Loading...

SKYDIVE SHENANDOAH, LLC.

Registration & Acknowledgement form, Release of Liability & Waiver of Rights


Today's Date: July 27, 2024  

WARNING:

SKYDIVING, PARACHUTING AND ALL RELATED ACTIVITIES ARE DANGEROUS AND MAY RESULT IN SERIOUS INJURY OR DEATH.

It is imperative that you are aware of the dangers and risks involved with the sport of skydiving as well as your responsibilities as a participant in it. Please read the following statements on all pages carefully and indicate that you understand the terms and conditions of this RELEASE AND WAIVER OF RIGHTS by signing, initialing and/or checking the boxes of the form where requested. 

 

SKYDIVING RISKS:  

Data obtained from USPA fatality reports indicates that one out of every twenty thousand jumps results in death.

Serious injuries and death have been caused while participating in this sport. Serious injury and/or death can occur under many circumstances, including but not limited to: equipment failure, failure to execute proper emergency procedures, and the conduct of other jumpers. Jumpers have also died due to plane crashes. Serious injury and/or death may occur regardless of whether you are on your 1st or 5000th jump, etc.

Accidents resulting in death or serious injury can occur even if all precautions and correct actions are taken by the jumper, other jumpers and/or any others involved in the jump (i.e. pilot, instructor, jump master, etc.). Accidents resulting in death or serious injury may also occur because of someone’s negligence (i.e. acting or failing to act reasonably under the circumstances).


 

PARTICIPANT’S RESPONSIBILITIES:  

Because of the inherent danger in of the sport of skydiving, the jumper is obligated to do the following: 

  • Understand the proper procedures which may help to minimize the risks of death or serious injury and to seek assistance, guidance and/or further instruction if he or she is unsure of any such procedures;
  • Attempt to comply with any and all Federal Aviation Administration rules or regulations regarding their currency and equipment, including inspecting gear or having a licensed rigger do so prior to each jump;
  • Be prepared, careful, and cautious;
  • Follow emergency procedures precisely and at appropriate altitudes;
  • Not become overly confident so as to increase the risk of harm to the jumper or others;
  • Report any conduct which may increase the risk of harm to the jumper or others.


 

CERTIFICATION OF HEALTH:  

I recognize that the sport of skydiving is a strenuous athletic activity requiring me to be in good physical and mental condition.

I hereby certify that I do not suffer from any physical or mental infirmities or illnesses which would affect my ability to engage in parachute training or jumping and that I have a duty not to jump if I am not in good physical or mental condition.

I further certify that I will not jump if I have ingested any drugs, whether legal or not, within the previous 24 hours. I also certify that I will not jump if I have ingested alcohol within the previous 8 hours, and will not jump even after eight hours if I am still under the effects of alcohol. If I suspect any other jumpers are under the influence of alcohol or drugs, I will report my suspicions and take reasonable action to protect myself from any harm those individuals may cause, including refusing to jump if necessary. 


 

I certify that I have carefully read and fully understand this portion of the RELEASE AND WAIVER OF RIGHTS, which includes the provisions entitled SKYDIVING RISKS, PARTICPANT’S RESPONSIBILITIES and CERTIFICATION OF HEALTH. 

I Agree
 

I understand that I may sustain serious injury, illness or die during the act of, or in association with the act of skydiving and that this may result from numerous factors, whether the result of anyone’s negligence or not. 

I Agree
 

With this knowledge, I nonetheless choose to engage in skydiving and expressly assume the risks of serious injury, illness and/or death that it carries with it. 

I Agree
 

In exchange for being permitted to use the facilities and/or equipment of Skydive Shenandoah, LLC., and any other services provided in connection with parachuting activities (the term “parachuting activities” includes but is not limited to engaging in parachute jumping in any manner, ground instruction, flying and any and all other activities that may take place while at the facility), I sign this contract with the intent to relieve the individuals and entities listed in this document of any liability in the event that I am injured or die or suffer other losses while jumping, being on the premises, in aircraft, or participating in any other parachuting activities even if they act negligently in doing so and hereby agree to the following:

 

ASSUMPTION OF RISK: 

I understand and acknowledge that parachuting activities have inherent dangers of which no amount of care, caution, instruction or experience can eliminate. I EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF DEATH, ILLNESS or INJURY sustained while participating in or in connection with parachuting activities WHETHER OR NOT CAUSED IN ANY PART BY NEGLIGENCE OF THE RELEASED PARTIES.

I understand that there is no insurance of any kind of which is available to the released parties that would cover any losses suffered in connection with my parachuting activities. 

I Agree
 

RELEASE OF LIABILITY: 

I hereby RELEASE & DISCHARGE from any and all liability, claims, demands or causes of action whatsoever that I or my heirs may hereinafter have for injuries, illness, death and/or other damages while jumping, being on the premises or aircraft, or while participating in any other parachuting activities, the following entities and/or individuals (hereinafter referred to as the “Released Parties”), even if their actions constitute negligence:

  • Skydive Shenandoah LLC., the corporation, its owners, officers, agents, servants, lessors and employees, including but not limited to the pilots, instructors, jump masters, riggers;
  • The owners of the aircraft and land used for parachuting activities, including but not limited to NORTHEAST AERONAUTICS LLC., NEW MARKET AERONAUTICS, LLC., BALLOONS UNLIMITED, LLC., FIN16 SKYDIVING SERVICES, LLC, FIN16 AVIATION,LLC., the corporation(s), its owners, officers, agents, servants, lessors and employees, including but not limited to the pilots and mechanics;
  • Any independent contractors providing services in connection with the parachuting activities that may be offered at Skydive Shenandoah, LLC.;
  • And the Unites States Parachute Association, manufacturers, distributors and dealers of skydiving equipment.

I Agree
 

COVENANT NOT TO SUE: 

I further agree that I WILL NOT SUE OR MAKE A CLAIM against the Released Parties for injuries, death or other damages or losses sustained by me as a result of my participation in parachuting activities even if their actions constitute negligence. I promise to NEVER INSTITUTE ANY SUIT NOR ASSIST ANYONE ELSE TO DO SO for any claim which I may have in connection with parachuting activities.

I also understand and agree that this provision extends to anyone who might otherwise be entitled to assert such a lawsuit or legal claim on my behalf such as an heir or other family member, personal representative or significant other. I have and/or will advise such individuals that I do not wish them to take such action and, in fact, that I have signed a contract which bars it and would subject them to costs and fees as discussed below. 

I Agree
 

PROMISE TO REIMBURSE LEGAL EXPENSES: 

In the event that I or anyone on my behalf attempts to make a legal claim or files a lawsuit in violation of Paragraph 3, above, the participant expressly agrees to FULLY REIMBURSE the Released Parties FOR ANY AND ALL LEGAL EXPENSES including reasonable counsel fees (minimum $10,000.00 retainer fee per counsel of the Released Parties, payable immediately upon filing any action, claim or demand), and all other related costs and expenses whatsoever incurred or paid by the Released Parties, for the investigation, prosecution or defense of any and all actions or cause of action or claim or demand for damages whatsoever stemming from any INJURY, DEATH OR OTHER LOSSES TO ME, regardless of any negligence of the part of the Released Parties. 

I Agree
 

INDEMNIFICATION FOR CLAIMS OF OTHERS: 

I agree to INDEMNIFY AND HOLD HARMLESS the Released Parties from any and all claims, losses, actions, judgments and costs, including attorney’s fees and legal expenses, MADE BY ANY OTHER PERSON OR ENTITY made directly or indirectly in connection with MY participation in parachuting activities, whether resulting from any negligence, willful or wanton, or intentional or unintentional act or not and whether or not the Released Parties are directly involved and whether their actions constitute negligence (for example, if I cause injury or damage to another person or his or her property). The promise to FULLY REIMBURSE the Released Parties FOR LEGAL EXPENSES as described in Paragraph 4, above, ALSO APPLIES to any and all claims for damages of any nature brought by any person or organization under this provision as well. 

I Agree
 

REFUND POLICY: 

I understand that, having paid for a skydive or services related to skydiving (such as a video package), and having not made the skydive or received the services I paid for, I may be reimbursed for the portion of payment that did not constitute a deposit for a maximum of 90 days, after which my payment will stand as credit with Skydive Shenandoah, LLC for up to two years, to be used as a skydive or as the service that was paid for. Deposits are not refundable. 

I Agree
 

WAIVER OF LEGAL RIGHTS: 

I understand that by signing this document I am giving up important legal rights and it is my intention to do so. 

I Agree
 

USE OF EQUIPMENT: 

I hereby agree to reimburse Skydive Shenandoah, LLC., for loss or damage to any equipment of any kind whatsoever caused by my personal negligence or other wrongdoing. 

I Agree
 

PHOTOS / MEDIA: 

I hereby understand that due to the nature of the business, I may appear in photographs or videos taken by Skydive Shenandoah, LLC., or its assignee(s), and that they may use the media as they deem appropriate of myself or my party including but not limited to uploading them on Facebook, Instagram, You-Tube, or any other social networking website or in print media. I specifically waive any interest, proprietary or otherwise, I may have in such photographs. 

I Agree

PERSONAL VALIDATION: 

Even though I may have failed to initial some or all of the paragraphs of this document, I still intend to be bound by all paragraphs. I further understand that this document can only be amended in writing, with the amendment signed by the attorney for the dropzone and myself. 

I Agree
 

I HAVE BEEN GIVEN AN OPPORTUNITY TO READ THIS DOCUMENT. I HAVE DONE SO. I UNDERSTAND ITS CONTENT. I INTEND THAT NOT ONLY I, BUT ALSO MY HEIRS, MY FAMILY AND ANYONE WHO MIGHT ACT ON MY BEHALF IN ANY CAPACITY WHATSOEVER BE BOUND BY ITS TERMS.

I freely and voluntarily agree to all of the above by signing this contract on July 27, 2024 at Skydive Shenandoah. 

NEW MARKET AERONAUTICS, LLC. - USE & RELEASE OF LIABILITY AGREEMENT

In consideration of NEW MARKET AERONAUTICS, LLC., BALLOONS UNLIMITED, LLC., NORTHEAST AERONAUTICS LLC., Fin16 Aviation, LLC., Fin16 Skydiving Services, LLC. and SKYDIVE SHENANDOAH, LLC., their officers, stockholders, agents, employees, servants, lessors, and administrators, hereinafter referred to as the “Released Parties” allowing the Participant to utilize the facilities, premises, products, and services of the Released Parties, and to participate in flying, sport parachuting, and all related activities, hereinafter referred to as “the activities contemplated by this Agreement”, it is agreed that:

PAYMENT AND REIMBURSEMENT FOR COSTS AND SERVICES:

The Participant expressly agrees and covenants to be solely liable and financially responsible for any and all expenses, costs, fees, charges, and claims of any kind and/or nature whatsoever, including, but not limited to: any rescue, first aid, equipment retrieval, emergency services, hospital and doctor care, rehabilitation, any and all medical related costs, fees, and expenses incurred by the Participant or incurred on behalf of the Participant, resulting from the Participant’s intentional or unintentional act or actions while participating in the activities contemplated by this Agreement, regardless of any negligence on the part of the Released Parties. 

I Agree
 

NEIGHBORING PROPERTY IS PRIVATE AND OFF LIMITS:

The Participant fully understands that the property adjoining the NEW MARKET AIRPORT is private property and is strictly off limits. The Participant further agrees to be solely liable and financially responsible for any damage he or she might cause to neighboring property, whether intentional or unintentional, while participating in the activities outlined in this Agreement. The Participant further agrees that it is his or her sole responsibility to choose whether or not to remain and participate in the act of skydiving, the associated activities outlined in this Agreement, or to descend by aircraft or parachute upon NEW MARKET AERONAUTICS, LLC., property. 

I Agree
 

CONTINUATION OF OBLIGATIONS:

The Participant agrees and acknowledges that the terms and conditions of the foregoing provisions shall continue in full force and effect now and in the future at all times during which the Participant participates, either directly or indirectly, in the activities permitted by the Released Parties, and shall be binding upon the agents, assigns, executors, and administrators of said Participant for his/her estate. 

I Agree
 

REPRESENTATIONS AND WARRANTIES: 

The Participant represents and warrants that he or she is covered by valid medical and life insurance for flying and sport parachuting activities, or acknowledges that it is strongly recommended by the Released Parties that he or she be covered by medical and/or life insurance, and that he or she has made adequate provisions for his or her survivors in the event of his or her death or disability, has successfully completed or will complete an approved training course in the particular area of activity contemplated by this Agreement prior to participation, is physically fit and in good health, is mentally sound, is able to act rationally during high stress emergency situations, and further warrants that he or she will abide by the rules, regulations, and the authority of the Federal Aviation Administration, the United States Parachute Association, and the Released Parties while participating in the activities contemplated by this Agreement. 

I Agree
 

VALIDITY OF AGREEMENT:

The Participant fully understands and expressly agrees that if he or she institutes any suit or action of law for any claim for damages or losses, or cause of action because of injury or death to his or her person or property due to, or as a result of, his or her participation in the activities contemplated by this Agreement, or should the Released Parties incur expenses, losses, or damages of any kind, or of nature resulting directly or indirectly from the participant’s participation in the activities contemplated by this Agreement, this Agreement can and will be used in the court of law. The Participant further understands that an agreement of this type has been upheld and enforced in similar circumstances. The Participant further agrees that this Agreement is intended to be as broad and inclusive as permitted by the laws of the state of Virginia and that if any portion thereof is held to be invalid or found to be unconstitutional, the remainder shall, notwithstanding, continue in full force and effect. 

I Agree
 

The terms and conditions of this Agreement are contractual, not a mere recital, and contain the entire agreement between the parties hereto. I have carefully read this agreement and have had the opportunity to discuss its nature and effects, and I fully understand its contents, and I am fully aware and completely understand that by entering in to this Agreement I am waiving valuable legal rights which I may otherwise have, and I sign this Agreement of my own free will and act on July 27, 2024. 


First Jumper's Name

First Name*

Middle Name

Last Name*

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
First Jumper's Signature*
Second Jumper's Name

First Name*

Middle Name

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
Third Jumper's Name

First Name*

Middle Name

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
Fourth Jumper's Name

First Name*

Middle Name

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
Fifth Jumper's Name

First Name*

Middle Name

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
Sixth Jumper's Name

First Name*

Middle Name

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
Seventh Jumper's Name

First Name*

Middle Name

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
Eighth Jumper's Name

First Name*

Middle Name

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
Ninth Jumper's Name

First Name*

Middle Name

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
Tenth Jumper's Name

First Name*

Middle Name

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
Jumper'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*
A signed copy of this waiver will be sent to the email address you provide.
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*
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*

Middle Name

Last Name*

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

USPA Membership# *

USPA License # *
Have you jumped with us before? *
Yes
No
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!