R23, 2017-05-24

NOTE: AerOhio does not accept paper waivers, please submit electronically.


GENERAL INFORMATION AND STATISTICS PERTAINING TO

SKYDIVING AND PARACHUTING ACTIVITIES

Latest Statistics: According to methodology developed over the last several years, The United States Parachute Association (USPA) is reporting the following statistics for the year 2016 on civilian skydiving in the United States:

Participants:

Over 350,000

USPA Members: Over 38,000

Students:

Over 250,000

Fatalities: 21 Total

USPA estimates that nearly 3,200,000 jumps were accumulated in the United States during 2016. During that period, USPA members reported over 1,308 injuries. Injuries are defined as those requiring medical treatment. That total was taken from members who chose to optionally report their injuries so the actual number of injuries that occurred is probably significantly higher. At least one jumper in 200 can expect to be injured while skydiving.

Ram-air parachutes do not always open properly and will have a malfunction rate of .03 percent according to some tests. On the average, a parachute is expected to malfunction at least once in every 333 activations. Ram-air parachutes have flight characteristics that are inherently dangerous. Over one-third of the people who died skydiving in 2016, did so while flying under fully open, properly functioning parachutes. Parachute flight is at least as dangerous as freefall skydiving.

Skydiving equipment can fail even if all possible precautions are taken by the user, the manufacturer, and anyone else involved with its packing or maintenance. Flying in an airplane can also result in serious bodily injury or death. Airplanes can and do fail even if all possible precautions are taken by the pilot, operator, owner and all persons associated with its manufacture, operation, and maintenance.

Your best guess

ADULT RELEASE, WAIVER AND INDEMNITY AGREEMENT

The terms of this Release, Waiver and Indemnity Agreement are contractual and not mere recital and contain the entire agreement between the parties hereto. WARNING: Skydiving, parachuting, and flying are exciting and challenging activities. However, THE RISK OF SERIOUS INJURY OR DEATH IS REAL and should not be overlooked or underestimated. You are exposing yourself to extreme danger. DO NOT PARTICIPATE unless you accept these risks.

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Initial

In consideration of the covenants and agreements and of being permitted by BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center (and their associated entities) to engage in parachute activities including but not limited to, inter alia, a course of ground instruction, parachuting instruction, skydiving training, flying activities, ground or air operations incidental to parachuting or flying, accelerated freefall, tandem skydiving, static line jumps, relative work (RW), canopy relative work (CRW), freeflying, wing suiting, hereinafter collectively referred to as “Parachuting Activities”, I hereby agree to the following:

For other valuable consideration, hereby acknowledged and with full knowledge of the perils and dangerous nature of the aforementioned “Parachuting Activities”, the risk of which is hereby assumed, I for myself, and as the only legal representative of my heirs, executors, administrators, assigns, beneficiaries, dependents, family, relatives, spouse, and estate do hereby fully and FOREVER RELEASE AND DISCHARGE BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center, Wink's Down to Earth, Inc., John Winkler, Linda Winkler, Tim Butcher, Sherry Butcher, their officers, directors, shareholders, agents, representatives, servants, employees, volunteers, pilots, aircraft owners, any other aircraft owners and pilots, instructors, coaches, riggers, employees, contractors, stockholders, agents, land/airport owner, drop-zone owners, successors and assigns, the United States Parachute Association, the Toll-Free Skydive Network, Inc., manufacturers, distributors and dealers of any and all of the equipment I use for my parachute jump, and all persons whomever directly or indirectly liable, (hereinafter referred to as "The Released Parties") from any and all claims and demands, actions or causes of action, damages, cost, loss of services, expenses and all other claims of damages whatsoever, both in law and in equity on account of or any way resulting from bodily injury, disfigurement, conscious suffering, death, negligent infliction of emotional distress, or property damages sustained by me, arising out of aircraft flights, skydiving, parachute jumps, or any other means of lift, ascent or descent, from an aircraft of any nature, or arising out of the ownership, operation, use, maintenance or control of any vehicle, aircraft, or otherwise, or any device or mooring, while on the ground or in flight, and meaning and intending to include herein all such bodily injury, disfigurement, conscious suffering, death, negligent infliction of emotional distress, or property damage resulting from or in any way connected with or arising out of instruction, training, and ground or air operations incidental thereto.

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And in consideration of the foregoing premises I do, for myself, and as the only legal representative of my heirs, executors, administrators, and assigns, hereby expressly stipulate, covenant and agree to INDEMNIFY AND HOLD FOREVER HARMLESS the said "The Released Parties" and all other persons whomsoever against and from any and all actions, causes of action, claim and demands for damages, including actions for wrongful death and survivorship, or any matter described in the following paragraph, executions, judgments, costs, loss of services, expenses, compensation, including, but not limited to, the immediate reimbursement of all legal fees, costs, expenses and attorneys' fees incurred or paid by any of “The Released Parties”, for the investigation, prosecution or defense of any such action, cause of action, or claim or demand for damages, whatsoever, which may hereafter arise, or be instituted or recovered against the said "The Released Parties" or any other person whomsoever, whether for the purpose of making or enforcing a claim

or damages on account of bodily injury, disfigurement, conscious suffering, death, negligent infliction of emotional distress, or property damages sustained by me, or whether for the purpose of enforcing a claim for damages of any nature by any person whomsoever, on account of, or in any way resulting from my negligence, willful or wanton, or intentional act or actions.

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I further agree that I WILL NOT SUE OR MAKE A CLAIM AGAINST THE RELEASED PARTIES for damages or other losses sustained by me as a result of my participation in “Parachuting Activities.” I also agree to INDEMNIFY AND HOLD “THE RELEASED PARTIES” FOREVER HARMLESS from all claims, judgments and costs, including but not limited to attorney's fees, incurred in connection with any action brought as a result of my participation in “Parachuting Activities.”

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I further agree to the ASSIGNMENT OF PROCEEDS as follows. In the event that I (or anyone on my behalf or any representative of my Estate) file a lawsuit against any of "The 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 the affected "The Released Parties " with the understanding that such funds (or tangible objects or assets) be distributed amongst the entities that constitute " The Released Parties" including but not limited to the person or entity against whom a judgment was obtained and funds (or tangible items or assets) were collected.

I further agree that in the event that I (or anyone on my behalf or any representative of my Estate) hire an attorney to pursue any lawsuit against any of "The 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 "The Released Parties" and no attorney fees shall be deducted from any sum (or tangible objects or assets) to be paid by "The Released Parties."

It is my understanding and intent that this assignment is irrevocable and will supersede any subsequent assignment of funds or fee agreement which I or any one 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 part of this Agreement. I further agree and understand that in addition to paying the proceeds (in whatever form that takes) that I (or anyone on my behalf or any representative of my Estate) receive from any lawsuit against "The Released Parties" to "The Released Parties", 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 any attorney or law firm representing me (or my Estate).

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I hereby acknowledge that I know how to read, write and understand the English language. I also certify that I am at least 18 years of age.

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I know that I do not have to skydive and that I can change my mind at any time prior to exiting the aircraft and choose not to jump.

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Initial 7

I hereby acknowledge that there is a Limitation of Warranty on the equipment provided to me for skydiving, parachuting, and flying activities and that this equipment is warranted only to the extent that it has been used previously for “Parachuting Activities.” This warranty is the only warranty made to me by “The 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.

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Initial 8

I understand and acknowledge that parachuting is a DANGEROUS, CALCULATED RISK ACTIVITY which can, and sometimes does result in BODILY INJURY OR DEATH to its' participants. I understand and acknowledge that I will be jumping out of an airplane in flight, which is known to be a very dangerous thing to do. I understand and acknowledge that I CAN BE INJURED OR KILLED, EVEN IF I DO EVERYTHING PROPERLY. I am accepting this risk in order to be allowed to jump of my own free will, with full understanding of the possible consequences and potential dangers, and without inducements, promises, or statements other than those contained in this Release of Liability, Waiver, and Indemnity Agreement. I understand and acknowledge that parachuting activities have inherent dangers that no amount of care, caution, instruction, or expertise can eliminate. I EXPRESSLY AND VOLUNTARILY ASSUME ALL RISKS, LIABILITY, DUTY OF CARE, AND RESPONSIBILITY FOR DEATH OR BODILY INJURY SUSTAINED WHILE PARTICIPATING IN “PARACHUTING ACTIVITIES” WHETHER SUCH RISK IS FORESEEN OR UNFORESEEN, CONTEMPLATED OR NOT CONTEMPLATED, CAUSED OR NOT CAUSED BY THE NEGLIGENCE OF “THE 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 fault of “The Released Parties.” I understand that I am releasing all claims or potential claims which could be asserted or are assertable by or through me, even if these claims arise out of the negligence of "The Released Parties."

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I hereby expressly recognize that this Release of Liability, Waiver and Indemnity Agreement is a contract by which I have released any and all claims which are assertable or could be asserted through me or by me against “The Released Parties" resulting from my participation in skydiving, parachuting and related activities including any claims caused by the active or passive negligence of "The Released Parties". I understand that there other skydiving service providers available to me locally, other than BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center, where I can participate in skydiving and parachuting activities. I hereby confirm that I have been given an option to purchase a waiver of the Waiver of All Claims and Covenant Not to Sue provisions contained in this agreement at an additional cost of $500.00.

   

It is understood that this purchase option does not constitute a contract of insurance but only a waiver of contractual defenses that would otherwise be available to "The Released Parties", and that there is no other insurance available to or through "The Released Parties."

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I hereby acknowledge that I have reviewed the posted Refund Policy for BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center and have heard its explanation and have full understanding of its terms. I understand that if I choose not to jump, I can receive a partial refund.

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INSURANCE COVERAGE CERTIFICATION

   

I certify that by checking either A or B in the above Insurance Coverage Certification that the remaining paragraph does not pertain to my circumstances.

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The USPA 90-day Introductory Membership may be purchased at the cost of $20. This includes $50,000 third-party liability and property damage coverage, a PARACHUTIST Magazine and follow-up information about the Association and about skydiving. I understand that without the third-party coverage I am responsible for any and all damages caused by my participation in skydiving activities. I have chosen to:

   

I understand and acknowledge the 90-day Introductory Membership coverage is a separately administrated program available only to all skydivers and in no way indicates the availability or existence of a general liability insurance policy covering "The Released Parties."

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I certify that considering my lifestyle and the manner in which I am supporting my dependents, I have made adequate provisions for my spouse, if any; children, if any; my heirs, if any; and all other persons dependent on me so that in the event of my death or disability, they will have suffered no financial loss.

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I further acknowledge that I have been advised and recognize that my skydiving and parachuting activities are NOT COVERED BY ANY PERSONAL INJURY ACCIDENT INSURANCE OR GENERAL LIABILITY INSURANCE POLICY issued to "The Released Parties" and that it is a commonly known fact that this type of insurance is unavailable.

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I have been advised that I am free to consult with an attorney of my choosing before entering into this agreement. I hereby certify that all of the statements contained herein are true and correct to the best of my knowledge and belief.

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I acknowledge that each of "The Released Parties" involved in skydiving, parachuting, flying and related activities is an Independent Contractor. Each Released Entity is not responsible or liable for any acts, actions, negligence, errors, commissions, or omissions of any other Released Parties, or Independent Contractor. I AGREE TO HOLD EACH OF THE RELEASED PARTIES, OR INDEPENDENT CONTRACTORS HARMLESS FOR THE ACTIONS OF OTHERS. For the ease of accounting, I request that BLUE SOVEREIGN, LLC

dba: AerOhio Skydiving Center collect and distribute fees and charges that I owe to these Released Parties and Independent Contractors.

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I understand that it is necessary for me to be suited with a harness/container system when doing an Accelerated Freefall (AFF) or Static Line skydive, or a harness which will allow me to be hooked to my instructor's harness when doing a Tandem skydive. I further understand that, for safety reasons, it is imperative that this harness fit snugly about my body and it may be necessary for my instructor or other staff to touch me in places I find personal or offensive, in order to insure the security of this harness system. I further understand that the harness, when attached to the Instructor during an actual Tandem skydive, places my body in close proximity to that of my instructor. By initialing below this paragraph, I acknowledge that I understand the procedure of fitting me with an AFF, Static Line, or Tandem harness system and waive any claim which I might have against any of "The Released Parties", by reason of the same.

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I further understand and agree that if I, or anyone on my behalf, initiates any suit or action of law against any of "The Released Parties" for any loss, no matter how minor or severe, to my person or property, that this document will be used in court. I also understand that agreements of this type have been upheld in courts in similar circumstances. Should any provision of this indemnity and release agreement be held or deemed to be unenforceable, invalid, or voided, the remaining provisions of this agreement shall nevertheless be binding upon and enforceable against the parties hereto, their respective heirs, executors, administrators, assigns, personal representatives, family, relatives, and spouses.

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The terms of this Release, Waiver and Indemnity Agreement are contractual and not a mere recital, and contain the entire agreement between the parties hereto. It is hereby further agreed that any lawsuit arising out of this Agreement or my participation in skydiving activities, or any damages allegedly arising there from, shall be tiled and maintained in the Common Pleas Court of Wayne County, Ohio. It is further agreed that in the event any lawsuit is filed in or removed to any court other than the Common Pleas Court of Wayne County, Ohio, including but not limited to any United States District Court, it shall be transferred to, or dismissed and re-filed in, said county on motion of and at the option of any of 'The Released Parties" released herein.

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I hereby agree and acknowledge that all of the terms and conditions of this Release, Waiver and Indemnity Agreement shall continue in full force and effect, now and in the future, at all times during which I participate either directly or indirectly in skydiving and parachuting activities, and shall be binding upon my heirs, representatives, successors, administrators, assigns, families, dependents, friends and executors of my estate.

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I understand that the success of my jump(s) is dependent on the exact, proper, specific condition, quality, control, timing, performance, function, use, and maintenance of the equipment, aircraft, airspace, landing areas; along with the abilities, judgment, and experience of "The Released Parties." I understand that each of these individual components and parties cannot be depended upon to function properly or perfectly, and that each of them is subject to, but not limited to, the following possible conditions: active or passive SIMPLE NEGLIGENCE, GROSS NEGLIGENCE, OR ERROR; physical or mechanical malfunction with possible defects in design, manufacture, assembly, improper or careless use, wind, weather conditions, acts of nature or God, whether any of these above conditions, acts or risks are foreseen or unforeseen, contemplated or not contemplated, obvious or hidden, or through omission or commission.

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The United States Parachute Association recommends that all skydiving participants receive a FAA Class III medical examination or be examined by a physician prior to making a parachute jump. In lieu of this certification, all participants must complete the following medical statement: “I represent and warrant that I have no known physical or mental infirmities that would impair my ability to participate in skydiving, or if I do have any such infirmities, that they have been or are being successfully treated so that they do not represent any foreseeable risk while skydiving. I also represent and warrant that I am not taking any medications or substances, prescription, or otherwise, that would impair my ability to participate in skydiving.”

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I further certify that I have not taken any alcoholic beverages or non-prescription or prescription drugs that could affect my ability to participate in “Parachuting Activities” within the last 12 hours. I also recognize that it is against Federal, State and USPA regulations to take either alcohol or drugs while engaging in parachuting activities and agree to refrain from doing so.

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I agree to consult with a medical professional if I have any questions concerning any medical conditions, which might affect my participation in skydiving and parachuting activities. I understand that BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center and their representatives cannot make any medical determination for me.

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I hereby give BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center, Wink’s Down to Earth Photography, Inc. permission to use any video or photographs taken of me or my party while participating in skydiving activities for advertising, promotional or other purposes. I specifically waive any interest proprietary or otherwise, I may have in such photographs and videos.

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In the event I sustain any injury while participating in parachuting activities, I authorize representatives of BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center to call emergency medical services for treatment or transport to a medical treatment facility. It is understood that this will be at my own expense, and is not covered by any general liability insurance of "The Released Parties."

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In the event of an accident, I further authorize representatives of the BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center to notify the following individuals:


BY SIGNING UNDER THE PARAGRAPH BELOW I INDICATE THAT I AM IN FULL AGREEMENT WITH THIS CONTRACT:

“I absolve each of the ‘Released Parties’ from any and all responsibility and liability for any loss, or future claims resulting from my participation in aviation and skydiving. I also instruct my heirs, family, friends, and executors or administrators of my estate that they are NOT authorized to file any lawsuits or claims for loss, reimbursement or damages of any kind in the event of my death or bodily injury. I understand and accept all risks, duty of care, responsibility and liability related to or arising from skydiving and related activities.”

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Signature 1

The terms of this Release, Waiver and Indemnity Agreement are contractual and not a mere recital and contain the entire agreement between the parties hereto. Warning: Parachuting and skydiving are exciting and challenging activities. However, THE RISK OF SERIOUS INJURY OR DEATH IS REAL and should not be overlooked or underestimated. DO NOT PARTICIPATE in these activities unless you voluntarily accept these risks.

I HAVE CAREFULLY READ THIS RELEASE, WAIVER AND INDEMNITY AGREEMENT. IT HAS BEEN EXPLAINED TO ME AND I UNDERSTAND THAT BY SIGNING THIS AGREEMENT I AM GIVING UP IMPORTANT LEGAL RIGHTS. I FULLY UNDERSTAND THE CONTENTS AND SIGN IT OF MY OWN FREE WILL.

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Signature 2

In consideration of the permission and facilities extended to the undersigned, BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center the undersigned, BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center agree to hold safe Sam and Judy Hilty, who have no independent knowledge of skydiving and the risks associated therewith, and who, in consideration of their release from liability, have agreed to permit me, the undersigned, BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center to use their airport facilities, as well as its agents and employees from any and all claims, demands, or causes of action for injuries, deaths, property damage arising from aircraft flights, skydiving and parachute activities, or related ground operations, on their premises at: Hilty Field, 11679 Blough Road, Rittman, Ohio.

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Signature 3

Warning:

BLUE SOVEREIGN, LLC dba: AerOhio Skydiving Center, Wink’s Down to Earth, Inc.inform you that:

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.

These are all exciting and challenging activities. However, THE RISK OF SERIOUS INJURY OR DEATH IS REAL and should not be overlooked or underestimated. DO NOT PARTICIPATE in these activities unless you voluntarily accept these risks.

I have been adequately warned of these dangers and voluntarily accept these risks and loss of important legal rights. I wish to participate in the activities of skydiving, parachuting, flying and all of its related activities.


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Signature 4

By checking here, you acknowledge you have read and understand the above terms, and 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.

*Initialing where indicated in this document indicates that you have read, understood, acknowledge and agree to the forgoing.