START SKYDIVING, LLC SKYDIVING AGREEMENT 

THIS IS AN IMPORTANT LEGAL DOCUMENT. BY SIGNING IT, YOU ARE GIVING UP CERTAIN LEGAL RIGHTS PLEASE READ IT CAREFULLY

In consideration of Start Skydiving, LLC allowing _____________________________________ to utilize the facilities and participate in the skydiving/parachuting, aviation, and related activities (hereinafter referred to as "activities covered by the Agreement”), I agree that: 1. ASSUMPTION OF RISK. I know and understand the scope, nature, and extent of the risks involved in the activities covered by this Agreement. I understand these risks include, but are not limited to: equipment malfunction and/or failure to function; defective and/or negligent design and/or manufacture of equipment; improper and/or negligent parachute packing and/or assembly; improper and/or negligent operation and/or use of the equipment; aircraft malfunction and/or negligent aircraft operation; carelessness and/or negligent instruction and/or supervision. I voluntarily, freely and expressly choose to incur all risks associated with the activities covered by this Agreement, understanding that those risks may include personal injury, damage to property, and/or death.

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2. EXEMPTION AND RELEASE FROM LIABILITY. I exempt and release the following persons, corporations, and organizations: Start Skydiving, LLC; all aircraft owners, and pilots with whom it contracts for flying services; the United States Parachute Association (USPA); the City of Middletown, B&B Aero, John & Suzanne Hart: and including all of each person's, corporations, and organization's officers. agents, servants, employees, representatives, lessors; (hereinafter collectively referred to as “Releasees”), from any and all liability, claims, demands pr actions or causes of action whatsoever arising out of any damage, loss or injury to me or my property, or my death, while upon the premises or aircraft or while participating in any of the activities covered by this Agreement, whether resulting from the negligence and/or other fault, either active or passive, of any of Releasees, or from any other cause.

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3. COVENANT NOT TO SUE. I agree never to institute any suit or action at law or otherwise against any of Releasees, 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 other fault, either active or passive, of any of Releasees, or from any other cause. 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 Releasees, nor shall they initiate or assist the prosecution of any claim for damages or 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, arising from activities covered by this Agreement, whether caused by the negligence and for other fault, either active or passive, of any of Releasees, 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 such suit or action at law or otherwise be instituted against any of Releasees, I agree that such Releasees shall be entitled to recover attorneys' fees and costs incurred in defense of such suit or action, including any appeals there from.

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4. INDEMNITY AGAINST THIRD PARTY CLAIMS. I will indemnify, save and hold harmless 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 persons or organizations and which arise directly or indirectly from my participation in the activities covered by this Agreement, whether resulting from the negligence and/or other fault, either active or passive, of any of Releasees or from any other cause.

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5. VALIDITY OF WAIVER. I understand and agree 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 Releasees 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 as evidence in court, and that agreements like this one have been upheld in courts in similar circumstances.

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6. REPRESENTATIONS AND WARRANTIES. 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 of the following: cardiac or pulmonary conditions or disease, 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 (circle one) wear corrective lenses.

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(List infirmities. If none, state “NONE”)

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ME:

7. APPLICABLE LAW/WAIVER OF JURY TRIAL/VENUE/HEADINGS. I agree that the law of the State of Ohio shall apply to issues involving the construction, interpretation, and validity of this Agreement and that Ohio law shall govern any dispute between the parties arising from the activities contemplated by this Agreement. Should this Agreement be violated and suit be brought against any of Releasees, my right to a jury trial is waived, and Butler County, Ohio shall be the sale venue for any such suit, which shall be tried non-jury. I agree that the headings and subheadings used throughout this Agreement are for convenience only and have no significance in the interpretation of the body of this Agreement.

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8. SEVERABILITY. 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.

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9. LIFT RATES / PHOTO RIGHTS I agree to pay the published rates as posted in the office and/or at manifest for each lift depending on the altitude flown on the flight. I agree to allow all photos and video taken to be used by Releasees.

Initial 10. CONTINUATION OF OBLIGATIONS. I agree and acknowledge that the terms and conditions of this 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 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 in favor of Releases I have signed.

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11. ACKNOWLEDGEMENT. I hereby acknowledge that I have read all of the provisions above and fully understand the terms and conditions expressed therein and agree to be bound by such terms and conditions.

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BY: ___________________________________ __________ _____________________________ PARTICIPANT'S SIGNATURE AGE DATE AND TIME

_____________________________________ ___________________________________ WITNESS’S SIGNATURE MANIFEST SIGNATURE

First Name Middle Initial Last Name (Family/Surname) Home Telephone

Street Address Work/Cell Telephone

City State Zip Code Country Email Address

Date of Birth Height Weight Occupation Other

For Emergency Notify: Name Relationship Phone Number

Address City State Zip Code Country

USPA or other Membership Number USPA or Other License Citizenship Number of Jumps

Membership Expiration Date Health Insurance Company Health Insurance Policy #

Reserve Pack Date (OFFICE USE ONLY)

This is an important legal document. Allow yourselfsu�cient time to carefully read and understand theentire document, because by signing it, you areagreeing to give up certain legal rights.

In consideration of the Uninsured United Parachute Technologies doing business as United Parachute Technology andStart Skydiving, LLC, hereinafter referred to as“Corporation”, allowing me the privilege of utilizing a dual-harness,dual container parachute pack assembly (also known as a “tandemparachute system”), designed, manufactured and/or assembled bythe Uninsured United Parachute Technologies, inc ,for the purpose of performing an intentional parachute jump, I agreethat:

1) Representations, Warranties, & Assumptions of Risk: Iunderstand that parachute jumping will expose me to the risk ofpersonal injury, property damage and/or death. I understand thatthe success of my jump is dependent upon the perfect functioningof the airplane from which I intend to jump and the parachute system,and that neither the airplane nor the parachute system can beguaranteed to function perfectly. I understand that the airplane andthe parachute system are both subject to mechanical malfunctionsas well as operator error. I freely, voluntarily and expressly chooseto assume all risks inherent in parachute jumping, including, butnot limited to, risks of equipment malfunction and/or failure tofunction, including those which may result from some defect indesign, assembly, and/or manufacture as well as those risks arisingfrom 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 thefollowing persons and organizations:

(A) The Corporations and their officers, directors, agents,servants, employees, shareholders, and other representatives;

(B) Manufacturers, designers, and suppliers of componentequipment incorporated in the dual-harness, dual-containerparachute pack assembly to which I will be attached during myintentional parachute jump;

(C) Owners, suppliers, and operators of aircraft from whichI am to make my intentional parachute jump;

(D) The owner of the dual-harness, dual-container parachutepack assembly, and any of its components, to which I will beattached during my intentional parachute jump;

(E) The operator (“parachutist in command”) of the dual-harness, dual-container parachute pack assembly to which I will

TANDEM PARACHUTE JUMPER AGREEMENTbe attached during my intentional parachute jump;

(F) If I am making my intentional parachute jump at or neara parachuting/skydiving facility, the owners and operators of thatfacility, as well as their officers, directors, agents, servants,employees, shareholders, and other representatives;

(G) The owners and lessees, if any, of land upon and fromwhich the parachute jumping and related aircraft operations areconducted; 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, andany and all other skydiving referral service business entities, and/or owners of fictitious name entities which I may have used inlocating and/or deciding upon a parachuting/skydiving facility orother location at which to perform an intentional parachute jump.

(I) Any other person and/or organization which is or maybe liable for any loss or injury to me and or my property, or mydeath, arising out of my participation in any of the activities coveredby this Agreement (as defined below);

From any and all liability, claims, demands or actions or causes ofaction whatsoever arising out of any damage, loss or injury to meor my property, or my death, whether occurring while I am trainingand/or preparing for my intentional parachute jump, while I ampresent in aircraft from which the jump is to be made, while I ammaking my intentional parachute jump, or while I am engaged inrelated activities (hereafter referred to as “activities covered by thisAgreement”), whether such loss, damage, injury, or death resultsfrom the negligence and/or other fault, either active or passive ofany of the persons and/or organizations described in paragraphs2(A)-(I) above, or from any other cause.

3) Covenant Not to Sue: I agree never to institute any suitor action at law or otherwise against any of the organizations and/or persons described in paragraph 2(A) through (I) above, or toinitiate or assist in the prosecution of any claim for damages orcause of action which I may have by reason of injury to my personor property, or my death, arising from the activities covered by thisAgreement, whether caused by the negligence and/or fault, eitheractive or passive, of any of the organizations and/or personsdescribed in paragraph 2(A) through (I) above, or from any othercause. I further expressly agree that I will never raise any claimagainst any of the organizations and/or persons described inparagraph 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 allegedto result from the fault or negligence of the parties released. Ifurther agree that my heirs, executors, administrators, personalrepresentatives, and/or anyone else claiming on my behalf, shallnot institute any suit or action at law or otherwise against any ofthe organizations and/or persons described in paragraph 2(A)

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Uninsured United Parachute Technologies

through (I) above, nor shall they initiate or assist the prosecution ofany claim for damages of cause of action which I, my heirs,executors, administrators, personal representatives, and/or anyoneelse claiming on my behalf may have by reason of injury to myperson or property, or my death arises from the activities coveredby this Agreement, whether caused by the negligence an/or fault,either active or passive, of any of the organizations and/or personsdescribed in paragraph 2(A) through (I) above, or from any othercause, 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 violationof this Agreement against any of the organizations and/or personsdescribed in paragraph 2(A) through (I) above, I agree that suchorganizations and/or persons shall be entitled to recover, in additionto any other damages which may be incurred, reasonable attorneys’fees and costs incurred in defense of such suit or action, includingany appeals therefrom.

4) Indemnity Against Claims: I will indemnify, defend, saveand hold harmless the organizations and/or persons described inparagraph 2(A) through (I) above from any and all losses, claims,actions or proceedings of every kind and character, includingattorneys’ fees and expenses, which may be presented or initiatedby any persons and/or organizations and which arise directly orindirectly from my participation in the activities covered by theAgreement, whether resulting from the negligence and/or other fault,either active or passive, or any of the organizations and/or personsdescribed in paragraph 2(A) through (I) above, or from any othercause.

5) Validity of Waiver: I understand that if I institute or anyoneon my behalf institutes, any suit or action at law or any claim fordamages or cause of action against any of the organizations and/or persons described in paragraph 2(A) through (I) above becauseof injury to my person or property, or my death, due to the activitiescovered by this Agreement, this Agreement can and will be used incourt, and that such agreements have been upheld in courts insimilar circumstances.

6) Representations and Warranties as to Medical Condition:I represent and warrant that (a) I have no physical infirmity, exceptthose listed below, am not under treatment for any other physicalinfirmity or chronic ailment or injury of any nature, and have neverbeen treated for any other of the following: cardiac or pulmonaryconditions or diseases, diabetes, fainting spells or convulsions,nervous disorder, kidney or related diseases, high or low bloodpressure; (b) I am not under any medication of any kind at thepresent time; and (c) I do/do not (strike one) wear corrective lenses.If I am prescribed corrective lenses, I agree to wear them during myintentional parachute jump.

(list infirmities, if not, state “none”)

7) Waiver of Jury Trial/Applicable Law/Venue/Headings: Iagree that the law of the State of Florida shall apply to issuesinvolving the construction, interpretation, and validity of thisAgreement, and that Florida law shall govern any dispute betweenthe parties arising from the activities covered by this Agreement. Inthe 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 thatVolusia County, Florida shall be the sole venue for any suit or actionarising from the activities covered by this Agreement. I agree thatthe headings and sub-headings used throughout this Agreementare for convenience only and have no significance in the interpretationof the body of this Agreement.

8) Severability/Multiple Waivers: I agree that should one ormore provisions in this Agreement be judicially determined to beunenforceable, the remaining provisions shall continue to be bindingand enforceable against me. If I have executed any other agreementcontaining provisions relating to the exemption and/or release fromliability and/or covenant not to sue in connection with the activitiescovered by this Agreement, I agree that the agreement which providesthe most protection from liability and/or suit to the Uninsured UnitedParachute Technologies, Inc shall be enforceableagainst me by the Uninsured United Parachute Technologies .

9) Continuation of Obligations: I agree and acknowledgethat the terms and conditions of this Agreement shall continue inforce and effect now and in the future at all times during which Iparticipate in the activities covered by this Agreement, and shall bebinding upon my heirs, executors, administrators, personalrepresentatives, and/or anyone else claiming on my behalf. ThisAgreement supersedes and replaces any prior such agreement Ihave signed.

10) Viewing of Videotape: I have viewed and I warrant thatI fully understand the accompanying “Tandem Vector Waiver” videotape.

I freely and voluntarily agree to all of the above by signing this

contract on the _____________ day of ______________________(day) (month and year)

at Start Skydiving, LLC of Middletown, Ohio 45042 . (location)

JUMPER: (Please Print Neatly)

Name: _____________________________________

Signature: __________________________________

Driver’s License Number: _______________________

Age: _________ Birthdate: _____________________

Address: ___________________________________

____________________________________________

Telephone #: ________________________________

Witness: ___________________________________*Please read each paragraph carefully. Your initial indicatesyou understand and agree to all of the information and termscontained therein.

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