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CONTRACT

AGREEMENT, RELEASE OF LIABILITY & ASSUMPTION OF RISK

Medical Statement
(Each item must be completed in full and legibly) 

STATEMENT OF MEDICAL FITNESS:

"I, the participant, represent and warrant that I have no physical or mental infirmities, except as listed below; am not under treatment for any other physical or mental infirmity or chronic ailment or injury of any nature; and have never been treated for or diagnosed to have any of the following: cardiac or pulmonary conditions or diseases, diabetes, fainting spells or convulsions, nervous disorders mental illness or depression, kidney or related diseases, high or low blood pressures, or any other disability which might in any way affect my ability to participate in skydiving, parachuting, flying, or related activities."

IN CONSIDERATION of being permitted to utilize the facilities and equipment of SKYDIVE NEPHI LLC, (and its associated entities and facilities) to engage in parachute activities, ground instruction, flying and related activities, skydiving, freefall and/or tandem jumping, hereinafter collectively referred to as “skydiving activities,” as defined in this contract. I HEREBY AGREE AS FOLLOWS:

1. I acknowledge that I have watched the Uninsured United Parachute Technologies, LLC tandem jump video that explains the process prior to my tandem jump and understood everything included in that video. 


I further understand I may take this document to my personal attorney for review. I elect not to do so.


2. PARTIES INCLUDED: I understand that this Agreement, Release of Liability and Assumption of Risk includes but is not limited to SKYDIVE NEPHI LLC and DZ AVIATION LLC, any of its officers, board members, and shareholders, or their agents, customers, associated entities, employees, volunteers, pilots, instructors, jumpmasters, coaches, videographers, photographers, riggers, load organizers, independent contractors, the owners of the aircraft,(which shall also include but not be limited to airfoils and balloons), the owners of any land utilized for “skydiving activities”, adjacent property owners, the United States Parachute Association and its members, anyone working with or for SKYDIVE NEPHI LLC and DZ AVIATION LLC, including independent contractors and/or any manufacturer of, owner or entity charged with the maintenance of any piece of equipment which I may use or am using or is in any way, shape or form being used in connection with my “skydiving activities” at the time of my INJURY or DEATH and anyone involved in any way, shape, form or manner in my “skydiving activities,” including the person or entity who pays for my jump, and specifically including but not limited to tandem or experimental test parachute jumping to include tandem parachute jumping, hereinafter collectively referred to in this Agreement, Release of Liability and Assumption of Risk as “SKYDIVE.”


3. I understand that this document is a legally binding contract between myself and the entities described herein as “SKYDIVE” and certify that I am of legal age and under no legal disability that would prevent me from entering into a binding contract. I have read, understand and intend to be bound by all of its terms.


4. By signing this document, I acknowledge that I have been advised, understand and accept that tandem masters, jump masters, parachute packers, load organizers, coaches, videographers, photographers, riggers, those charged with the maintenance of the parachutes and parachute equipment, those charged with the maintenance of the aircraft, and pilots are independent contractors. As independent contractors, no other entity, including but not limited to those coming under the heading of “SKYDIVE” can be held responsible for that independent contractor’s actions, including but not limited to gross negligence, ordinary negligence and willful and/or wanton misconduct. I accept this limitation.


5. RISKS CONTEMPLATED: This Agreement is made in contemplation of all “skydiving activities,” which for purposes of this agreement shall include but not be limited to all occurrences contemplated or not contemplated, foreseen and unforeseen, likely or unlikely to occur, including but not limited to instruction, parachute jumping, tandem or experimental test parachute jumping, ground instruction, flying and related activities, the exit from the aircraft, skydiving, freefall, canopy opening, time under the canopy, the landing, including but not limited to crash landings, either under canopy or not, inside or outside the aircraft, equipment malfunctions of any kind, any rescue operations or attempts by “SKYDIVE,” whether on or off the designated landing area or any facilities used by “SKYDIVE”, ground transportation provided to me by any entity in any way associated with “SKYDIVE” and any activity whatsoever in any way, shape, form or manner connected with my “skydiving activities” or my presence on or near the facility and grounds of “SKYDIVE”, or any location which is used for my “skydiving activities”. I further agree that this includes but is not limited to all recreational activities which I may engage in including, but not limited to camping, socializing, or any other recreational activities whatsoever, which are in any way associated with “SKYDIVE”. This includes any activity which may or does or be claimed to cause or contribute to my INJURY or DEATH, even if caused directly or indirectly by negligence or other fault which terms shall include but not be limited to gross negligence and ordinary negligence on the part of “SKYDIVE”. These risks shall be referred to for purposes of this agreement as “skydiving activities”.


6. NEGLIGENCE: The term negligence as used anywhere in the body of this document shall include, but not be limited to gross negligence, ordinary negligence and/or willful, wanton or reckless conduct.


7. I am aware that “skydiving activities” are inherently dangerous and may result in INJURY or DEATH and agree that the unforeseen may happen and no one can delineate all risks or possibilities of error. Therefore, I specifically include in this Release, any INJURY or my DEATH resulting from any occurrence, whether foreseen or unforeseen, and whether contemplated or not contemplated which I, in any way shape or form, am in any way connected with my “skydiving activities” and/or presence on the premises used for my skydiving activities or any other place or entity connected with “SKYDIVE.” even if caused by the negligence or other fault of “SKYDIVE.”


8. PARTIES BOUND BY THIS AGREEMENT: It is my understanding and intention that this Agreement, Release of Liability and Assumption of Risk be binding not only on myself, but on anyone or any entity, including but not limited to my estate and my heirs and any one or any entity that may be able to or does sue because of my INJURY or DEATH. It is further my understanding and agreement that this Release is intended to and does in fact release “SKYDIVE” from any and all claims or obligations whatsoever, foreseen and unforeseen, contemplated and not contemplated, arising in any way from my participation in “skydiving activities”, even if caused by the negligence or other fault of “SKYDIVE”.


9. REPRESENTATIONS AS TO PRIOR KNOWLEDGE AND TRAINING: I understand that I am a student of “SKYDIVE” and it is my intention to be additionally trained to complete a solo jump or a jump without being harnessed to an instructor. I represent and affirm that I have already received significant training and experience that will allow me to complete a solo jump and I am at “SKYDIVE” as a student to receive additional training and experience. During this solo jump there will be instructors present, we will have radio communications intended to help guide and give instruction to me through the solo jump. Should this radio communication fail for any reason my prior knowledge and training will allow me to safely reach the ground without any guidance from an instructor. I represent and warrant that without any additional training I can complete a solo jump and I have been sufficiently trained to land safely on the ground. 


10. RELEASE OF LIABILITY: I hereby release and discharge “SKYDIVE” from any and all liability, claims, demands or causes of action that I or any person or entity may have for my INJURY or my DEATH or other damages arising out of my participation in “skydiving activities” even if caused by negligence or other fault of “SKYDIVE”.


11. COVENANT NOT TO SUE: In exchange for good and valuable consideration, the sufficiency of which is acknowledged, I further agree that I, MY ESTATE OR ANYONE OR ANY ENTITY ACTING ON MY BEHALF OR ON BEHALF OF MY ESTATE WILL NOT SUE OR MAKE CLAIM against “SKYDIVE” for damages or other losses, including my INJURY OR DEATH, sustained as a result of my “skydiving activities” even if caused by negligence or other fault of “SKYDIVE.”


12. INDEMNIFICATION AND HOLD HARMLESS: I also agree to INDEMNIFY AND HOLD “SKYDIVE” HARMLESS from all claims, judgments and costs, including but not limited to reasonable attorney's fees, and to reimburse “Skydive” for any expenses whatsoever incurred in connection with any action or lawsuit brought as a result of my participation in “skydiving activities,” including but not limited to actions brought by myself or on behalf of myself or my estate, including but not limited to repayment to “SKYDIVE” of any judgments obtained against or collected from “SKYDIVE”, even if “SKYDIVE” is claimed or found to be negligent or otherwise at fault.


13. ASSUMPTION OF RISK: I understand and acknowledge that “skydiving activities” are inherently dangerous and I EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF DEATH OR PERSONAL INJURY SUSTAINED WHILE PARTICIPATING IN “SKYDIVING ACTIVITIES” WHETHER SUCH RISK IS FORESEEN OR UNFORESEEN, CONTEMPLATED OR NOT CONTEMPLATED, AND WHETHER OR NOT CAUSED BY THE NEGLIGENCE OR OTHER FAULT OF “SKYDIVE” including but not limited to equipment malfunction from whatever cause, inadequate training, any deficiencies in the landing area, rescue attempts, the weather, (including but not limited to wind conditions) bad landings, rescue attempts, or any other cause whatsoever, including but not limited to those set forth in other paragraphs of this document, even if those INJURIES or my DEATH are caused by the negligence or any fault of “SKYDIVE.”


14. OTHER RECREATIONAL ACTIVITIES. This Agreement shall also be effective for and include any and all recreational activity(ies) which is organized, provided by or in any way associated with “SKYDIVE” or takes place on the grounds of “SKYDIVE”, or the property owned by any entity in any way associated with, organized or provided by “SKYDIVE”, including but not limited to camping and socializing.


15. DURATION OF RELEASE: It is my understanding and intention that this Release and Agreement be effective not only for my first jump, but for all subsequent jumps or “skydiving activities” and shall be in full force and effect from the signing of this Agreement. I further agree that any subsequent release signed by me shall include the terms of this release to the extent they are not inconsistent with the subsequent release, and that any and all inconsistencies be decided in favor of “SKYDIVE”. I agree that this contract may be terminated upon (180) days written notice, sent by either party by certified mail return receipt requested. I further agree that such termination shall not affect events occurring or which have occurred prior to the effective date of the termination.


16. ENFORCEABILITY: I agree that if any portions of this Agreement, Release of Liability and Assumption of Risk are found to be against public policy or unenforceable for any reason, only that portion shall fall, but I specifically waive any unenforceability or any public policy argument that I may make or that may be made on behalf of myself, my estate or by anyone or entity who could or does sue because of my INJURY or DEATH.


17. I hereby authorize “SKYDIVE” or its assignee to take any photographs and videos as they may deem appropriate of myself and to use those photographs in such a manner, as they may deem appropriate and specifically waive any interest, proprietary or otherwise, I may have in such photographs.


18. I GIVE UP LEGAL RIGHTS: It has been explained to me, and I understand, that by signing this document I am giving up important legal rights and it is my intention to do so.


19. In the event it is found that any portion or portions of this document conflict with any one or more other portion in this document the interpretation of that portion which is most favorable to “SKYDIVE” shall control.


20. UNDERSTANDING OF AGREEMENT: I HEREBY CERTIFY THAT I HAVE READ AND UNDERSTAND THE CONTENTS OF THIS DOCUMENT AND I WISH TO BE BOUND BY ITS TERMS AND I UNDERSTAND THAT BY SIGNING THIS, I HAVE FOREVER GIVEN UP IMPORTANT LEGAL RIGHTS. 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 SKYDIVE NEPHI LLC AND MYSELF.


21. I ELECT NOT TO ATTEMPT TO NEGOTIATE A CHANGE IN THIS AGREEMENT.


22. THIS WAIVER MEANS THAT IF YOU SIGN, YOU ARE BOUND BY THIS ENTIRE DOCUMENT. IT MEANS IN THE BROADEST GENERAL TERMS THAT IF YOU SUE “SKYDIVE” YOU CANNOT WIN AND, FURTHER, YOU WILL OWE “SKYDIVE” MONEY, INCLUDING BUT NOT LIMITED TO ATTORNEY’S FEES, REPAYMENT OF ANY JUDGMENT OBTAINED AND OTHER EXPENSES INCURRED BY “SKYDIVE” IN DEFENDING YOUR LAWSUIT AND YOU WILL HAVE TO REIMBURSE “SKYDIVE” FOR ANY JUDGMENT YOU MIGHT GET AGAINST “SKYDIVE” EVEN IF YOUR INJURY OR DEATH IS CAUSED BY THE NEGLIGENCE OF “SKYDIVE”. I UNDERSTAND AND AGREE TO BE BOUND BY THIS PARAGRAPH AND ALL OTHERS IN THIS DOCUMENT.


23. I UNDERSTAND THAT WHEN I SIGN THIS DOCUMENT, I WILL BE GIVING UP ANY AND ALL RIGHTS I OR MY HEIRS MAY HAVE TO SUE ANYONE IN ANY WAY, SHAPE OR FORM ASSOCIATED WITH MY SKYDIVE, EVEN IF THE ENTITY I OR MY HEIRS INTEND TO SUE HAS CAUSED MY INJURY OR DEATH BY THEIR NEGLIGENCE OR OTHER FAULT.


24. I HAVE BEEN GIVEN AN OPPORTUNITY TO READ THIS DOCUMENT. I HAVE READ EVERY SINGLE WORD ON EVERY SINGLE PAGE. I UNDERSTAND ITS CONTENTS. I INTEND THAT I, AND MY HEIRS, MY FAMILY AND/OR ANYONE WHO MIGHT ACT ON MY BEHALF OR ON BEHALF OF MY ESTATE, IN ANY CAPACITY WHATSOEVER BE BOUND BY ITS TERMS.


READ EVERY SINGLE WORD ON EVERY SINGLE PAGE BEFORE YOU SIGN. YOU ARE GIVING UP IMPORTANT LEGAL RIGHTS. IF YOU NEED MORE TIME TO READ THE DOCUMENT, PLEASE ALL YOU NEED TO DO IS ASK.



WARNING!

SKYDIVING, PARACHUTING, FLYING AND ALL OF ITS RELATED ACTIVITIES ARE DANGEROUS AND THERE ARE RISKS INVOLVED IN YOUR PARTICIPATION. YOU CAN BE SERIOUSLY AND PERMANENTLY INJURED OR EVEN KILLED AS A RESULT OF YOUR PARTICIPATION IN SKYDIVING, PARACHUTING, FLYING OR ALL OF ITS RELATED ACTIVITIES. EACH INDIVIDUAL PARTICIPANT, REGARDLESS OF EXPERIENCE, HAS FINAL RESPONSIBILITY FOR HIS/HER OWN SAFETY. I FURTHER UNDERSTAND THERE IS NO LIABILITY INSURANCE AVAILABLE TO SKYDIVE AS “SKYDIVE” IS DEFINED IN THIS DOCUMENT COVERING THESE ACTIVITIES.

I am not under the influence of alcoholic beverage, I have not ingested any illegal substances within the past 24 hours, nor have I taken any prescription medication, which may affect my judgment or ability to perform. I agree not to jump nor or in the future under the influence of alcohol or other drugs.

I have read the attached Agreement, Release of Liability and Assumption of Risk; I understand that it is a legal contract binding on me. I understand what it says. I intend to be bound by what it says and I know that when I sign it, I give up important legal rights.


Dated this date of July 26, 2026

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
Parent or Guardian's Email Address
Email*
Confirm Email*
Participant'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:*
For Emergency, Injury or Death Notify:
Name *
Relationship *
Phone #1 *
Phone #2
Address
City
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*
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Information
Preferred Name (What you would like to be called by your instructor and on your certificate)
Weight (lbs.)
Height (in.)

INFIRMITIES or EXCEPTIONS (if none, so state the word "None" on the line below):
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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