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UNDERSTANDING OF AGREEMENT: I HEREBY CERTIFY THAT I HAVE READ AND UNDERSTAND THE ENTIRE CONTENTS OF THE THREE (3) PAGE AGREEMENT, RELEASE OF LIABILITY & ASSUMPTION OF RISK DOCUMENT AND THE WARNING FROM "SKYDIVE INDIANAPOLIS, BUCKET LIST HOLDINGS, LLC": I CERTIFY THAT I INTEND TO BE BOUND BY THE TERMS AND CONDITIONS. I HEREBY STATE THAT I HAVE SIGNED THIS ACKNOWLEDGEMENT OF UNDERSTANDING OF THE RISKS AND RESPONSIBILITIES OF SKYDIVING, I UNDERSTAND THAT I RELEASE SKYDIVE INDIANAPOLIS, BUCKET LIST HOLDINGS, LLC FROM ALL LIABILITY - INCLUDING THAT CAUSED BY ITS NEGLIGENCE OR OTHER FAULT­ AND I FURTHER STATE THAT I FULLY UNDERSTAND THAT BY SIGNING THESE DOCUMENTS THAT I INTEND TO FOREVER GIVE UP IMPORTANT LEGAL RIGHTS FOR MYSELF AND/OR MY ESTATE AND HEIRS.

AGREEMENT 

THIS IS AN IMPORTANT LEGAL DOCUMENT. BY SIGNING IT, YOU ARE GIVING UP CERTAIN LEGAL RIGHTS. 

PLEASE READ IT CAREFULLY 

In consideration of Bucket List Holdings LLC, allowing Participant to utilize the facilities and participate in the skydiving/parachuting, aviation, and 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; close physical proximity and physical contact with other persons; 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, infection, damage to property, and/or death.




2. EXEMPTION AND RELEASE FROM LIABILITY. I exempt and release the following persons, corporations, and organizations: Skydive Indianapolis, Bucket List Holdings, LLC, the city of Frankfort, the County of Clinton, Frankfort Municipal Airport, Frankfort-Clinton County Airport authority, Xtreme Aviation LLC, and its officers, directors, shareholders and employees, and further including the pilot provided to fly the Aircraft, Jet Access Group, Inc. and subsidiary companies, and their respective shareholders, members, partners, officers, directors, employees, agents, Little Engine Ventures, LLC, United States Parachute Association, Frankfort Airport Authority, SkyHi Aero LLC and including all of each person's, corporation's, 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, infection, 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. USPA and manufacturers, distributors and dealers of skydiving equipment.



3. COVENANT 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, infection, 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, infection, or my death, arising from 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 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 therefrom.



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. 



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. 



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.



7. APPLICABLE LAW/WAIVER OF JURY TRIAL/VENUE/HEADINGS. I agree that the law 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 Clinton County, Indiana shall be the sole venue for any such suit, which shall be tried non-jury. 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. 



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. 



9. LIFT RATES. I agree to pay the published rates as posted in the office and/or at manifest for each lift. 



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 in favor of Releasees I have signed. 



11. CONTAGIOUS ILLNESSES AND COVID-19. I hereby certify that I do not currently have or suspect that I may have a contagious illness that is communicable through ordinary social or physical contact. I further certify that I do not currently have COVID-19, suspect that I have COVID-19, have symptoms consistent with COVID-19, or within the last two weeks have been in contact with someone infected with COVID-19 (excepting as a health care professional with proper personal protective equipment). I agree that, should any of the foregoing be true on a date I am scheduled or intend to be present at a Skydive Indianapolis facility, activity, or event, I will notify Skydive Indianapolis by calling (800) 990-5509 and will not come to the facility, activity, or event unless I am approved to do so.



12. EQUIPMENT RENTAL AGREEMENT AND LIABILITY. I acknowledge as a licensed skydiver ("Fun Jumper"), am required to execute this Rental Agreement as a condition of my participation, regardless of my current intent to utilize equipment provided by Skydive Indianapolis. This agreement shall govern my use of any and all equipment provided by Releasees, including but not limited to: parachute systems (rigs), main and reserve canopies, jumpsuits, altimeters, goggles, and helmets. In the following clauses, "The Participant" refers to me, the renter.

(A) ASSUMPTION OF FINANCIAL RESPONSIBILITY: The Participant acknowledges that parachute equipment rental from Skydive Indianapolis, LLC constitutes a binding contract of absolute liability for the condition and return of said gear. In the event that any piece of rented equipment is lost, stolen, or damaged beyond normal wear and tear, the Participant agrees to be personally and financially responsible for the full cost of repair or the current retail replacement value of the item(s), at the sole discretion of Skydive Indianapolis, LLC.

(B) COMPONENT LOSS AND CUTAWAYS: In the event of an emergency procedure resulting in a "cutaway" of the parachute system, the Participant assumes the affirmative duty to locate and recover all components, including the main canopy, free-bag, and ripcord handles. Failure to recover these items, for any reason, shall render the Participant liable for the immediate replacement cost of all missing components.

(C) NEGLIGENCE AND IMPROPER USE: Participant acknowledges that they are responsible for the proper configuration and security of all rented gear. This includes, but is not limited to, the proper fastening of helmet chin straps and the correct operation of altimeters and jumpsuits. Any damage or loss resulting from Participant’s failure to secure or properly utilize equipment shall be the sole financial responsibility of the Participant.

(D) INDEMNIFICATION FOR REPAIR: Should any rented item sustain damage during the period of use, the Participant agrees to indemnify Releasees for all incurred repair costs, including shipping and master rigger fees, or the full replacement cost if the equipment is deemed unairworthy or unsafe for future use.



12. 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. 




UNDERSTANDING OF AGREEMENT: I HEREBY CERTIFY THAT I HAVE READ AND UNDERSTAND THE ENTIRE CONTENTS OF THIS THREE (3) PAGE AGREEMENT, RELEASE OF LIABILITY & ASSUMPTION OF RISK DOCUMENT AND THE WARNING FROM "SKYDIVE INDIANAPOLIS, BUCKET LIST HOLDINGS LLC". I CERTIFY THAT I INTEND TO BE BOUND BY THE TERMS AND CONDITIONS. I HEREBY STATE THAT I HAVE SIGNED THIS ACKNOWLEDGEMENT OF UNDERSTANDING OF THE RISKS AND RESPONSIBILITIES OF SKYDIVING, I UNDERSTAND THAT I RELEASE SKYDIVE INDIANAPOLIS, BUCKET LIST HOLDINGS LLC FROM ALL LIABILITY — INCLUDING THAT CAUSED BY ITS NEGLIGENCE OR OTHER FAULT —AND I FURTHER STATE THAT I FULLY UNDERSTAND THAT BY SIGNING THESE DOCUMENTS THAT I INTEND TO FOREVER GIVE UP IMPORTANT LEGAL RIGHTS FOR MYSELF AND/OR MY ESTATE AND HEIRS. 

First Experienced Jumper Name
First Name*
Last Name*
Phone*
First Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
First Experienced Jumper Signature*
Second Experienced Jumper Name
First Name*
Last Name*
Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
Third Experienced Jumper Name
First Name*
Last Name*
Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
Fourth Experienced Jumper Name
First Name*
Last Name*
Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
Fifth Experienced Jumper Name
First Name*
Last Name*
Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
Sixth Experienced Jumper Name
First Name*
Last Name*
Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
Seventh Experienced Jumper Name
First Name*
Last Name*
Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
Eighth Experienced Jumper Name
First Name*
Last Name*
Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
Ninth Experienced Jumper Name
First Name*
Last Name*
Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
Tenth Experienced Jumper Name
First Name*
Last Name*
Experienced Jumper Date of Birth*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
Yes
Experienced 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*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card
Driver's License / ID Card Number*
Issuing State*
Licensed Jumper Information
Total Number of Jumps *
Date of Last Jump *
USPA Number *
USPA Expiration Date *
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*
Date of Birth
Information
Please list any physical infirmities (if none, type NONE) *
Do you wear corrective lenses?*
No
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.


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