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Skydive Windy City

2018 Tandem Skydiving Waiver

MEDICAL STATEMENT AND WAIVER

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

STATEMENT OF MEDICAL FITNESS:

I, the participant, represent and warrant that I have no physical or mental infirmities, except as listed below; I am not under treatment for any physical or mental infirmity or chronic ailment or injury of any nature; I 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 disorders, mental illness or depression, kidney problems or related diseases, high or low blood pressure, or any other disability which might in any way affect my ability to participate in skydiving, parachuting, flying, or other related activities.  I will bring a doctor's release for participation in skydiving if I have any conditions I feel may affect my safety and/or health during my skydive.

WARNING! >> SKYDIVING, PARACHUTING, FLYING AND ALL RELATED ACTIVITIES ARE DANGEROUS AND THERE ARE RISKS INVOLVED WITH YOUR PARTICIPATION.

YOU CAN BE SERIOUSLY INJURED OR EVEN KILLED BY PARTICIPATION IN SKYDIVING, PARACHUTING, FLYING AND ALL RELATED ACTIVITIES. EACH INDIVIDUAL PARTICIPANT, REGARDLESS OF EXPERIENCE, HAS THE SOLE AND FINAL RESPONSIBILITY FOR HIS/HER OWN SAFETY. I FURTHER UNDERSTAND THERE IS NO LIABILITY INSURANCE AVAILABLE FOR SKYDIVING, PARACHUTING, FLYING AND ALL RELATED ACTIVITIES AS DEFINED IN THIS DOCUMENT AND ANY/ALL OTHER DOCUMENTS I MAY SIGN.

I will not be under the influence of alcohol in any form. I will not ingest any illegal substances in the 48 hours prior to my skydive. I will not take any prescription or non-prescription medicine that may affect my judgment or my ability to perform. I agree not to skydive under the influence of alcohol or any other drugs.

I have read the attached Agreement, Release of Liability and Assumption of Risk. I understand that it is a legal contract binding on me. I understand the document in its entirety. I intend to be bound by the document and understand that by signing the document I waive important legal rights.

I Agree

 

TANDEM SKYDIVING TERMS AND CONDITIONS

  1. All Tandem students must be at least 18 years of age on the day of their jump and bring a valid government issued photo ID (i.e. driver license or passport) when checking in to skydive.
  2. For safety reasons, tandem students must be under the maximum weight for their height according to our chart. The absolute maximum weight is 270 pounds (as weighed on our scale in the attire you will wear on the skydive). Tandem students between 210 and 239 pounds (still under maximum weight for height according to our chart) will be charged an extra $30.  Tandem students between 240 and 270 pounds (still under maximum weight for height according to our chart) will be charged an extra $50.  Extra charges are due to extra work for instructor, weight in aircraft, and wear & tear on equipment.  If we feel your physical condition or body shape is not appropriate for skydiving, we cannot allow you to jump regardless of your weight or size.  If you are under the maximum weight for your height according to our chart, we are 99% sure you can skydive with us.
  3. You may not be under the influence of any alcohol, drugs, or prescription medication that may affect your judgment or limit your ability to perform. If we feel you are under the influence, or not in an appropriate mental state to skydive, we cannot allow you to jump. If you have a medical release (from a doctor), it will be fully considered.
  4. If weather (or other conditions outside of our control) prevents you from skydiving, you will be allowed to reschedule without penalty for one (1) year from your original reservation (reservations are required for return visit).
  5. There are no refunds. If you cannot go through with your skydive before your class, you may return within one year and make another attempt at no charge (reservations are required). If you cannot go through with your skydive after your class, but before you board the aircraft, you may return within one year and make another attempt for a charge of $10.00 (reservations are required for return visit). If you cannot go through with your skydive after you board the aircraft, you may return within one year to make another attempt for a charge of $80.00 (reservations are required for return visit). If you throw-up on your instructor or equipment, there is a $30.00 equipment cleaning fee.
  6. If you leave the immediate area before your skydive (for any reason), please let the office personnel know. If you miss your skydive because you cannot hear announcements, you may be charged an additional $40.00 to complete your jump.
  7. Skydive Windy City strives to provide a safe family environment, but all children (under 18) must be constantly under direct parental supervision. You and any family/friends (spectators) with you must remain in designated areas unless escorted by dropzone or airport personnel.
  8. No pets (of any kind) are allowed on airport property at any time.  You must make sure anyone (spectators/family/friends) coming with you does not bring a pet or they may be denied entrance.
  9. You may request a specific instructor.  Special requests will be honored whenever possible, but may delay your skydive (to ensure the requested team members are available).
  10. We strive to schedule and operate efficiently to keep time on site below 3 hours, but it is possible it may take longer.
  11. For safety reasons, you may not jump barefoot or in clothing or footwear that is not appropriate for skydiving (including but not limited to sandals, hard-soled shoes or boots, clothing or footwear with hooks or snag points). Lace-up tennis shoes are required.
  12. We do not have a secure place for your valuables. You should leave all valuables in your car or with another member of your party.
  13. Feel free to take pictures (with your own camera) on the ground (provided you stay in designated spectator areas), but for safety reasons, you will not be allowed to skydive with a camera or take it with you in the aircraft.
  14. An airport can be a dangerous place; please refrain from touching or climbing on any aircraft or equipment without express consent from your instructor.
  15. You only need to complete and reply to confirmation email for one waiver per season.  Once you complete this 2018 waiver you may jump as many times as you like in 2018 without completing another waiver.

I Agree

 

AGREEMENT, RELEASE OF LIABILITY, AND ASSUMPTION OF RISK

In consideration of Skydive Windy City allowing me to utilize the facilities and participate in the skydiving, freefall, parachuting, aviation, and/or other related activities (hereinafter referred to as "activities covered by the Agreement), I agree that:

1. ASSUMPTION OF RISK. I know and understand the scope, nature, and extent of the risks involved in the activities covered by this Agreement. I understand these risks include, but are not limited to: equipment malfunction and/or failure to function; defective and/or negligent design and/or manufacture of equipment; improper and/or negligent parachute packing and/or assembly; improper and/or negligent operation and/or use of the equipment; aircraft malfunction and/or negligent aircraft operation; carelessness and/or negligent instruction and/or supervision. I voluntarily, freely and expressly choose to incur all risks associated with the activities covered by this Agreement, understanding that those risks may include personal injury, damage to property, and/or death.

I Agree

2. EXEMPTION(S) AND RELEASE FROM LIABILITY. I exempt and release the following persons, corporations, and organizations: Sky Sports, Inc., doing business as Skydive Windy City, any and all equipment manufacturers, vendors, suppliers, repair facilities or repair persons, any and all aircraft owners, any and all pilots with whom it contracts for flying services; the United States Parachute Association (USPA); the City of Michigan City Indiana, the Michigan City Municipal Airport, Michigan City Board of Aviation Commissioners (BOAC): and including all of each person's, corporations, and organization's officers, agents, servants, employees, representatives, lessors; (hereinafter collectively referred to as Releasees), from any and all liability, claims, demands or actions or causes of action whatsoever arising out of any damage, loss or injury to me or my property, or my death, while upon the premises or aircraft or while participating in any of the activities covered by this Agreement, whether resulting from the negligence and/or other fault, either active or passive, of any of Releasees, or from any other cause.

I Agree

3. COVENANTS NOT TO SUE. I agree never to institute any suit or action at law or otherwise against any of Releasees, or to initiate or assist in the prosecution of any claim for damages or cause of action which I may have by reason of injury to my person or property, or my death, arising from the activities covered by this Agreement, whether caused by the negligence and/or other fault, either active or passive, of any of Releasees, or from any other cause. I further agree that my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf, shall not institute any suit or action at law or otherwise against any of Releasees, nor shall they initiate or assist the prosecution of any claim for damages or cause of action which I, my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf may have by reason of injury to my person or property, or my death, arising from activities covered by this Agreement, whether caused by the negligence and for other fault, either active or passive, of any of Releasees, or from any other cause. I hereby so instruct my heirs, executors, administrators, personal representatives and/or anyone else claiming on my behalf. Should any such suit or action at law or otherwise be instituted against any of Releasees, I agree that such Releasees shall be entitled to recover attorneys' fees and costs incurred in defense of such suit or action, including any appeals there from.

I Agree

4. INDEMNITY AGAINST THIRD PARTY CLAIMS. I will indemnify, save and hold harmless Releasees from any and all losses, claims, actions, or proceedings of every kind and character, including attorney's fees and expenses, which may be presented or initiated by any other persons or organizations and which arise directly or indirectly from my participation in the activities covered by this Agreement, whether resulting from the negligence and/or other fault, either active or passive, of any of Releasees or from any other cause.

I Agree

5. VALIDITY OF WAIVER. I understand and agree that if I institute, or anyone on my behalf institutes, any suit or action at law or any claim for damages or cause of action against any of Releasees because of injury to my person or property, or my death, due to the activities covered by this Agreement, this Agreement can and will be used as evidence in court, and that agreements like this one have been upheld in courts in similar circumstances.

I Agree

6. REPRESENTATIONS AND WARRANTIES. I represent and warrant that (a) I have no physical infirmity, except those listed below, am not under treatment for any other physical infirmity or chronic ailment or injury of any nature, and have never been treated for any of the following: cardiac or pulmonary conditions or disease, diabetes, fainting spells or convulsions, nervous disorder, kidney or related diseases, high or low blood pressure, (b) I am not under any medication of any kind at the present time that may affect my judgment or limit my ability to perform, and (c) If I am prescribed corrective lenses, I agree to wear them during my intentional parachute jump.

I Agree

7. APPLICABLE LAW/WAIVER OF JURY TRIAL/VENUE/HEADINGS. I agree that the laws of the State of Indiana shall apply to issues involving the construction, interpretation, and validity of this Agreement and that Indiana law shall govern any dispute between the parties arising from the activities contemplated by this Agreement. Should this Agreement be violated and suit be brought against any of Releasees, my right to a jury trial is waived, and LaPorte County, Indiana shall be the venue for any such suit. I agree that the headings and subheadings used throughout this Agreement are for convenience only and have no significance in the interpretation of the body of this Agreement.

I Agree

8. SEVERABILITY. I agree that should one or more provisions in this Agreement be judicially determined to be unenforceable, the remaining provisions shall continue to be binding and enforceable against me.

I Agree

9. LIFT RATES / PHOTO RIGHTS I agree to pay the published rates as posted on the website and/or at manifest for each lift depending on the altitude flown on the flight. I agree to allow all photos and/or video taken while at Skydive Windy City to be used by any of Releasees. I also agree that Skydive Windy City is open to the public, and any persons on the premises at the time of my skydive may view a live feed from the airplane, watch me skydive, and take personal pictures and/or video that may include me.

I Agree

10. CONTINUATION OF OBLIGATIONS. I agree and acknowledge that the terms and conditions of this Agreement shall continue in full force and effect now and in the future at all times during which I participate, either directly or indirectly, in the activities covered by this Agreement, and shall be binding upon my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf. This Agreement supersedes and replaces any prior such agreement I have signed.

I Agree

11. ACKNOWLEDGEMENT. I hereby acknowledge that I have read all of the provisions above and fully understand the terms and conditions expressed therein and agree to be bound by such terms and conditions.

I Agree

UNINSURED UNITED PARACHUTE TECHNOLOGIES TANDEM PARACHUTE JUMPER AGREEMENT

In consideration of the Uninsured United Parachute Technologies doing business as United Parachute Technology and Sky Sports, Inc. doing business as Skydive Windy City, hereinafter referred to as Corporation, allowing me the privilege of utilizing a dual-harness, dual container parachute pack assembly (also known as a tandem parachute system), designed, manufactured and/or assembled by the Uninsured United Parachute Technologies, Inc. for the purpose of performing an intentional parachute jump, I agree that:

I Agree

1) Representations, Warranties, & Assumptions of Risk: I understand that parachute jumping will expose me to the risk of personal injury, property damage and/or death. I understand that the success of my jump is dependent upon the perfect functioning of the airplane from which I intend to jump and the parachute system, and that neither the airplane nor the parachute system can be guaranteed to function perfectly. I understand that the airplane and the parachute system are both subject to mechanical malfunctions as well as operator error. I freely, voluntarily and expressly choose to assume all risks inherent in parachute jumping, including, but not limited to, risks of equipment malfunction and/or failure to function, including those which may result from some defect in design, assembly, and/or manufacture as well as those risks arising from improper an/or negligent operation and/or use of the equipment, for and in consideration of the thrill of participation in this activity, understanding full well that those risks may include personal injury, property damage, and/or death.

I Agree

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

I Agree

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

I Agree

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

I Agree

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

I Agree

(D) The owner of the dual-harness, dual-container parachute pack assembly, and any of its components, to which I will be attached during my intentional parachute jump;

I Agree

(E) The operator (parachutist in command) of the dual-harness, dual-container parachute pack assembly to which I will be attached during my intentional parachute jump;

I Agree

(F) If I am making my intentional parachute jump at or near a parachuting/skydiving facility, the owners and operators of that facility, as well as their officers, directors, agents, servants, employees, shareholders, and other representatives;

I Agree

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

I Agree

(H) The Toll-Free Skydiving Network, Inc., Uninsured (800) Skydive Leasing Corp., Uninsured (888) Skydive Leasing Corp., Uninsured (877) Skydive Leasing Corp., 1-800 FREEFALL, and any and all other skydiving referral service business entities, and/ or owners of fictitious name entities which I may have used in locating and/or deciding upon a parachuting/skydiving facility or other location at which to perform an intentional parachute jump.

I Agree

(I) Any other person and/or organization which is or may be liable for any loss or injury to me and or my property, or my death, arising out of my participation in any of the activities covered by this Agreement (as defined below);

I Agree

From any and all liability, claims, demands or actions or causes of action whatsoever arising out of any damage, loss or injury to me or my property, or my death, whether occurring while I am training and/or preparing for my intentional parachute jump, while I am present in aircraft from which the jump is to be made, while I am making my intentional parachute jump, or while I am engaged in related activities (hereafter referred to as activities covered by this Agreement), whether such loss, damage, injury, or death results from the negligence and/or other fault, either active or passive of any of the persons and/or organizations described in paragraphs 2(A)-(I) above, or from any other cause.

I Agree

3) Covenant Not to Sue: I agree never to institute any suit or action at law or otherwise against any of the organizations and/ or persons described in paragraph 2(A) through (I) above, or to initiate or assist in the prosecution of any claim for damages or cause of action which I may have by reason of injury to my person or property, or my death, arising from the activities covered by this Agreement, whether caused by the negligence and/or fault, either active or passive, of any of the organizations and/or persons described in paragraph 2(A) through (I) above, or from any other cause. I further expressly agree that I will never raise any claim against any of the organizations and/or persons described in paragraph 2(A) through (I) above for product liability, failure to warn, negligence, breach of warranty, breach of contract, or strict liability, regardless of whether my claims for damages or injuries are alleged to result from the fault or negligence of the parties released. I further agree that my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf, shall not institute any suit or action at law or otherwise against any of the organizations and/or persons described in paragraph 2(A) through (I) above, nor shall they initiate or assist the prosecution of any claim for damages of cause of action which I, my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf may have by reason of injury to my person or property, or my death arises from the activities covered by this Agreement, whether caused by the negligence an/or fault, either active or passive, of any of the organizations and/or persons described in paragraph 2(A) through (I) above, or from any other cause, I hereby so instruct my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf. Should any suit or action at law or otherwise be instituted in violation of this Agreement against any of the organizations and/or persons described in paragraph 2(A) through (I) above, I agree that such organizations and/or persons shall be entitled to recover, in addition to any other damages which may be incurred, reasonable attorneys fees and costs incurred in defense of such suit or action, including any appeals therefrom.

I Agree

4) Indemnity Against Claims: I will indemnify, defend, save and hold harmless the organizations and/or persons described in paragraph 2(A) through (I) above from any and all losses, claims, actions or proceedings of every kind and character, including attorneys fees and expenses, which may be presented or initiated by any persons and/or organizations and which arise directly or indirectly from my participation in the activities covered by the Agreement, whether resulting from the negligence and/or other fault, either active or passive, or any of the organizations and/or persons described in paragraph 2(A) through (I) above, or from any other cause.

I Agree

5) Validity of Waiver: I understand that if I institute or anyone on my behalf institutes, any suit or action at law or any claim for damages or cause of action against any of the organizations and/ or persons described in paragraph 2(A) through (I) above because of injury to my person or property, or my death, due to the activities covered by this Agreement, this Agreement can and will be used in court, and that such agreements have been upheld in courts in similar circumstances.

I Agree

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

I Agree

7) Waiver of Jury Trial/Applicable Law/Venue/Headings: I agree that the law of the State of Florida shall apply to issues involving the construction, interpretation, and validity of this Agreement, and that Florida law shall govern any dispute between the parties arising from the activities covered by this Agreement. In the event this Agreement is violated and suit is brought against any of the organizations and/or persons described in paragraph 2(A) through (I) above, I waive my right to a jury trial, and agree that Volusia County, Florida shall be the sole venue for any suit or action arising from the activities covered by this Agreement. I agree that the headings and sub-headings used throughout this Agreement are for convenience only and have no significance in the interpretation of the body of this Agreement.

I Agree

8) Severability/Multiple Waivers: I agree that should one or more provisions in this Agreement be judicially determined to be unenforceable, the remaining provisions shall continue to be binding and enforceable against me. If I have executed any other agreement containing provisions relating to the exemption and/or release from liability and/or covenant not to sue in connection with the activities covered by this Agreement, I agree that the agreement, which provides the most protection from liability and/or suit to the Uninsured United Parachute Technologies, Inc, shall be enforceable against me by the Uninsured United Parachute Technologies

I Agree

9) Continuation of Obligations: I agree and acknowledge that the terms and conditions of this Agreement shall continue in force and effect now and in the future at all times during which I participate in the activities covered by this Agreement, and shall be binding upon my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf. This Agreement supersedes and replaces any prior such agreement I have signed.

I Agree

10) Viewing of Video: I have viewed and fully understand the Tandem Vector Waiver video prior to making my tandem skydive (the video you watched at the beginning of this waiver).

I Agree

I freely and voluntarily agree to all of the above by signing this contract with Skydive Windy City of Michigan City, Indiana

I Agree

First Jumper Name

First Name*

Middle Name

Last Name*

Phone*
First Jumper Date of Birth*
First Jumper Information

Height (feet/inches) *

Weight (pounds) *
First Jumper Signature*
Second Jumper Name

First Name*

Middle Name

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

Height (feet/inches) *

Weight (pounds) *
Third Jumper Name

First Name*

Middle Name

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

Height (feet/inches) *

Weight (pounds) *
Fourth Jumper Name

First Name*

Middle Name

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

Height (feet/inches) *

Weight (pounds) *
Fifth Jumper Name

First Name*

Middle Name

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

Height (feet/inches) *

Weight (pounds) *
Sixth Jumper Name

First Name*

Middle Name

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

Height (feet/inches) *

Weight (pounds) *
Seventh Jumper Name

First Name*

Middle Name

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

Height (feet/inches) *

Weight (pounds) *
Eighth Jumper Name

First Name*

Middle Name

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

Height (feet/inches) *

Weight (pounds) *
Ninth Jumper Name

First Name*

Middle Name

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

Height (feet/inches) *

Weight (pounds) *
Tenth Jumper Name

First Name*

Middle Name

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

Height (feet/inches) *

Weight (pounds) *
Jumper 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*
Emergency Contact

Emergency Contact's Name*

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

Driver's License / ID Card Number*

Issuing State*
INFIRMITIES OR EXCEPTIONS
You must be 18 years or older to fill out this waiver. *
I am 18 years of age or older today.
Do you have any infirmities or exceptions that may prevent a safe skydive? (if yes, you must bring a doctor's release note).*
No
Yes
Do you have any medical conditions that Skydive Windy City should know about?*
No
Yes

List any infirmities or medical conditions that may prevent you from making a safe skydive. (do not enter anything if you have no infirmities or medical conditions to report)
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

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

Height (feet/inches) *

Weight (pounds) *
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 (for an extra charge). 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. A fee may 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.<br> An email will be sent to the address you provided after completing this waiver. You must verify that email address by following instructions contained in that email.


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