SKYDIVING, PARACHUTING, AND ITS RELATED ACTIVITIES CAN BE DANGEROUS AND THERE ARE RISKS INVOLVED IN YOUR PARTICIPATION. YOU CAN BE SERIOUSLY INJURED OR KILLED AS A RESULT OF YOUR PARTICIPATION IN SKYDIVING OR ITS RELATED ACTIVITIES
Please note: After viewing the instructional tape and signing this waiver you are electing to make a skydive. Please realize that skydiving is a weather dependent sport and we will try to jump with you as soon as possible. If you do not get to jump today, you may have to reschedule for another time. You may get a refund at any time before you suit up.
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 and Jumping.
I further certify that I am not on any Regular Medication and have not consumed any Alcoholic Beverages or Drugs within the last twelve (12) hours now and before any jumping activity. I also recognize that it is against Federal, State, United States Parachute Association, SKYDIVE MOAB, LLC and SKYDIVE NEW HAMPSHIRE, LLC and Utah Rules and Regulations to ingest either Alcohol or Drugs while engaging in Parachuting Activities and agree to refrain from doing so.
I certify that I am at least eighteen years of age and have shown proof of my age by State ID, driver’s license, or valid passport.
SKYDIVE MOAB, LLC AND SKYDIVE NEW HAMPSHIRE, LLC - Utah Release Form
THE UNDERLYING DOCUMENT IS A "WAIVER", AN "ASSUMPTION OF RISK AGREEMENT" AND A "RELEASE OF LIABILITY". READ IT CAREFULLY!
SIGNING THIS DOCUMENT DRASTICALLY AFFECTS YOUR LEGAL RIGHTS.
Skydiving is a dangerous sport!
There is no way to eliminate the possibility of serious injury or death.
AGREEMENT AND RELEASE OF LIABILITY
In consideration for being permitted to use the facilities of SKYDIVE MOAB, LLC and SKYDIVE NEW HAMPSHIRE, LLC, and more generally, the facilities and equipment located at the Grand County Canyonlands Field, North Hwy 191, Moab, Utah, and to engage in parachute jumping, ground instruction, flying and all related activities (Hereinafter referred to as "Parachuting Activities"), I hereby agree to the following:
1. I HEREBY RELEASE AND DISCHARGE SKYDIVE MOAB, LLC, SKYDIVE NEW HAMPSHIRE, LLC, UNITED STATES PARACHUTE ASSOCIATION (USPA) AND MANUFACTURERS, DISTRIBUTORS AND DEALERS OF SKYDIVING EQUIPMENT, RED CLIFFS LODGE, SORREL RIVER RANCH, MOAB AIRPARK, RANDY DAY, JULIE WENTZ, CAVEMAN RANCH, BUREAU OF LAND MANAGEMENT, COLIN FRYER, SKYDIVE ARIZONA, CLINT MACBETH, MICHAEL CARPENTER, THEIR AGENTS, EMPLOYEES, INDEPENDENT CONTRACTORS, INSTRUCTORS, JUMP MASTERS, PARACHUTE PACKERS, PARACHUTE RIGGERS, PILOTS USED FOR THE PARACHUTING ACTIVITIES AS WELL AS THE CANYONLANDS FIELD AIRPORT AND GRAND COUNTY (Hereinafter referred to as the “RELEASED PARTIES"), FROM ANY AND ALL LIABILITY, CLAIMS, DEMANDS AND CAUSES OF ACTION FOR INJURIES AND DAMAGES ARISING FROM MY PARTICIPATION IN PARACHUTING ACTIVITIES, INCLUDING BUT NOT LIMITED TO LOSSES CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES.
2. I further agree that I WILL NOT SUE OR MAKE A CLAIM against the Released Parties for damages or other losses sustained as a result of my participation in Parachuting Activities.
3. I also agree to INDEMNIFY AND HOLD THE RELEASED PARTIES HARMLESS from all claims, judgments, and costs, including attorneys' fees, incurred in the connection with any action brought as a result in my participation in Parachuting Activities, including actions based on the negligence of the Released Parties.
4. I understand and acknowledge that Parachuting Activities have inherent dangers that no amount of care, caution, instruction or expertise can eliminate. I EXPRESSLY AND VOLUNTARILY ASSUME ALL RISKS OF PERSONAL INJURY OR DEATH SUSTAINED WHILE PARTICIPATING IN PARACHUTING ACTIVITIES WHETHER OR NOT CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES
5. 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.
6. I agree that any action arising out of my Parachuting Activities are filed in the state of Utah.
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7. I realize that I can opt to stop after reading this form and get a full refund. I choose to SKYDIVE and assume the risk.
SKYDIVE MOAB, LLC AND SKYDIVE NEW HAMPSHIRE, LLC – Utah Release Form
8. I certify that I have watched the video introduction explaining the risks of making a skydive and parachute jump which has further explained the information contained in these documents.
9. I do not hold the Released Parties responsible for damage or loss of my property while with SKYDIVE MOAB, LLC and SKYDIVE NEW HAMPSHIRE, LLC and CANYONLANDS AIRFIELD and GRAND COUNTY and, CITY OF MOAB, and BEAURO OF LAND MANAGEMENT, and STATE OF UTAH SCHOOL AND INSTITUTIONAL TRUST LANDS ADMINISTRATION
10. I hereby grant the Released Parties and their designees my consent to create video and audio recordings of me and to take photographs of me (both in the air and on the ground) (“Recordings”). I understand that the Recordings may be used for any purpose (including, among others, advertising, promotion and marketing products or services). I grant permission to the Released Parties, their designees, their sponsors, and their successors and assignors to use my appearance, name, voice, and likeness (at their election) in connection with the Recordings and in any and all manner and media throughout the world in perpetuity. I agree that the Recordings may be combined with other images, text, and graphics, and may be cropped, altered or modified.
Certified Skydivers Only: In addition to the AGREEMENT & RELEASE OF LIABILITY
I will not cross the runway under 2000Ft AGL. If I land on the NorthWest side of the runway, I will walk away from the runway towards the windsock, and wait for a safety vehicle to pick me up. If I violate the FAR (105.23C) regarding runway crossing I agree to leave the airport immediately and I forfeit and registration or associated jump costs. I recognize if I do not comply with these rules I will face repercussions by the FAA
I promise to abide by all United States Parachute Association, Basic Safety Regulations, Federal Aviation Regulations and State and Local laws.
I promise to maintain all parachute equipment by keeping it current, legal and airworthy. [intial]
I HAVE CAREFULLY READ AND INITIALED THIS AGREEMENT & RELEASE OF LIABILITY, AND CERTIFY THAT I FULLY UNDERSTAND IT. I AM SIGNING THIS AGREEMENT & RELEASE OF LIABILITY OF MY OWN FREE WILL.
Today's Date: October 16, 2019