, PRODUCTS LIABILITY, STRICT LIABILITY, BREACH OF IMPLIED WARRANTIES OF FITNESS FOR USE AND MERCHANTABILITY, OR INCIDENTAL OR CONSEQUENTIAL DAMAGES, WHICH I MAY, AT ANY TIME, HAVE AGAINST THE HEREINBEFORE DEFINED RELEASED PARTIES AND AFFILIATES, EXCEPT AS OTHERWISE PROVIDED IN SECTION 10 HEREOF.  I DO THIS WITH FULL UNDERSTANDING THAT NO ONE CAN GUARANTEE THAT THE EQUIPMENT UTILIZED IN THE SKYDIVING, PARACHUTE JUMPING AND RELATED ACTIVITIES WILL NOT FAIL, OR THAT IT WILL PERFORM AS INTENDED.  

    I FURTHER AGREE FOR MYSELF AND FOR MY SPOUSE, HEIRS, ASSIGNS, HEIRS, ASSIGNS, REPRESENTATIVES, SUCCESSORS AND ADMINISTRATORS THAT NEITHER I, NOR ANY OF MY SPOUSE, HEIRS, ASSIGNS, REPRESENTATIVES, SUCCESSORS OR ADMINISTRATORS WILL SEEK REIMBURSEMENT OR INDEMNIFICATION FROM ANY RELEASED PARTY OR AFFILIATE, OR THE RELEASED PARTIES OR AFFILIATES, OR ANY OF THEM, FOR ANY INSURANCE PAYMENTS OF ANY KIND, OR FOR REIMBURSEMENT FOR ANY EXPENSES, INCLUDING BUT NOT LIMITED TO MEDICAL EXPENSES AND FUNERAL AND BURIAL EXPENSES, WHICH MAY BE INCURRED BY ME IN CONNECTION WITH MY SKYDIVING, PARACHUTE JUMPING AND RELATED ACTIVITIES, EXCEPT AS OTHERWISE PROVIDED IN SECTION 10 HEREOF.  

 I hereby acknowledge that I am here being advised that, if I have been scuba diving involving my diving sufficiently deeply, within 24 hours of making a parachute jump, the combination of the two may well have an adverse medical effect on my body.

 
                                                 

12.    COVENANT NOT TO SUE

         I AGREE NEVER TO INSTITUTE ANY SUIT OR ACTION AT LAW OR OTHERWISE AGAINST ANY OF THE RELEASES PARTIES OR AFFILIATES, OR TO ASSIST IN THE PROSECUTION OF ANY CLAIM FOR DAMAGES OR ANY CAUSE OF ACTION WHICH I MAY HAVE BY REASON OF INJURY TO MY PERSON OR ANY PROPERTY, INCLUDING BUT NOT LIMITED TO SKYDIVING, PARACHUTE JUMPING AND RELATED ACTIVITIES, WHETHER CAUSED BY THE NEGLIGENCE AND/OR FAULT, EITHER ACTIVE OR PASSIVE, OF ANY OF THE RELEASED PARTIES OF AFFILIATES, EXCEPT AS OTHERWISE PROVIDED IN SECTION 10 HEREOF.  I further expressly agree that I will never raise any claim against any of the Released Parties or Affiliates for product liability, failure to warn, negligence, 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 Released Parties or Affiliates, or any of them, except as otherwise provided in Section 10 hereof. I further agree that my spouse, 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 Released Parties or Affiliates, nor shall they initiate or assist in the prosecution of any claim for damages or cause of action which I, my spouse, heirs, executors, personal representatives, and/or anyone else claiming on my behalf may have by reason of injury to my person or any property, or my death, arising from Skydiving, Parachute Jumping and Related Activities, whether caused by the negligence and/or fault, either active or passive, of any of the Released Parties or Affiliates, except as otherwise provided in Section 10 hereof.

 

13.    INDEMNIFICATION

         I HEREBY AGREE TO INDEMNIFY, DEFEND, PROTECT, SAVE AND HOLD HARMLESS THE RELEASED PARTIES AND AFFILIATES, AND EACH OF THEM, FROM ANY AND ALL LOSSES, CLAIMS, ACTIONS OR PROCEEDINGS OF EVERY KIND AND CHARACTER RELATED TO SKYDIVING, PARACHUTE JUMPING, AND RELATED ACTIVITIES BY ANY AND ALL THIRD PARTIES, AND/OR THEIR PROPERTY, WHETHER ARISING IN CONTRACT OR IN TORT, OR OTHERWISE, INCLUDING BUT NOT LIMITED TO CLAIMS FOR COMPENSATION, INCIDENTAL CONSEQUENTIAL, PUNITIVE, AND OTHER DAMAGES, DAMAGES FOR WRONGFUL DEATH, PRODUCTS LIABILITY OR NEGLIGENCE, WHETHER PASSIVE OR ACTIVE, AND INCLUDING BUT NOT LIMITED TO NEGLIGENT RESCUE, AND FOR ATTORNEYS FEES, ANY OR ALL OF WHICH MAY ARISE DIRECTLY OR INDIRECTLY AS A RESULT OF (1) MY BREACH OF ANY OF THE COVENANTS OF THIS AGREEMENT, OR (2) FROM MY OWN NEGLIGENCE, AND/OR FAULT, EITHER ACTIVE OR PASSIVE, OF ANY OF THE ORGANIZATIONS AND/OR PERSONS HEREINABOVE DESCRIBED AS RELEASED PARTIES OR AFFILIATES, EXCEPT AS OTHERWISE PROVIDED IN SECTION 10 HEREOF.

         I also hereby agree to indemnify, defend, protect, save and hold harmless the Released Parties and Affiliates, and each of them from any and all claims for damages, fines, demands, and attorney’s fees and other damages and/or compensation, which may be made by third parties against any of the Released Parties or Affiliates, resulting from my Skydiving, Parachute Jumping and Related Activities, except as otherwise provided in Section 10 hereof.

 

14.    OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS

             I understand that I may purchase, and have been given an opportunity to purchase, from Skydive Midwest Skydiving Center, Inc., relief from the RELEASE AND WAIVER OF ALL CLAIMS, COVENANT NOT TO SUE, and INDEMNIFICATION provisions contained in Sections 11, 12, and 13 of this Agreement for an additional payment of FIVE HUNDRED DOLLARS ($500.00).  I understand and agree that this purchase option does not constitute a contract of insurance but constitutes a negotiated release ONLY of the provisions contained in Sections 11, 12, and 13 of this Agreement that would otherwise be binding against me in this contract, and that all other provisions of this Agreement shall remain in full force and effect.    

15.    RELEASE AND WAIVER INTERPRETATION    
          I EXPRESSLY WAIVE ANY RULE OF LAW RESOLVING CONTRACTUAL AMBIGUITIES IN MY FAVOR AND AGAINST THE RELEASED PARTIES AND AFFILIATES, being advised hereby that I have an opportunity to consult with competent legal counsel prior to signing this document, and having voluntarily chosen not to do so.  I understand and agree that this Agreement Applies to all phases of my involvement in Skydiving, Parachute Jumping and Related Activities, and I agree that this document shall not be broadly construed against any and all of the Released Parties and Affiliates and in my favor, and that any and all ambiguities shall not be resolved in my favor and against any and all of the Released Parties and Affiliates referred to in this Agreement.  

16.    VALIDITY/ENFORCEMENT IN WHOLE AND IN PART

         I understand and agree that this document is a legally binding contract. I further agree that should any Court determine that any clause or provision of this contract is illegal or otherwise unenforceable, such determination shall not affect the validity and enforceability of the remaining provisions hereof, all of which shall remain in full force and effect. I further agree that if any portion of this document is found to be against public policy, that only that portion shall fail. 

17.    LEGAL AGE TO CONTRACT    
          I hereby state that I am of lawful age to enter into this contract (18 YEARS OF AGE OR OLDER) and am legally competent to execute this Agreement and I further understand that the terms contained herein are contractual in nature, and are not mere recitals.    
                         

18.    CONTINUATION OF OBLIGATIONS    
          I hereby agree and acknowledge that all of the terms and conditions of this Agreement shall be periodically renewed and shall continue in full force and effect now and in the future at all times during which I participate in Skydiving, Parachute Jumping and Related Activities and shall be binding upon my spouse, heirs, executors, administrators, personal representatives and/or anyone else claiming on my behalf.

19.    WAIVER OF JURY TRIAL AND CONSENT TO CHOICE OF LAW AND VENUE    

         The procedural and substantive law of the State of Wisconsin shall apply to any and all issues involving the construction, interpretation and validity of this Agreement, and Wisconsin procedural and substantive law shall govern any dispute between the parties hereto arising from the activities covered by this Agreement, if suit is brought against any of the Released Parties or Affiliates.  I hereby expressly waive my right to a jury trial and agree that the State courts of Racine County, Wisconsin shall be the sole venue for any suit or action arising from the activities covered by this Agreement.

20.    NO MODIFICATION OF AGREEMENT

        This Agreement shall not be amended, modified, or altered without prior express written consent of  Skydive Midwest.

21.    MERGER OF ANY OTHER PRIOR AGREEMENT

       This Agreement contains the entire agreement of the parties hereto with respect to the release from liability of the Released Parties and Affiliates, and all prior understandings and agreements, whether written or oral, between the parties hereto relating to the release from liability of the Released Parties and Affiliates are merged in this Agreement or superseded hereby; provided further, however, that if I have executed, or in the future execute, any other agreement or agreements containing provisions relating to the release from liability of the Released Parties and Affiliates, in connection with the Skydiving, Parachute Jumping and Related Activities, I agree that the agreement which provides the most protection from liability and/or suit to the Released Parties and Affiliates, and any and each of them, shall be deemed to be controlling.

22.    TITLES AND SUBTITLES

         Titles of the sections are placed herein for convenient reference only and shall not to any extent have the effect of modifying, amending, or changing the expressed terms and provisions of this Agreement.

I HAVE CAREFULLY READ THIS ENTIRE RELEASE AND WAIVER OF LIABILITY, COVENANT NOT TO SUE, AND INDEMNIFICATION AGREEMENT, FULLY UNDERSTAND IT, AND I AGREE TO BE BOUND BY ITS CONTENTS. I FULLY UNDERSTAND THE POTENTIAL AND THE REAL DANGERS INCIDENTAL TO ENGAGING IN SKYDIVING, PARACHUTE JUMPING AND RELATED ACTIVITIES, INCLUDING THE RISK OF SERIOUS AND PERMANENT INJURIES AND DEATH.  I AM AWARE THAT BY SIGNING THIS DOCUMENT, I AM ENTERING INTO A BINDING CONTRACT, AND I AM THEREBY GIVING UP IMPORTANT LEGAL RIGHTS, AND IT IS MY INTENTION TO DO SO.  I UNDERSTAND THAT THIS DOCUMENT CONTRACTUALLY BINDS ME TO THE TERMS I HAVE AGREED TO HEREINABOVE.

     I AM FURTHER AWARE THAT I SHOULD SEEK COMPETENT LEGAL COUNSEL PRIOR TO SIGNING THIS DOCUMENT, AND BY MY SIGNATURE BELOW, IN ADDITION TO AGREEING TO ALL OF THE TERMS, CONDITIONS AND COVENANTS CONTAINED IN THIS DOCUMENT, I HAVE EITHER CONSULTED COMPETENT LEGAL COUNSEL PRIOR TO SIGNING THIS DOCUMENT, OR I HAVE VOLUNTARILY CHOSEN NOT TO DO SO.

Signature:

Date: May 6, 2025
                         

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YOU ARE NOW SIGNING A SEPARATE WAIVER

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PARACHUTE JUMPING APPLICATION
(TANDEM JUMP COURSE)

      I (“THE APPLICANT”) AM BY THIS DOCUMENT APPLYING TO SKYDIVE MIDWEST SKYDIVING CENTER, INC., dba SKYDIVE MIDWEST (“SKYDIVE MIDWEST”) TO ACCEPT ME FOR ENROLLMENT IN SKYDIVE MIDWEST’S TANDEM JUMP COURSE, PROVIDING INSTRUCTION ON, PREPARATION FOR, AND MY ACCOMPLISHMENT OF, A TANDEM PARACHUTE JUMP FROM AN AIRCRAFT IN FLIGHT (“THE TANDEM JUMP COURSE”).  I UNDERSTAND AND AGREE THAT SKYDIVE MIDWEST’S ACCEPTANCE OF THIS PARACHUTE JUMPING APPLICATION (“THE APPLICATION”) WILL BE ON THE FOLLOWING TERMS AND CONDITIONS.   

1.    THIS IS A LEGAL DOCUMENT

       My signature, where indicated, is my acknowledgment of the contents of the Application, and of my full understanding of, and agreement to be bound by, its contents.

2.    FAMILIARITY WITH THE ENGLISH LANGUAGE

       I know how to read, write, and understand the English language, or have used the services of a competent translator, sufficiently to understand this document and to fully appreciate its nature and the consequences of each and every covenant contained in this Agreement and the consequences of my consent thereto.

3.    DEFINITIONS    
       As used in this Application, the term “Skydiving, Parachute Jumping and Related Activities” whenever and wherever used in this document, shall be deemed to include, but not to be limited to, all activities in any way related to skydiving, parachuting, parachute packing, parachute use, freefall, wingsuit use, canopy flight, aircraft passenger operations, aircraft flight and ground operations, motor vehicle operations and any and all activities occurring on or about any location from which, or to which, skydiving or parachute jumping is taking place, has taken place, is contemplated or is intended to take place, or may, unintentionally, take place, and including but not limited to Skydiving, Parachute Jumping and Related Activities at or in the area at, around and/or above the Sylvania Airport.  I agree that it is difficult to describe all activities that may be included in the term “Skydiving, Parachute Jumping and Related Activities” and that this term shall, therefore, be interpreted broadly and inclusively and not be limited to the above-stated activities.

4.    DATE AND TERMS OF TANDEM JUMP COURSE

       The Tandem Jump Course is to take place on the date listed below, unless otherwise agreed by the Applicant and Skydive Midwest, or unless the Course is postponed, and “rain checks issued” for a future jump date, as deemed advisable in the sole discretion of Skydive Midwest, on the basis of circumstances including but not limited to inclement weather and other unforeseen adverse conditions, or as requested by me, in either of which event Skydive Midwest shall have the discretion to make or decline to make a full or partial refund of any Tuition which has been charged and collected from me by Skydive Midwest.  Skydive Midwest shall also have the discretion to make or decline to make a partial refund of Tuition collected from the Applicant in the event of equipment, operational, or other failure which results in the inability to produce acceptable copies of any photos and/or videos the charges for which have been included in the Tuition collected from the Applicant.

5.    CONTENT OF TANDEM JUMP COURSE

      The Tandem Jump Course will include a program of instruction that will prepare the Applicant to make his or her first parachute jump from an aircraft in flight, including aircraft safety, aircraft exit and stabilized freefall technique, landing technique, and various other emergency and safety procedures.    

6.    DEPOSIT    
       I understand that Skydive Midwest requires a separate, nonrefundable, fee to cover the administrative costs of processing this Application, which is to be paid at the time of my making a reservation for a parachute jump.

7.    TUITION

       The Tuition for the Tandem Jump Course is to be paid by the Applicant upon the execution of this Application and the Release and Waiver of Liability, Covenant not to Sue, and Indemnification Agreement (the “Waiver and Release”) which I am being asked to sign for the benefit of Skydive Midwest.  

8.    TUITION REFUND AND REFUSAL POLICY

       In the event that Skydive Midwest determines at the conclusion of the Course that the Applicant is for any reason incapable of safely attempting his or her first parachute jump, Skydive Midwest reserves the right to prohibit the Applicant from attempting any parachute jump, in which event Skydive Midwest shall not be required to refund any part of the Tuition.  Skydive Midwest reserves the right to postpone the Applicant’s Tandem Jump Course and  “issue a rain check” for a future jump date, as deemed advisable in the sole discretion of Skydive Midwest, and to refuse to accept an Application of, and to conduct a Tandem Jump Course for, any Applicant who is disorderly, rude, using illegal or otherwise dangerous substances, or otherwise disrupting the orderly conduct of the operations of Skydive Midwest.    

VIDEO/PHOTOS: Skydiving is an extreme sport and equipment failure is a possibility. Please understand that video/photos are not guaranteed. Skydive Midwest will offer partial refunds for equipment malfunctions.


9.    TANDEM JUMPS

       I understand that I will be wearing a separate harness, which may need to be adjusted by the jump master or others involved with my Skydiving, Parachute Jumping and Related Activities. If my jump is a tandem jump, I understand that the jump master and/or tandem master will attach my harness to his/her harness and that this will put my body in close proximity to that of the tandem master. It may be necessary during my Skydiving, Parachute Jumping and Related Activities, that I be touched in ways that would, in other circumstances, be deemed offensive, however, I specifically agree to this physical contact between me and the tandem instructor, and/or the jump master and/or others involved in my Skydiving, Parachute Jumping and Related Activities.

10.    NO INSURANCE COVERAGE

        The applicant understands that Skydive Midwest, together also with the following parties who or which have business affiliations with Skydive Midwest, Keith George, AGL Services LLC, Direct Action Aviation LLC, Direct Action Aviation Management and Logistics, Inc., the United States Parachute Association, Sylvania Airport, LLC, Sun Path Products, Inc., Aerodyne Research, LLC, Skydiving Services, LLC, Win Win Aviation, Inc., Win Aviation Maintenance, Inc., Performance Designs, Inc., Uninsured United Parachute Technologies, LLC, and United Parachute Technology, Inc., all other similarly situated parties which have business affiliations with the Released Parties, and any and all directors, officers, owners, shareholders, members, volunteers, employees, agents, independent contractors, heirs, representatives, successors and assigns of the aforementioned persons and entities, may well carry no insurance of any kind to cover any loss which the Applicant may sustain, including medical insurance, property insurance, wage loss insurance, or any other insurance to cover any loss I may sustain.  

11.    MEDICAL CONDITIONS

         I understand and agree that I must seek independent medical advice regarding any questions regarding my physical and mental ability to participate in skydiving, parachute jumping, and related activities.  I further understand that none of the parties described in  Section 9 of this Application employ a doctor to give medical advice to determine whether or not a past or current injury or condition should prohibit or affect my participation in Skydiving, Parachute Jumping and Related Activities. 

12.    STATEMENT RE DIAGNOSIS OR TREATMENT

      I understand and agree that, if I now have any of the following medical conditions, whether or not I should proceed to make a parachute jump is something I should address with a health professional prior to making the jump:

a.    Cardiac or pulmonary condition or disease
b.    High or low blood pressure
c.    Fainting spells, convulsions, epilepsy or narcolepsy
d.    Ear infection, hearing loss or impairment, inner ear disorders or sinus problems
e.    Nervous or mental disorders
f.     Diabetes
g.    Back injury
h.    Kidney disease or related disorders
i.     Alcohol or drug addiction / dependency
j.     Any orthopedic problem
k.    Artificial limb(s) or glass eye
l.     Recent surgical procedure
m.   Contagious disease, infection or virus, or a cold
n.    Subluxation or joint dislocation
o.    Pregnancy or other related conditions
p.    Any other mental or physical condition which might interfere with, prohibit, or detrimentally affect my participation in Skydiving, Parachute Jumping and Related Activities

13.    NON-USE OF ALCOHOL, CONTROLLED SUBSTANCES AND OTHER DRUGS

         I hereby state and affirm that I will not use, and have not used, alcohol, controlled substances, or other drugs, prescription of otherwise, within 12 hours prior to or during my skydiving, parachute jumping, and related activities.

14.    CHANGE IN MEDICAL/HEALTH CONDITION    
         I hereby agree to inform Skydive Midwest, in writing, of any changes in my medical condition, including but not limited to any requirement for me to take any drug, prescription or otherwise, or to seek the advice of any medical doctor, chiropractor, or any other health care professional, and I shall not participate further in Skydiving, Parachute Jumping and Related Activities until all of said medical doctors, chiropractors, and other health care professionals have determined that I may again participate in said Skydiving, Parachute Jumping and Related Activities.

15.    PHOTO/VIDEO RELEASE

         I understand and agree that any photos and/or video taken of me at, around, and/or above the facilities of Skydive Midwest, and/or by Skydive Midwest, or by any of its agents or representatives, may be used for promotional and any and all other purposes by Skydive Midwest, and/or its agents and assigns, as they may see fit to do, without compensation to me, or to anyone claiming on my behalf, and without my further permission I further hereby agree that any copyright for any such photos and/or video taken of me shall lie with Skydive Midwest, or its assignees, and that none of such photos and/or video shall be considered to be a “work for hire.” I also consent to the use of my name in conjunction with any use of any such photo or video, without compensation to me, or to anyone claiming on my behalf.

16.    OTHER SKYDIVING CENTERS

         I understand that Skydive Midwest is not the only option I have to make a parachute jump, nor are the methods employed by Skydive Midwest the only methods available to enable me to make a parachute jump, and that, even if I am not permitted to make a parachute jump with Skydive Midwest, there are other skydiving centers at which I may make a parachute jump.

17.    ADEQUATE PROVISIONS FOR SURVIVORS

         I understand and agree that, considering my lifestyle, the risks of the Skydiving, Parachute Jumping and Related Activities in which I am about to engage, and the manner in which I am supporting my dependents, if any, I should, prior to engaging in such activities, have made adequate provisions for my spouse, if any, my heirs, if any, and all other persons dependent upon me so that in the event of my death or injury they will not suffer a substantial  financial loss for which I have not made adequate provisions.

18.    DURATION

         I understand that the willingness of Skydive Midwest to provide the parachute jumping services subject of this Application depends on my execution of the above-referenced Waiver and Release contemporaneously with my accomplishing a parachute jump, and I agree that, if I do not accomplish a jump on the date of my signing the Waiver and Release, I will re-sign the Waiver and Release on the date on which I am actually to accomplish the jump.  This Application shall in any event lapse 60 days after the date of my signing it.

19.    LEGAL AGE TO CONTRACT    
         I hereby state that I am of lawful age to enter into this contract (18 YEARS OF AGE OR OLDER)  and am legally competent to execute this Agreement, and I further understand that the terms contained herein are contractual in nature, and are not mere recitals. I have executed this Agreement of my own free will.

DATE: May 6, 2025
SIGNATURE:

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YOU ARE NOW SIGNING A SEPARATE WAIVER

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ASSUMPTION OF RISK AND WAIVER OF LIABILITY RELATING TO CARONAVIRUS/COVID-19

 

    The novel coronavirus (“COVID-19”) has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people

 

    Skydive Midwest Skydiving Center, Inc. d/b/a Skydive Midwest (“SDMW”) has put in place preventative measures to reduce the spread of COVID-19 while participating in Skydiving, Parachute Jumping and Related Activities; however, SDMW cannot guarantee that you will not become infected with COVID-19 while participating in Skydiving, Parachute Jumping and Related Activities. Further, attendance and participation in Skydiving, Parachute Jumping and Related Activities could increase your risk of contracting COVID-19.  For the purpose of this Release, “Skydiving, Parachute Jumping and Related Activities,” whenever and wherever used, shall be deemed to include, but not be limited to, all activities in any way related to skydiving, parachuting, parachute packing, parachute use, freefall, wingsuit use, canopy flight, aircraft passenger operations, aircraft flight and ground operations, motor vehicle operations, access to SDMW facilities and any and all activities occurring on or about any location from which, or to which, skydiving or parachute jumping is taking place, has taken place, is contemplated or is intended to take place, or may, unintentionally, take place, and including but not limited to Skydiving, Parachute Jumping and Related Activities at or in an area at, around and/or above the Sylvania Airport. I agree that it is difficult to describe all activities that may  be included in the term “Skydiving, Parachute Jumping and Related Activities” and that this term shall, therefore, be interpreted broadly and inclusively and not be limited to the above stated activities. 

 

    I hereby acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by participating in Skydiving, Parachute Jumping and Related Activities and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed or infected by COVID-19 during participation in Skydiving, Parachute Jumping and Related Activities may result from the actions, omissions, or negligence of myself and others, including, but not limited to, SDMW employees, representatives, volunteers, agents and/or affiliates. 

 

    In consideration of my participation in Skydiving, Parachute Jumping and Related Activities, I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur as a result of COVID-19 in connection with my participation in Skydiving, Parachute Jumping and Related Activities (“Claims”). I, for myself and for my spouse, heirs, representatives, assigns, successors, and administrators hereby release, covenant not to sue, discharge, indemnify, and hold harmless Skydive Midwest Skydiving Center, Inc., d/b/a Skydive Midwest, Keith George, AGL Services, LLC, Direct Action Aviation LLC, Direct Action Aviation Management and Logistics, Inc., and the United States Parachute Association, and any and all directors, officers, owners, shareholders, members, volunteers, employees, agents, independent contractors, heirs, representatives, successors and assigns of the aforementioned persons and entities (the “Released Parties”), of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Released Parties, whether a COVID-19 infection occurs before, during, or after participation in any Skydiving, Parachute Jumping and Related Activities. 

 

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABLITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL. 

DATE: May 6, 2025
SIGNATURE: 

 

First Jumper's Name

First Name*

Last Name*

Phone*
First Jumper's Date of Birth*
First Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
First Jumper's Signature*
Second Jumper's Name

First Name*

Last Name*
Second Jumper's Date of Birth*
Second Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
Third Jumper's Name

First Name*

Last Name*
Third Jumper's Date of Birth*
Third Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
Fourth Jumper's Name

First Name*

Last Name*
Fourth Jumper's Date of Birth*
Fourth Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
Fifth Jumper's Name

First Name*

Last Name*
Fifth Jumper's Date of Birth*
Fifth Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
Sixth Jumper's Name

First Name*

Last Name*
Sixth Jumper's Date of Birth*
Sixth Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
Seventh Jumper's Name

First Name*

Last Name*
Seventh Jumper's Date of Birth*
Seventh Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
Eighth Jumper's Name

First Name*

Last Name*
Eighth Jumper's Date of Birth*
Eighth Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
Ninth Jumper's Name

First Name*

Last Name*
Ninth Jumper's Date of Birth*
Ninth Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
Tenth Jumper's Name

First Name*

Last Name*
Tenth Jumper's Date of Birth*
Tenth Jumper's Information
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
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.
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
IN CASE OF ACCIDENT OR EMERGENCY NOTIFY (Must NOT be a skydiving member in your group):

NAME: *

RELATIONSHIP: *

PHONE #: *

CELL PHONE #: *
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
OPTION TO PURCHASE RELIEF FROM RELEASES AND WAIVERS*
Corrective Lenses*

(list infirmities, if not, type "none") *
HOW DID YOU HEAR ABOUT US? *
FACEBOOK
INSTAGRAM
TWITTER
YOUTUBE
GOOGLE SEARCH
GOOGLE AD
RADIO
DROVE BY
FRIEND REFERRAL
EVENT/RAFFLE PRIZE
MWR
OTHER

IF YOU SELECTED OTHER, PLEASE ELABORATE.

HEIGHT *

The Tandem Jump Course is to commence on *
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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