RS#: JR#: Height: Weight: BMI: FIRST NAME: LAST NAME: RELEASE OF LIABILITY AND AGREEMENT NOT TO SUE Requirements: Age at least 18 years old; medical statement is required for 60 and 60+ years old tandem students Weight Ladies: Less than 90kg. (BMI 27.5) Men: Less than 100kg. (BMI 30) Absolutely NO Alcohol or Drugs in your body before making Tandem Skydive Plan to spend 2-4 hours at Skydive Dubai for the whole experience I understand and confirm that I meet the above requirements. ( ) [Please INITIAL when read, This is an important agreement! By signing it, you are giving up certain rights. PLEASE READ IT CAREFULLY BEFORE SIGNING. In consideration for being permitted to participate in skydiving/parachute jumping, tandem jumping, accelerated freefall instruction, demonstration jumps, water jumps, ground transportation, flying, landing and/or any related activities (hereinafter collectively referred to as the activities covered by this Release ) conducted by Skydive Dubai LLC (Skydive Dubai) and/or any of their affiliates, I (PRINT FULL NAME), hereby agree as follows: 1. RELEASE OF LIABILITY. I hereby fully release and discharge Skydive Dubai, the United States Parachute Association, their subcontractors, service providers, affiliates, designees and their instructors, jumpmasters, pilots, riggers, drivers, officers, directors, agents, employees, members, fans, groups and volunteers; the owners and manufacturers of the aircraft, motor vehicles, land and equipment utilized for the activities covered by this Release, and any other landowners, tenants and sponsors connected by the activities covered by this Release (hereinafter collectively referred to as the Releasees ), from any and all liability, claims, demands, or causes of action whatsoever arising out of any damage, loss or injury to me or my property, or my death, while preparing to participate and/or participating in any of the activities covered by this Release, whether resulting from the negligence or other fault, act of omission, either active or passive, direct or indirect, of any of the Releasees, or from any other cause. ( ) [Please INITIAL when read, acknowledged and agreed.] 2. ASSUMPTION OF RISK. I know and fully understand the scope, nature and extent of the risks involved in the activities covered by this Release and that some dangers cannot be foreseen. I understand that these risks include, but are not limited to: equipment malfunction or failure to function; defective or negligent design or manufacture of equipment; improper or negligent parachute packing or assembly; improper or negligent operation or use of equipment; carelessness or negligence of skydivers/parachutists, instructors, jump masters, pilots or ground crew; strenuous bodily movement; improper or negligent instruction or supervision or implementation; personal injury or death; and property damage. I voluntarily, freely, and expressly, choose to incur all risks associated with the activities covered by this Release, including all risks set out in this paragraph, and expressly understand that those risks may include bodily and personal injury, damage to property, disfigurement or death. I voluntarily and freely choose to incur such risks and take all responsibility in respect of such risks. ( ) [Please INITIAL when read, acknowledged and agreed.] 1
3. AGREEMENT NOT TO SUE. I agree never, at any time now or in the future, to institute any lawsuit or cause of action against any of the Releases, or initiate or to assist in the prosecution of any claim for damages against the Releasees, in respect of injury to person or property, or my death, or any other loss or damage, howsoever occasioned arising from the activities covered by this Release, whether caused by the act, omission, negligence or fault, active or passive, direct or indirect, of any of the Releasees, or from any other cause. I further agree that my heirs, executors, administrators, personal representatives, or anyone else claiming on my behalf, shall not institute any lawsuit, cause of action, or claim for damages against the Releasees, nor shall they initiate or assist in the prosecution of any claim for damages against the Releasees, which I, my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf may have in respect of injury to my person or property, or my death, or any other loss or damage, howsoever occasioned arising from the activities covered by this Release, whether caused by the act, omission, negligence or fault, either active or passive, direct or indirect, of any of the Releasees or from any other cause. I hereby so instruct my heirs, executors, administrators, personal representatives, or anyone else claiming on my behalf. Should any such lawsuit or cause of action be instituted against any of the Releasees, I agree that such Releasees shall be entitled to recover from me or my estate, the value of any attorney s fees and costs incurred in the defense of any such lawsuit or cause of action. ( ) [Please INITIAL when read, 4. INDEMNITY AGAINST THIRD PARTY CLAIMS. I agree to indemnify, safe, and hold harmless the 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 person or organization and which arise directly or indirectly from my participation in the activities covered by this Release, whether resulting from the act, omission, negligence or other fault, either active or passive, of any of the Releasees, or from any other cause. ( ) [Please INITIAL when read, 5. WAIVER OF CONTRACT DEFENSES. I understand that this Release is a binding contract pursuant to which I have released any and all claims against the Releasees resulting in any way from my participation in the activities covered by this Release, INCLUDING ANY CLAIMS CAUSED BY THE NEGLIGENCE OF THE RELEASEES, as set forth in this Release. ( ) [Please INITIAL when read, 6. VALIDITY OF AGREEMENT. I understand that if I institute, or if anyone on my behalf institutes, any lawsuit, cause of action, or claim for damages against any of the Releasees because of injury to my person or property, or my death, as a result of my participation in the activities covered by this Release, this Release can and will be used in court, and that agreements like this one have been upheld by courts in similar circumstances. ( ) [Please INITIAL when read, 7. GROUND TRANSPORTATION NOT MANDATORY. I understand that my use of the ground transportation provided by the Releasees between the main building and the landing area or the aircraft loading area is not mandatory, and that I may walk if I elect to do so but the Releasess shall not be held liable for any costs, losses or claims in respect of such election by me. [Please INITIAL when read, 8. APPLICABLE LAW/WAIVER OF TRIAL/VENUE HEADINGS. I agree that this Release shall be subject to the laws of Dubai and the applicable Federal laws of the United Arab Emirates (the Laws) and the Laws shall apply to issues involving the construction, interpretation, and validity of the Release, and that the Laws shall govern any dispute arising from or related to this Release or the activities covered by this Release. Should this Release be violated and suit be brought against any of the Releasees, I hereby waive my right to a trial. The headings used throughout this Release are for convenience only and have no significance in the interpretation of the body of Release. ( ) [Please INITIAL when read, 9. SEVERABILITY OF PROVISION. I agree that this Release is intended to be as broad and inclusive as permitted by the Laws and if any part of this Release is found to be unenforceable or against public policy, that only those portions shall fail, and I agree to be bound by the remainder of the Release. I specifically waive any unenforceability or public policy argument that I could make or could be made on behalf of my estate or by anyone who would sue the Releasees as a result of my participation in the activities covered by this Release. ( ) [Please INITIAL when read, 2
10. CONTINUATION OF OBLIGATIONS. I agree that the terms and conditions of this Release shall continue in full force and effect now and in the future at all times including (without limitation) during the period when I participate, either directly or indirectly, in the activities covered by this Release, and shall be binding upon my heirs, executors, administrators, personal representatives, and/or anyone else claiming on my behalf. This Release supersedes and replaces any prior agreement between the Releasees and myself. ( ) [Please INITIAL when read, acknowledged and agreed.] 11. NO PHYSICAL INFIRMITIES. I have no physical infirmity, chronic ailment, or injury of any nature and am not under treatment for a physical infirmity or chronic ailment of any nature and have never been treated for any of the following: cardiac/pulmonary conditions or disease; high or low blood pressure; fainting spells, seizures or convulsions; nervous system disorder; dislocated shoulder or joint; artificial joints; kidney or related diseases; shortness of breath, hearing loss or impairment. I am not taking any medication of any kind. I have not taken any alcoholic beverages or drugs within the last twelve hours. I have not been scuba diving within the last 24 hours. I confirm that I am physically fit and capable of undertaking the activities covered by this Release. I agree to abide by the decision of Skydive Dubai s official or agent regarding my approval to participate in any skydiving activities. ( ) [Please INITIAL when read, 12. WAIVER OF RIGHTS. I understand that by signing this Release, I am giving up important legal rights, and it is my intent to do so and I do so of my own free will and with full acknowledgement of, and agreement to, the terms and conditions in this Release. ( ) [Please INITIAL when read, 13. RULES AND CONDITIONS. I accept that all rules and conditions imposed on the activities covered by this Release are subject to change without notice and I agree to comply with any such rules and conditions upon notice by Skydive Dubai. ( ) [Please INITIAL when read, 14. TRAINING. I represent and warrant that I have been thoroughly and completely trained in all activities covered by this Release and I acknowledge and agree that Skydive Dubai makes no representation or warranty about adequacy, suitability or completeness of any training that Skydive Dubai may or may not offer in respect of the activities covered by this Release and that I have satisfied myself as to the thoroughness and completeness of any training I have undertaken in respect of the activities covered by this Release. ( ) [Please INITIAL when read, 15. ENTIRE AGREEMENT. I understand this Release contains the entire understanding and undertaking by me in respect of the activities covered by this Release and the terms of this Release are contractual and not a mere recital and the Releasees are entitled to rely on this Release for their benefit. ( ) [Please INITIAL when read, 16. PHOTO & VIDEO RELEASE. For valuable consideration received, I hereby grant Skydive Dubai and its legal representatives and assigns (hereinafter collectively referred to as the Photographer ), the irrevocable and unrestricted right to use and publish photographs and video images of me, or in which I may be included, for editorial, trade, advertising, and any other purpose and in any manner and medium and in any jurisdiction, to alter the same without restriction, and to copyright the same. This includes any and all uses that the Photographer deems are necessary or desirable. I agree that any images purchased by me from the Photographer are for personal use only and may not be used for commercial gain, and that I may request commercial licencing information from Skydive Dubai by contacting video@skydivedubai.ae if I wish to use any images for that purpose. I hereby release the Photographer from all claims and liability relating to any photographs or video images of me. ( ) [Please INITIAL when read, 17. REFUND POLICY. I hereby acknowledge and agree that a deposit refund will be offered in the sole case of poor weather where operations must cease for safety reasons, or in the case of cancellation where operations must cease due to circumstances beyond Skydive Dubai's control, which will be determined by the Safety and Training Officer present or other such qualified personnel at Skydive Dubai, and not for any other reason. I understand and agree that this refund may be full or partial, and Skydive Dubai retains the right to withhold any sum it may be owed due to expenses incurred, for example international bank charges or similar. I further acknowledge that any 3
recordings or photographs I have paid for by purchasing a tandem skydive at Skydive Dubai is only a fraction of the total cost and is separate from other costs included. Therefore, in the case of an equipment malfunction or fault concerning any recording equipment where no images were recorded or are otherwise incomplete, I will not be entitled to a full refund. In such a case a re-jump may be offered at no additional cost, or if this is not possible, a partial refund may be issued at the sole discretion of Skydive Dubai, which is not to exceed the amount of 300 AED. ( ) [Please INITIAL when read, acknowledged and agreed] 18. CANCELLATIONS & POSTPONEMENTS. Skydive Dubai reserves the right to cancel a jump or refuse a student or skydiver from performing a skydive if it is deemed by Skydive Dubai staff that the student is unfit, for whatever reason, to safely perform his or her duties, or poses a risk to his or her own safety or the safety of others. A skydive may also be cancelled or postponed if weather conditions, weight, harness or container fit, or for any other reason if it is deemed a safety concern, even if conditions are within the recommended limits outlined by Skydive Dubai and their affiliates. In the case of a student refusing to skydive once the aircraft has taken-off, the skydiver s slot will be considered lost, and no reimbursement will be offered. I further understand that for safety reasons, Skydive Dubai instructors cannot and will not force an unwilling student to exit the aircraft unless an emergency situation deems it necessary for those on board to do so. ( ). Please INITIAL when read, acknowledged and agreed] 19. INSURANCE AVAILABILITY. Medical insurance, passenger liability insurance, accident insurance or any other kind of personal or general liability insurance coverage are not available in respect of the activities covered by this Release or in respect of any of the services offered by any of the Releasees. ( ) [Please INITIAL when read, WITHOUT LIMITATION, I ACKNOWLEDGE AND AGREE THAT I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF ALL LIABILITY AND A WAIVER OF ANY RIGHT THAT I MAY HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM FOR INJURY OR LOSS OF ANY KIND AGAINST THE RELEASEES. IF ANY ATTEMPT FOR CLAIM IS MADE, I UNDERSTAND I WILL BE RESPONSIBLE FOR ALL DEFENSE COSTS INCURRED BY THE RELEASEES. With my signature below, I confirm that I have read the Release, been given the opportunity to ask questions, considered its effects, understand its content, given true information, and agree fully to the terms as stated above. First Name Middle Initial Last Name Nationality Street or PO Box Mailing Address City/State Zip/Postal Code Country Your Telephone Email Address Date of Birth Day Month Year Your Age Gender M F In Emergency Call (Name and Telephone) 4
What is your occupation? How did you hear about us? Comments Your Signature / Date Witness (Qualified Skydive Dubai Staff) 5
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. 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. 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. 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 do/do not (strike one) wear corrective lenses. If I am prescribed corrective lenses, I agree to wear them during my intentional parachute jump. (list infirmities, if not, state none ) 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. 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 shall be enforceable against me by the Uninsured United Parachute Technologies, LLC,. d/b/a UPT Vector. 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 freely and voluntarily agree to all of the above by signing this contract on the day of (day) (month and year) at. (location) JUMPER: (Please Print Neatly) Name: Signature: Driver s License Number: Age: Address: Birthdate: Telephone #: Witness: *Please read each paragraph carefully. Your initial indicates you understand and agree to all of the information and terms contained therein.
Uninsured United Parachute Technologies, LLC 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, and Skydive Dubai, 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, 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. 2) Exemption and Release from Liability: I exempt and release the following persons and organizations: (A) The Corporations and their officers, directors, agents, servants, employees, shareholders, and other representatives; (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; (C) Owners, suppliers, and operators of aircraft from which I am to make my intentional parachute jump; (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; (E) The operator ( parachutist in command ) of the dualharness, dual-container parachute pack assembly to which I will be attached during my intentional parachute jump; (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; (G) The owners and lessees, if any, of land upon and from which the parachute jumping and related aircraft operations are conducted; and (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) 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); 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. 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)