Massachusetts Sport Parachute Club d.b.a Jumptown

Tandem Waiver

Skydiving can cause death and serious bodily injuries. 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 and all persons associated with its manufacture, operation and maintenance.                           

I. MEDICAL STATEMENT, AGREEMENT, RELEASE OF LIABILITY AND ASSUMPTION OF RISK

1. 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.

2. The terms of this Medical Statement, Agreement, Release of Liability and Assumption of Risk are contractual and not mere recital and contain the entire agreement between the parties hereto. WARNING: 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 in these activities unless you voluntarily accept these risks.

3. I UNDERSTAND THAT THE SPORT OF SKYDIVING COULD CAUSE SERIOUS INJURY OR EVEN DEATH. I RECOGNIZE THAT IT IS AN ADULT SPORT AND I AGREE TO TREAT IT AS SUCH. I HEREBY ACKNOWLEDGE AND ASSUME THE RISKS INVOLVED WITH THIS SPORT. 

4. The United States Parachute Association recommends that all skydiving participants receive an FAA Class 3 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:

5. I recognize that the sport of parachuting is a strenuous, athletic endeavor requiring me to be in physical condition, and that even if in good physical condition I may suffer or become prone to knee, neck and/or back degeneration of ailments. I hereby certify that I am not aware of, and do not suffer from, any physical or medical condition or any of the following:​

1. Cardiac or pulmonary condition or disease
2. High or low blood pressure
3. Fainting spells, convulsions or epilepsy
4. Neck or back soreness or injury of any kind
5. Nervous or mental disorders
6. Kidney or related diseases
7. Shortness of breath
8. Drug or alcohol dependency
9. Any orthopedic, bone or musculoskeletal condition
10. Any impairment of alertness  
    I Agree
    ​​

6. I further certify that I am not on any regular medication and have not taken alcoholic beverages or drugs within the last twelve (12) hours. I also recognize that it is against Federal, State, United States Parachute Association, and JUMPTOWN rules and regulations to take either alcohol or drugs while engaging in parachuting activities and agree to refrain from doing so.

7. 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 JUMPTOWN and their representatives cannot make any medical determination for me. 

II. In consideration of being permitted to utilize the facilities, equipment or training provided by JUMPTOWN or the services of any of its personnel or of any Released Party as the term shall be defined herein to engage in parachute jumping, ground instruction flying and related activities herein after collectively referred to as parachuting activities, I hereby agree as follows:

a. I hereby FULLY AND FOREVER RELEASE AND DISCHARGE any person or entity connected in any way with training, flying, skydiving or parachute jumping, including but not limited to JUMPTOWN, JUMPTOWN BOARD OF DIRECTORS, JUMPTOWN CLUB MEMBERS, TOWN OF ORANGE, ORANGE MUNICIPAL AIRPORT, ORANGE MUNICIPAL AIRPORT COMISSION, PAUL ROSSOUW, JAMES FORDE, CHRISTOPHER BELLI, ANDREA BOHDIEWICZ, JAMES LEE, ISR Aviation LLC, the University of Massachusetts, Massachusetts Institute of Technology, United Parachute Technologies, Parachute Labs, Inc DBA Jump Shack, manufacturers, distributors and dealers of skydive equipment, their officers, directors, agents, employees; all property owners, aircraft owners, pilots, aircraft or other contractors or providers; all instructors, jump masters and riggers utilized for parachuting activities: all airport operators and/or owners and fixed base operators; all municipalities and utilities and the United States Parachute Association (all hereinafter collectively referred to as Released Parties: which term shall include each person so released in his individual as well as any representative capacity and whether or not an employee, volunteer or independent contractor), from any and all suits, claims, liability, demands or causes of action that I may hereinafter have for injuries and/or damages arising out of my participation in parachuting activities, wherever and whenever-conducted, including but not limited to LOSSES CAUSED BY ANY AND ALL DEGREES OF NEGLIGENCE OR OTHER FAULT OF THE RELEASED PARTIES.

b. I further agree that I WILL NOT SUE, OR MAKE CLAIM AGAINST, THE RELEASED parties for injuries and/or damages or other losses sustained as a result of my participation in parachuting activities.

c. I also agree to INDEMNIFY AND HOLD THE RELEASED PARTIES HARMLESS from all claims, judgments and costs, including attorney fees, incurred in connection with any action brought by me, my estate, heirs, or by any person as a result of my participation in parachuting activities. I understand and agree that any and all releases given or made by me in this document shall continue and inure to the benefit of any Released Party with whom I may have in the past or may in the future interact or contract for any purpose connected in any way with parachuting activities or the sport of parachuting, or flying or skydiving on an individual, separate or private basis.

d. I understand and acknowledge that parachuting activities have inherent dangers that no amount of care, caution, instruction or experts can eliminate and I EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF DEATH OR PERSONAL INJURY SUSTAINED WHILE PARTICIPATING IN PARACHUTING ACTIVITIES WHETHER OR NOT CAUSED BY ANY AND ALL DEGREES OF NEGLIGENCE OR FAULT OF THE RELEASED PARTIES OR ANY DEFECT IN THE AIRCRAFT OR EQUIPMENT PROVIDED OR LANDING AREA OR SURROUNDINGS. 

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

6. 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 issues to the Released Parties, and that it is a commonly known fact that this type of insurance is unavailable. I further assume all responsibility for any damage, harm or injury of any nature that my parachuting activities may cause to others. 

7. Limitation of Warranty: I hereby acknowledge that there is a Limitation of Warranty on the equipment provided to me for skydiving and parachuting activities and that this equipment is warranted only to the extent that it has been used previously for these activities. 

THIS WARRANTY IS THE ONLY WARRANTY MADE IN LIEU OF ANY OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING BUT NOT LIMITED TO A WARRANT OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. 

III. 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. 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 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 that I have against The Released Parties by reason of the same.

IV.  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; the 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. 

V. I hereby give JUMPTOWN permission to use any video or photograph taken of me while participating in skydiving activities for advertising, promotional or other purposes. 

VI. I understand that any property left at Jumptown or on Jumptown property that is under Jumptown’s control is done so by the owner at his or her own risk for the sole convenience of the owner, whether it is in a locked or unlocked location and Jumptown assumes no responsibility whatsoever.

VII. Duration of Release: It is my understanding and intention that this release is effective not only for my first jump or plane flight, but also for all subsequent jumps or flights made with the facilities or equipment of, or in any way involving the personnel of or relying on the training provided by the Released Parties, I hereby agree and acknowledge that all of the terms and conditions of this Release of Liability, Agreement and Assumption of Risk 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, assignees, families, dependents, friends and executors of my estate. 

VIII. Enforceability: I agree that if any portion of this document should be found to be unenforceable or against public policy, then only such portions shall fail, but I specifically waive any unenforceability or any public policy argument that I may make or that may be made on my behalf or by or on behalf of my estate or anyone who would sue because of my, or anyone’s injury or death. 

IX. Whole Agreement: I acknowledge that this is the WHOLE AND ENTIRE agreement between the Released Parties and me. I am relying on no other oral or other terms, representations, assurances or any written or printed material of any kind. 

X. In the event that I sustain injury while participating in parachuting activities, I authorize representatives of Jumptown to call emergency medical services for treatment or to 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.

XI. The terms of this Medical Statement, Agreement, Release of Liability and Assumption of Risk are contractual and not mere recital and contain the entire agreement between the parties hereto. WARNING: Skydiving and parachuting 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 in these activities unless you voluntarily accept these risks.

XII. I HAVE CAREFULLY READ THIS AGREEMENT & RELEASE OF LIABILITY, FULLY UNDERSTAND ITS CONTENTS AND SIGN IT OF MY OWN FREE WILL. I UNDERSTAND BY SIGNING THIS AGREEMENT I AM GIVING UP IMPORTANT LEGAL RIGHTS. I UNDERSTAND IT IS A BINDING CONTRACT AND THAT NO ORAL REPRESENTATIONS OR STATEMENTS OF ANY KIND BY ANY PERSON CAN MODIFY THE RIGHTS OR DEFENSES IT CREATES IN THE RELEASED PARTIES, WHICH RIGHTS AND DEFENSES MAY BE IN ADDITION TO THOSE AVAILABLE UNDER STATUTE, THE COMMON LAW AND THE LAWS OF THE JURISDICTION. Further, any written modifications of this agreement I am giving up important legal rights, and it is my intention to do so. I have been advised that I am free to seek independent legal rights, and it is my intention to do so. I have been advised that I am free to seek independent advice or counsel of my own choosing before signing this document. I further agree that should I for any reason fail to initial part of this release, I will be deemed to do so.

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Today's Date: April 24, 2024

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 Jumptown, 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) 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.

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 againstany 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. 10) Viewing of Videotape: I have viewed and I warrant that I fully understand the accompanying “Tandem Vector Waiver” video tape. I freely and voluntarily agree to all of the above by signing this contract on April 24, 2024 at Jumptown.

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