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RELEASE OF LIABILITY

AGREEMENT NOT TO SUE

This is an important legal document certain rights are given up upon signing

PLEASE READ CAREFULLY BEFORE SIGNING

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PARACHUTE JUMP AGREEMENT

THIS AGREEMENT is entered into by and between Skydive Northstar, LLC an Minnesota Limited Liability Company, (hereinafter referred to as "Northstar" and I, the individual signing this waiver (hereinafter referred to as "STUDENT" or "SKYDIVER").

IN CONSIDERATION of the mutual promises, covenants, and agreements contained herein, (the receipt, mutuality, and sufficiency of which is hereby acknowledged), and for other good and valuable consideration, the parties hereby agree as follows:

1. ENROLLMENT: Northstar agrees to accept the STUDENT for enrollment in the First Jump Course to commence on the date of this agreement at its instructional facilities in Waseca, Minnesota

2. PROGRAM OF INSTRUCTION: Northstar agrees to provide a program of instruction that will prepare the STUDENT to make his/her first parachute jump from an aircraft in flight. Such instruction will include, but not limited to: aircraft familiarization and safety; parachute equipment familiarization; aircraft exit and stabilized freefall technique; activation of the main canopy and the reserve canopy; control of the parachute canopy; landing techniques; various emergency and safety procedures.

3. THE PARACHUTE JUMP: Northstar will provide equipment, aircraft and supervisory personnel for the STUDENT'S initial parachute jump.

4. TUITION:  The tuition for the course is to be paid by the STUDENT upon the execution of this Agreement. In the event that Northstar determines at the conclusion of the course that the STUDENT is, for any reason, incapable of safely attempting the initial parachute jumps, Northstar shall not be required to refund the tuition.

5. WARRANTIES: Northstar represents warrants that all instruction in the course shall be under the supervision of a qualified personnel in accordance with the United States Parachute Association guidelines.

6. AGREEMENT, RELEASE OF LIABILITY & ASSUMPTION OF RISK: The STUDENT agrees to execute simultaneously here within a document entitled Agreement, Release of Liability  & Assumption of Risk; the parties agree that such a document shall be incorporated by reference into this Agreement as if set for in haec verba.

7. CONTINUATION OF OBLIGATIONS: The STUDENT agrees and acknowledges that the terms and conditions of this Agreement and those of the Agreement, Release of Liability & Assumption of Risk shall continue in full force and effect for the first parachute jump and all subsequent jumps conducted by Northstar; the STUDENT agrees that all obligations herein shall be binding upon his/her heirs, assigns, guardians, and all representatives of his/her estate.

8. LEGAL RIGHT: It had been explained to me, and I understand, that by signing this document I am giving up important legal rights. I acknowledge that this document was available to me in advance and that I have had sufficient time and opportunity to consult an attorney. I hereby state that it is my intention to give up such rights as are waived by this document.

9. UNDERSTANDING OF AGREEMENT: THE STUDENT HEREBY CERTIFIED THAT HE/SHE HAS READ AND UNDERSTANDS THE CONTENTS OF THIS DOCUMENT AS WELL AS THE CONTENTS OF THE COMPANION DOCUMENT (AGREEMENT, RELEASE OF LIABILITY & ASSUMPTION OF RISK); THAT HE/SHE HAS FREELY AND VOLUNTARILY CHOSEN TO ACCEPT THE PROVISIONS OF THESE DOCUMENTS AND TO ACCEPT THE RISKS OF SKYDIVING.

10. LEGAL AGE: I Acknowledge that I am of 18 years of age or older. I agree to provide proof of age with valid identification and understand by not doing so, I will not be allowed to skydive at Skydive Northstar.

IN WITNESS WHEREOF the parties have here unto set their hands to and initialed or signed 4 pages of this 4 page document this day:August 8, 2020 

REFUND POLICY

  • Please note that deposits are non-refundable.
  • Rainchecks will be issued for all situations resulting in no skydiving.
  • Rainchecks are non-refundable, non-transferable and are good for one year from date of issue.

I have read and understand the above refund policy:

MEDICAL STATEMENT

I recognize that the sport of skydiving is a strenuous, athletic activity that requires me to be in good physical condition. I hereby represent and warrant that (a) I have no physical infirmity or chronic illness or any other disability; (b) that I am not now, nor have I ever been treated for, or diagnosed to have any of the following: cardiac or pulmonary condition or disease, abnormal blood pressure, fainting spells, convulsions, nervous disorders, kidney or related diseases, diabetes, shortness of breath, hearing loss, or any other disability which in any way affect my ability to safely participate in training, flying, skydiving, and related activities

I Agree
 

I further represent and warrant that I am not currently taking any medications, prescription or otherwise that will impair my ability to skydive.

I Agree
 

I further represent and warrant that I have not consumed any alcohol and have not smoked, inhaled or otherwise consumed any illegal substances in the past eight hours.

I Agree
 

I further represent and warrant that I am NOT PREGNANT.

August 8, 2020

AGREEMENT, RELEASE OF LIABILITY & ASSUMPTION OF RISK AGREEMENT

IN CONSIDERATION of being permitted to utilize the equipment and facilities of Skydive Northstar, an Minnesota Limited Liability Company, (and its' associated entities) and to engage in parachuting activities (including, but not limited to, ground instruction, flying and related activities, skydiving, freefall, freeflying, tandem jumping, relative work, CRW), hereinafter collectively referred to as "skydiving," I HEREBY AGREE AS FOLLOWS

1. It is agreed by and between the parties that "skydiving" is inherently dangerous and may result in injury or death. It is further agreed between the parties that the unforeseen may happen and that it is not possible for any person or entity to delineate all the risks or possibilities of error that can occur while engaging in "skydiving". Therefore, I specifically include in this Agreement, and agree to be bound thereby, a Release of Liability for any injury resulting from any occurrence, whether foreseen or unforeseen, and whether contemplated or not contemplated; I agree to Assume any and all risks associated with "skydiving"; and I agree to all other covenants and promises enumerated herein through and including paragraph 19.

I Agree
 

RELEASE OF LIABILITY

2. PARTIES RELEASED FROM LIABILITY: It is my understanding and intent that this agreement shall release and discharge any and all liability of:

  • Dan Gieser
  • Kasey Matejcek
  • Lina Matejcek
  • Skydive Northstar LLC or the owner of the aircraft, whoever that may be
  • Uninsured United Parachute Technologies, LLC
  • S.E Inc d/b/a Strong Enterprises
  • The United States Parachute Association (USPA)
  • The City of Waseca MN USA
  • Waseca Municipal Airport
  • The owner on record of any land utilized for skydiving, including the beneficiaries of any Minnesota Land Trust orinter vivos Trust
  • All vendors and/or suppliers of materials or equipment for skydiving, including, but not limited to, the manufacturer of the equipment, its officers, directors, shareholders, and all associated entities, including officers, directors, shareholders, partners, employees, and all other persons in any way associated with any entity mentioned in the body of this document.
  • Any other party or entity mentioned in the body of this document by name or by category.
  • Anyone involved in any manner with skydiving including, but not limited to, your instructor(s) & videographer(s).

For each corporation named herein, this release specifically includes the corporation's directors, officers, shareholders, agents, representatives, servants, employees, pilots, jumpmasters, owners of the aircraft, volunteers, parachute riggers and packers and associated entities. It is my specific intent to release from any and all liability and claims, demands, causes, of action that I may have at any time whatsoever for any and all injuries and/or damages of any nature against any person and/or entity herein named arising from my participation in any parachuting activity. All parties enumerated in this paragraph shall hereinafter be collectively referred to in this agreement, release of liability & assumption of risk as "released parties".

ASSUMPTION OF RISK AGREEMENT

3. ASSUMPTION OF RISK: I understand and acknowledge that "skydiving" is inherently dangerous and that I hereby EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF DEATH OR PERSONAL INJURY SUSTAINED WHILE PARTICIPATING IN "SKYDIVING" WHETHER SUCH RISK IS FORESEEN OR UNFORESEEN, CONTEMPLATED OR NOT CONTEMPLATED, AND WHETHER OR NOT CAUSED BY THE NEGLIGENCE, IN ANY DEGREE, OR OTHER FAULT OF "RELEASED PARTIES", including, but not limited to, equipment malfunction from whatever cause, inadequate training, any deficiencies in the landing area, rescue attempts, bad landings, or any other injury I may sustain even if caused by the negligence, in any degree, or any fault of "released parties".

I Agree
 

4. I understand that canopy maneuvers, including, but not limited to, riser turns, down planes, canopy relative work, low hook turns, down wind landings, wind turbulence, wind shear, and other canopy maneuvers are inherently dangerous and have possible injuries and dangers that include, but are not limited to abrasions, fractures, disfigurement, contusions, loss of limbs, paralysis, neurological impairment, and even death, and that no amount of care, caution, instruction, or experience by "released parties" can eliminate, and I EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF DEATH OR PERSONAL INJURY SUSTAINED WHILE PARTICIPATING IN THESE ACTIVITIES WHETHER OR NOT CAUSED BY THE NEGLIGENCE OF THE "RELEASED PARTIES".

I Agree
 

OTHER COVENANTS AND PROMISES

5. 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 "skydiving". I also agree to INDEMNIFY AND HOLD HARMLESS the "released parties" from any and all claims, judgments, and costs, including attorney's fees and court costs incurred in connection with any action brought as a result of my participation in "skydiving". I further agree on behalf of myself and my heirs AGREE TO PAY ANY AND ALL REASONABLE LEGAL FEES TO RELEASE ALL PARTIES FOR THEIR DEFENSE PRIOR TO INITIATION OF ANY LEGAL ACTION ON MY PART OR BEHALF.

I Agree
 

6. INDEMNIFICATION AND HOLD HARMLESS: I hereby agree to Indemnify and Forever Save and Hold "released parties" harmless from all claims, judgments and costs (included, but not limited to, "released parties'" attorney's fees) and to reimburse "released parties" for any expenses whatsoever incurred on connection with any action brought as a result of my participation in "skydiving", including, but not limited to, actions brought by myself or brought on mybehalf or brought by the representative of my estate.

I Agree
 

7. I further agree on behalf of myself and my heirs TO PAY ANY AND ALL LEGAL FEES INCURRED BY ANY RELEASED PARTY TO DEFEND ANY LEGAL ACTION BROUGHT ON MY BEHALF.

I Agree
 

8. LIMITATION OF WARRANTY: "Released parties" hereby warrants that the equipment provided by "released parties" has been previously used for "skydiving". This warranty is the ONLY warrant made to me by "released parties" and is made in lieu of any other warranties (expressed or implied), including, but not limited to, warranty of merchantability or fitness for a particular purpose.

I Agree
 

9. I have been advised and recognize that my skydiving activities are NOT being covered by any personal accident or general liability insurance policy issued to the "released parties".

I Agree
 

10. I hereby agree and understand that my parachute equipment meets the Department of Transportation, Federal Aviation Administration Regulations at all times while participating in "skydiving", including current reserve parachute repacks and TSO'd equipment, except as exempted by the Department of transportation, Federal Aviation Administration Regulations.

I Agree
 

11. CONTINUATION OF OBLIGATIONS: I agree and acknowledge that the terms and conditions of the foregoing contract of agreement, exemption of liability and assumption of risk agreement shall continue in force and effect now and in the future at all times during which I participate, either directly or indirectly, in the activities of the "released parties" and shall be binding upon my heirs, executors, and administrators of my estate.

I Agree
 

12. DURATION OF RELEASE: It is my understanding and intention that this release and agreement be effective not only for my first jump, but it is intended to include any and all subsequent jumps or activities at any time in any way associated with "released parties" from and since the date I execute this agreement and release.

I Agree
 

13. ENFORCEABILITY: I agree that if any portion of this agreement, release of liability & assumption of risk is found to be unenforceable or against public policy, that only that portion shall be deleted; but I hereby specifically waive any unenforceability or any public policy argument that I may make or that may be made on my behalf or that may be made on the behalf of my estate or by any other person or entity that would sue because of my injury, damages, or death.

I Agree
 

14. It is further agreed by and between the parties that no matter where venue lies that any and all lawsuits against "released parties" shall be filed in the Circuit Court of the Third Judicial Circuit of the State of Minnesota. It is further agreed by and between the parties that in the event of any lawsuit it filed against "released parties" in another Circuit or jurisdiction that such lawsuit shall be transferred to Waseca County, Minnesota, or such location as "released parties" shall specify, on motion and at the sole option of "released parties".

I Agree
 

15. I hereby agree to pay for any and all damages to any and all equipment, parachutes, aircraft, grounds, or airport properties which may occur while "skydiving", and/or caused by a malicious act by me.

I Agree
 

16. I hereby authorize "released parties" or its' assignee to take any photographs and videos as they may deem appropriate of myself or of my party and use those photographs in such a manner as they deem appropriate. I specifically waive any interest, proprietary or otherwise, I may have in such photographs or videos.

I Agree
 

17. ASSIGNMENT OF PROCEEDS: In the event that I (or anyone on my behalf or any representative of my estate) file a lawsuit against "released parties" and funds (or any tangible objects or assets) are in fact collected, then I hereby irrevocably agree to pay 100% of such funds (or such tangible objects or assets) to a nominee, to be selected by "released parties", including, but not limited to the person or entity against whom a judgment was obtained and funds (or tangible objects or assets) were collected. I further agree in the event that I (or anyone on my behalf or any representative of my estate) hire an attorney to pursue any lawsuit against "released parties" that I (or such person or entity on my behalf or such representative of my estate) will be solely and personally responsible to pay any attorney hired by me (or any attorney hired by anyone on my behalf or any attorney hired by the representative of my estate). In no case shall any attorney hired by me (or any attorney hired by anyone acting or purporting to act on my behalf or any attorney acting on behalf of my estate) be permitted to seek to collect their fees from "released parties" and no attorney fees shall be deducted from any sum (or tangible objects or assets) to be paid by "released parties". It is my understanding and intent that this assignment is irrevocable and will supercede and subsequent assignment of funds or fee agreement which I, or anyone, may enter into on my behalf with any attorney or law firm. I further agree that this paragraph is separate and apart from the indemnification for attorney fees I have signed which is a part of this agreement; I further agree and understand that in addition to paying the proceeds (in whatever form that it takes) that I (or anyone on my behalf or any representative of my estate) will be totally and wholly responsible for any and all attorney fees charged or billed by an attorney or law firm representing me (or my estate).

I Agree
 

18. I hereby agree and understand that the waiting period for my skydive may be 2 or more hours from the completion of my training class.

I Agree
 

19. THIRD PARTY BENEFICIARIES. This agreement, including but not limited to the release, hold harmless, assumption of risk and other provisions and promises from Student/Skydiver may be enforced by and shall benefit as an intended 3rd party beneficiary the Instructor hereunder, including but not limited to the Corporation or LLC providing the instruction and all agents or employees of said Instructor.

I Agree
 

20. Understanding of agreement: I hereby certify that I have read and understand the contents of this document and that I intend to be bound by its' terms and conditions. I further state that I fully understand that by signing this document I intend to forever relinquish important legal rights.I acknowledge that this document was available to me in advance and that I have had sufficient time and opportunity to consult an attorney.

I Agree
 

21. I have carefully read this agreement, release of liability, assumption of risk and the other covenants and promises contained herein, consisting of (21) Twenty-one paragraphs, including this one, that I fully understand its' contents and that I sign it of my own free will. I further acknowledge that I have the option and right to seek advice and counsel of the attorney of my choice prior to signing this agreement and that I voluntarily waive that option.

I Agree
 

22. I am not currently under the influence of alcohol or any other substances that would impair my ability to understand and consent to this waiver.

I Agree
 

I HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS:

 

CITY OF WASECA, MINNESOTA
WAIVER AND RELEASE

Please read carefully before signing.
1. I wish to participate in the skydiving activity (the “Activity”) sponsored by Skydive Northstar, LLC.The Activity will utilize the Waseca Municipal Airport (the “Airport”) owned by the City of Waseca, Minnesota (the “City”).
2. My participation in the Activity is voluntary. I acknowledge that participating in the Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. In consideration of being allowed to use the Airport, I assume all risk of injury, whether known or unknown. Such injuries may include catastrophic injuries including paralysis and death.
3. To the best of my knowledge I have no physical or medical conditions that would prevent me from participating in the Activity. I acknowledge that the City recommends that prior to participating in the Activity, I should first consult with my physician and abide by any limitations set by my physician.
4. In consideration for being permitted to use the Airport, I understand and agree that neither the City nor any person acting on behalf of the City, may be held liable in any way for any event which occurs in connection with my participation in the Activity which may result in harm, death, injury or other damage to me. This Waiver and Release does not waive liability for any injuries that I obtain as the result of willful, wanton or intentional misconduct by the City or any person acting on behalf of the City.
5. I agree to defend, indemnify and hold harmless the City for any expense or liability the City may incur as a result of my conduct, actions or omissions while participating in the Activity.
6. It is my express intent that this Waiver and Release shall bind the members of my family, if I am alive, and my heirs, assigns and personal representatives if I am deceased.
7. I have read the above and understand the legal significance of signing this Waiver and Release. I have had the opportunity to ask any and all questions regarding this Waiver and Release and its effect. I further state that I am fully competent and understand that the terms herein are contractual and not a mere recital. I sign this Waiver and Release as my own free act; no oral representations, statements or inducements apart from the foregoing written agreement have been made

NOTICE: No Participants under the age of eighteen (18) years is allowed to participate in this activity
I certify that I am the above individual and hereby consent to participation in this activity. I have read and
understand the above Waiver and Release of liability and I agree to be bound by the terms stated therein

 

*Yes, even licensed skydivers need to fill out the section below:

Uninsured United Parachute Technologies, LLC

Strong Enterprises

TANDEM PARACHUTE JUMPER AGREEMENT

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. In consideration of the Uninsured United Parachute Technologies, LLC, doing business as UPT Vector, S.E inc doing business as Strong Enterprises, and Skydive Northstar, 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, LLC, d/b/a UPT Vector or S. E. Inc d/b/a Strong Enterprises, for the purpose of performing an intentional parachute jump, I agree that: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 dualharness, dual-container parachute pack assembly to which I will Uninsured United Parachute Technologies, LLC or Strong Enterprises TANDEM PARACHUTE JUMPER AGREEMENT 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; and (c) I will declare whether Iwear corrective lenses. 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, LLC, d/b/a UPT Vector or S.E. Inc d/b/a Strong Enterprises shall be enforceable against me by the Uninsured United Parachute Technologies, LLC,. d/b/a UPT Vector or S.E. Inc d/b/a Strong Enterprises.

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 Videotape: I have viewed and I warrant that I fully understand the accompanying "Tandem Vector Waiver" video tape

I Agree
 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
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

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*
Licensed Skydivers Only

USPA Membership Number

USPA Membership Expiration Date

USPA License Number

Number of Jumps
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*

Last Name*

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

Height *

Weight *

List infirmities, if not, state "none" *

Occupation
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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