WARNING! 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. MEDICAL STATEMENT
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 Utah and Canyonlands Regional Airport, 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, JRSKY INC, UNITED STATES PARACHUTE ASSOCIATION (USPA) AND MANUFACTURERS, DISTRIBUTORS AND DEALERS OF SKYDIVING EQUIPMENT, SORREL RIVER RANCH, CASTLE VALLEY INC (DBA DAYSTAR ADVENTIST ACADEMY AND CASTLE VALLEY FARMS), SPANISH VALLEY HOLDINGS (AND ALL DIRECTORS AND AFFILIATES) BUREAU OF LAND MANAGEMENT, SKYDIVE ARIZONA, CLINT MACBETH, KEITH MACBETH, THEIR AGENTS, EMPLOYEES, INDEPENDANT CONTRACTORS, INSTRUCTORS, JUMP MASTERS, PARACHUTE PACKERS, PARACHUTE RIGGERS, PILOTS USED FOR THE PARACHUTING ACTIVITIES AS WELL AS THE CANYONLANDS REGIONAL AIRPORT AND GRAND COUNTY UTAH (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 NEGLIGIENCE 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. ***************************Please Read Carefully***************************** 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 accept the risks of making an intentional 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 REGIONAL AIRPORT and GRAND COUNTY UTAH and, CITY OF MOAB, and BUREAU 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. 11.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 12. 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 13. Indemnity Against Claims: I will indemnify, defend, save and hold harmless the organizations and/or persons (Released Parties) 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 (Released Parties), or from any other cause. I Agree 14. 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 (Released Parties) 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 15. 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 (Released Parties) , 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 (Released Parties), or from any other cause. I further expressly agree that I will never raise any claim against any of the organizations and/or persons (Released Parties) 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 (Released Parties), 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 (Released Parties), 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 (Released Parties), 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 Certified Skydivers Only: In addition to the AGREEMENT & RELEASE OF LIABILITY I will not cross the runway under 3000Ft AGL (7550F MSL). If I land on the NorthWest side of the runway, I will LAND 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: September 18, 2024 |