Loading...

REGISTRATION FORM

PARACHUTE GATINEAU-OTTAWA SKYDIVE

WARNING!

SKYDIVING, PARACHUTING AND 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.

Date: May 8, 2025

 

Medical Statement

I recognize that the sport of parachuting is a strenuous, athletic endeavor, requiring me to be in good physical condition. I hereby certify that I do not suffer from any physical infirmities or chronic illness which would affect my ability to engage in parachute training or jumping, and that I am not now under any treatment for any of the following:

  1. Cardiac or pulmonary condition or disease.
  2. High or low blood pressure.
  3. Fainting spells or convulsions.
  4. Inner or middle ear problems.
  5. Nervous disorder.
  6. Diabetes.
  7. Kidney or related diseases.
  8. Shortness of breath

I further certify that I am not on any regular medication and have not taken any alcoholic beverages or drugs within eight (8) hours. I also recognize that it is against the Canadian Sport Parachuting Association (CSPA) and PARACHUTE GATINEAU-OTTAWA SKYDIVE’s rules and regulations to take either alcohol or drugs while engaging in parachuting activities and agree to refrain from doing so.

May 8, 2025

Assumption of Risk Agreement and Release of Liability

In consideration of PARACHUTE GATINEAU-OTTAWA SKYDIVE, allowing me the privilege of utilizing the facilities and equipment of PARACHUTE GATINEAU-OTTAWA SKYDIVE to engage in parachute jumping and or skydiving, ground instruction, flying and all other related activities incidental to parachute jumping and skydiving, hereinafter collectively referred to as "parachuting activities",

I, hereby agree as follows:

REPRESENTATIONS, WARRANTIES AND ASSUMPTION OF RISK

I understand that I will be performing a parachute jump or jumps/skydiving and or flying as an observer. I ALSO UNDERSTAND THAT PARACHUTE JUMPING AND OR FLYING WILL EXPOSE ME TO RISK OF PERSONAL INJURY AND DEATH. I understand that the success of my jump is dependent upon the perfect functioning of the aircraft from which I intend to jump and the parachute system, and neither the aircraft nor the parachute system can be entirely depended upon to function perfectly, but that each of them subject to mechanical malfunction and operator error. I freely and voluntarily choose to assume all risks inherent in parachute jumping, including risks of equipment malfunction or failure to function which may result from some defect in design/manufacture, improper or negligent or use of the equipment, for the thrill of participating in this activity.

I Agree

EXEMPTION FROM LIABILITY

I hereby exempt, release and discharge PARACHUTE GATINEAU-OTTAWA SKYDIVE, their officers, directors, agents, servants, employees, contractors, shareholders, suppliers, pilots, aircraft owners and any/ and all contracted aircraft, manufactures of equipment and the Canadian Sport Parachute Association from any and all liability, claims, demands or cause of action whatsoever that I may hereafter have arising out of any damage, loss or injury to me or my property while participating in my activities contemplated by this agreement, whether such loss, damage or injury results from the negligence.

I Agree

INDEMNITY AGAINST CLAIMS

I will indemnify, save and hold harmless the "RELEASED PARTIES" from any and all losses, claims, or proceedings of every kind and character which may be presented or initiated by any persons or organizations arising directly or indirectly from my parachute jumping.

I Agree

ASSUMPTION OF RISK

Parachuting activities, including ground instruction, parachute jumping, flying and all related activities are inherently dangerous, injuries requiring professional medical care are not uncommon and serious injury or death can and has resulted from participation in parachute activities. Not all of these risks can be foreseen or prepared for, or avoided, to the extent that even if I do everything as I was trained to do and all equipment functions properly, I can still be injured or killed.

I Agree

VOLUNTARY NATURE OF PARTICIPATION

I agree that I am not under any compulsion to ride in or jump from a plane. My participation is only for personal satisfaction and is entirely voluntary.

I Agree

COVENANT NOT TO SUE

I understand and acknowledge that parachuting activities have inherent dangers that no amount of care, caution, instruction or expertise can eliminate and I EXPRESS AND VOLUNTARILY ASSUME ALL RISK OF DEATH OR PERSONAL INJURY SUSTAINED WHILE PARTICIPATING IN PARACHUTING ACTIVITIES WHETHER OR NOT CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES. I agree never to institute any suit or action of law or otherwise against the Released Parties, nor to initiate or assist the prosecution of any injury to my person or to my property arising from activities contemplated by this agreement.

I Agree

CONTINUATION OF OBLIGATION

I agree and acknowledge that the terms and conditions of the foregoing EXEMPTION FROM LIABILITY, COVENANT NOT TO SUE, AND INDEMNIFY AGAINST ALL CLAIMS shall continue in full force and effect now and in the future at all times during which I participate either directly or indirectly in parachute jumping and shall be binding upon my heirs, executors and administrators of my estate.

I Agree

MEDIA RELEASE

I agree that if my image appears on any picture, film or videotape taken at PARACHUTE GATINEAU- OTTAWA SKYDIVE, I am willing to allow PARACHUTE GATINEAU-OTTAWA SKYDIVE to use it for publicity, informational, or entertainment purposes at no charge. I also state my willingness to be named in such materials.

I Agree

INSURANCE

I have been advised and recognize that my parachuting activities are not covered by any personal accident or general liability insurance policy issued to the Released Parties. I understand that as a parachuting student I allowed 10 jumps as a CSPA affiliated member, an affiliation offered by to me by PARACHUTE GATINEAU-OTTAWA SKYDIVE, excluding Tandem Passengers and/or Observer Slots, or as a skydiver with previous experience I am required to belong to the Canadian Sport Parachute Association (CSPA) which membership carries with it for the term of that membership Public Liability and Property Damage Insurance in my name and for my benefit.

I Agree

Please select who will be participating...
AdultMinor
Continue
First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Sexe:*
Male
Female

Weight: *

Height: *
Where did you hear about GO Skydive?*
Choose an option below:
Friends / Family
Google
Facebook
Youtube
Radio
Promo Kiosk
Do you understand that you can be seriously injured or killed from parachuting and all its related activities? *
YES
Do you understand that by signing this document you are giving up important legal rights in exchange for the opportunity to participate in parachuting activities, and that this document can and will be used against you in a court of law? *
YES
In spite of the above warning do you fully consent to all of the terms of this document and sign it with complete understanding and free will? *
YES
First Participant's Signature*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Skydiving Status of Registrant
Membership Type:*

CSPA# / USPA# *

Expiration date: *

License# *

Reserve repack date:
Functional AAD?*
Yes
No
I use GO Skydive equipment
By the following, I authorize my minor child to engage in sport parachuting and/or to participate in any activity related to sport parachuting. I, as well as my child, commit to respect the rules and conditions stated in this document.


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*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Sexe:*
Male
Female

Weight: *

Height: *
Where did you hear about GO Skydive?*
Choose an option below:
Friends / Family
Google
Facebook
Youtube
Radio
Promo Kiosk
Do you understand that you can be seriously injured or killed from parachuting and all its related activities? *
YES
Do you understand that by signing this document you are giving up important legal rights in exchange for the opportunity to participate in parachuting activities, and that this document can and will be used against you in a court of law? *
YES
In spite of the above warning do you fully consent to all of the terms of this document and sign it with complete understanding and free will? *
YES
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!