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CERTIFIED PARACHUTIST STATEMENT OF MEDICAL FITNESS, AND RELEASE OF LIABILITY & ASSUMPTION OF RISK

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Conditions of Rental Equipment:

Whenever used herein, the term "equipment" shall include any equipment rented from Skydive Qatar.

RESPONSIBILITY FOR DAMAGE OR LOSS:

Customer agrees he/she will return the equipment in the same good condition as when received, ordinary wear and tear accepted, and to repair and replace lost or stolen, damaged or broken parts or to reimburse Skydive Qatar for said equipment or parts by means of the provided Credit information. The Loss of Handles & other damage to equipment during the time of  use including emergency reserve repacks are not considered as normal wear and tear. Therefore regardless of the party at fault, customer understands and agrees to be responsible for the damage to said equipment and is liable for any related cost of repairing or replacing the equipment.

CUSTOMER LIABILITY:

Customer shall assume liability for any and all damage or loss to personal property, accident/injury to other persons related to Skydive Qatar rental equipment.

TERMINATION OF AGREEMENT:

Customer agrees that Skydive Qatar has the right to terminate this agreement at any time and retake possession of said equipment and for said purpose.

I, the renter, agree:

- to use rental equipment in accordance of its intended use - to not alter or substitute any parts on the equipment without prior consent from Skydive Qatar employees

- to adhere to all rules and laws of the CAA, USPA, and Skydive Qatar

- to refrain from using said rental equipment while under the influence of drugs or alcohol

- to wear a protective helmet , Altimetre and goggles at all times in accordance with USPA Rules and Regulations.

- to refrain from smoking while wearing any of the equipment or jumpsuits.

by signing this document, I approve of the current functioning condition of all rented equipment -by signing this document, I am stating my proficiency and confidence in participating in skydiving sports, experience, and knowledge of the laws and dangers of participating in such activities I HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTAND ITS CONTENT. I AM AWARE THIS IS AN ASSUMPTION OF RISK, WAIVER, AND RELEASE OF LIABILITY AND I SIGN IT VOLUNTARILY.

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In consideration of being permitted to utilize the facilities and equipment of SKYDIVE QATAR LLC, and its associated entities and facilities to participate in parachuting/skydiving activities, ground instruction, flying and aviation activities, and all other related activities including, but not limited to, solo, experimental and/or tandem skydiving, hereinafter collectively referred to as “Skydiving Activities,” as defined hereunder.


I hereby declare and acknowledge that, I am not under the influence of alcoholic beverages, I have not ingested any substances, nor have I taken any prescription medication within the past 24 hours that may affect my judgment or ability to perform. I agree not to jump now or in the future under the influence of alcohol or other drugs or substances.

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I hereby declare that I am physically fit. I do not, and have not, suffered from any of the following conditions, which I understand may lead to a dangerous situation with regard to myself or other persons during parachuting and I declare that I do not suffer from the following:

•    Epilepsy, fits, severe head injury, recurrent blackouts or giddiness, disease of the brain or nervous system, high blood pressure, heart or lung disease, dislocated shoulder, recurrent weakness or dislocation of any limb, diabetes, mental illness, drug or alcohol addiction.

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I further declare that I do Free-fall Skydive Jump under my responsibility without any coercion by SKYDIVE QATAR LLC and I am responsible for any injury or accident might be occurred if related to the above-mentioned sickness.

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I hereby release and discharge to the fullest extent allowed by law SKYDIVE QATAR LLC, its owners, officers, shareholders, their agents, customers, associated entities, pilots, riggers, jumpmasters, instructors, guides, technicians, independent contractors, and all other employees, volunteers, and/or owners of any and all aircraft used for Skydiving Activities, owners of any land utilized for Skydiving Activities, any owner or entity charged with the setup, inspection or maintenance of any piece of equipment which I may use or which is in any way, shape or form being used in connection with my Skydiving Activities, all parties mentioned anywhere herein by name or by category, all vendors, manufacturers, suppliers or owners of materials or equipment used for Skydiving Activities, and anyone involved in any way, shape, form or manner in my Skydiving Activities, specifically including but not limited to solo, tandem and/or experimental test parachute jumping (hereinafter collectively referred to in this Agreement as “Released Parties”), from any and all liability, claims, demands, suits, actions or causes of action that I and/or any person or entity may have on account of or arising out of any injury or death which I may sustain or any damages or loss of any kind to me or my property arising out of my participation in Skydiving Activities under this Agreement, even if caused by the negligence or other fault, act or omission, either active or passive, direct or indirect, of one or more of the Released Parties.

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I hereby certify that I am a licensed skydiver and shall use sound judgment and undertake Skydiving Activities in accordance with USPA regulations, any other applicable laws, instructions, warnings, regulations, best practices, and/or manufacturers’ operating manuals and guidelines.

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I hereby agree to comply with all rules, instructions, warnings, regulations, best practices, and operational limitations imposed by any relevant governing entity. I further certify that I have received a SKYDIVE QATAR LLC’s Drop Zone briefing, understand its rules and guidelines and shall fully abide by them. In the event that I undertake Skydiving Activities in violation of any such rule, I agree to indemnify and hold Released Parties harmless from all claims, judgments, disbursements, penalties, fines, and costs, including but not limited to reasonable attorneys’ fees, and I further agree to reimburse Released Parties for any expenses incurred by them in connection with any regulatory action, claim, penalty, administrative procedure, action or lawsuit brought as a result of my alleged violation(s) of any such rule(s), regulation(s), instruction(s), warning(s), best practices(s), and/or operational limitation(s) imposed by the Federal Aviation Administration and/or any other relevant governing or regulating entity, including any such regulatory action, claim, or lawsuit brought directly against Released Parties.

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I hereby certify that I have inspected and am content with the packing of my gear, whether it be my own gear or rental gear rented from Released Parties. I have confirmed that my reserve parachute has been packed, by an appropriately certified parachute rigger and will be “in-date”, on all parachute jumps I may make at all times envisioned under this Statement. Should my reserve parachute become “out of date”, I will have it properly packed prior to making any jumps.

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For any non-tandem or student Skydiving Activities, I assume full responsibility for any gear I rent, use and/or borrow from SKYDIVE QATAR LLC. I also agree that I will pay for the cost of all repairs and the replacement of any gear damaged beyond repair, or any gear that is lost and not recovered. I will pay the cost of the main canopy repack and the reserve repack, if necessary. If I have any questions about the gear, I will consult a SKYDIVE QATAR LLC rigger or instructor before using the gear. I understand that I am responsible to inspect and pack all gear that I use on every jump.


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I hereby agree that I, my heirs, or any person or entity acting on my behalf, at any time, will not institute any lawsuit, make any claim or take any action whether at law, equity or otherwise, against Released Parties for damages or other losses, including my injury or death, which may sustain or any damages or loss of any kind to me or my property arising out of my participation in Skydiving Activities, even if caused by the negligence or other fault, act or omission, either active or passive, direct or indirect, of one or more of the Released Parties. I further agree that I, my estate or anyone or any entity acting on my behalf or on behalf of my estate, will not initiate or assist in the prosecution of any claim for damages or cause of action which I, my heirs, executors, or administrators hereafter may have by reason of injury and/or death to my person or property arising from Skydiving Activities.

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NOTES FOR PARACHUTISTS: No persons under the age of 18 are permitted to parachute without Parents approval. Certified parachutists do not have to be particularly fit but there are some medical conditions that can cause problems. As well as the conditions listed overleaf, the following may cause problems to parachutists. If you have ever suffered from any of them you must have your doctor’s approval before parachuting:

•    Previous fractures, back strain, arthritis and severe joint spins. Chronic bronchitis. Asthma. Rheumatic fever. Pneumothorax. Liver or Kidney disease. Anemia. Thyroid, adrenal or other glandular disorder. Chronic ear or sinus disease. Any condition which requires the regular use of drugs. Regular or recent blood donation.

However, if you do wear spectacles they should be securely attached while parachuting. Protective goggles should be worn.

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NOTES FOR DOCTORS: Cardiorespiratory fitness is important. Certified parachutists make descents from unpressurised aircraft at heights of 5,500 to 15,000 feet above sea level without supplementary oxygen. At 15,000 feet, there is a 40% reduction in available oxygen. A tachycardia of 120 – 160 bpm is common in experienced parachutists. The tachycardia may be present at the same time as relative hypoxia. Ischemic heart disease, uncontrolled hypertension and cerebrovascular disease are absolute contraindications. Candidates with traumatic tetraplegia may have reduced ventilator capacity. The examining doctor should be satisfied that any impairment will not cause respiratory embarrassment at altitude. A history of autonomic dysreflexia should be excluded in candidates with spinal injuries above mid-dorsal level. Specialist advice should be sought in cases of doubt.


Unstable or dislocated shoulders are particularly likely to dislocate again while parachuting. This is painful and risks further injury to the joint. During the parachute deployment there is a brisk deceleration, usually about 4g but occasionally up to 15g. Unstable spinal injuries or subluxation may be exacerbated by such deceleration. The landing impact typically involves a variable descent rate equivalent to jumping from a wall 0 - 4 feet high, with a horizontal speed of 0 - 15 mph. occasionally the landing impact may be considerably greater than this. Pre-existing spinal problems, joint injuries and arthritis can be exacerbated but are far less likely to be.


Middle ear or sinus disease may cause problems due to the rapid changes in ambient air pressure. The rate of descent in free-fall may exceed 10,000 ft. /min and under an open canopy 1,000 ft. /min. 


The candidate must be capable of appreciating what is happening and of giving informed consent. Stable diabetes with no tendency to hypoglycemia is acceptable. Epilepsy is not a contraindication provided that control is good and there have been no fits or changes in medication in the last two years. Most neurodegenerative disorders are acceptable unless respiratory impairment or marked postural hypotension is present.

 
Normal mental development and a stable mental state are important. The candidate must be able to understand what he/she is about to do and be capable of giving fully informed consent. Current neurosis requiring active treatment, history of psychosis, subnormality, pathological euphoria, drug addiction and alcohol dependence all constitute a contraindication. 


A certifying doctor is not stating that a candidate will remain free of injury during parachuting, but that records, history or appropriate clinical examination have not suggested unacceptable medical risk factors. The preferred level of skill is usually that of a GP without specialist knowledge of parachuting but usually with access to the candidates’ records or a specialist responsible for the patients care. Other doctors completing the certificate should remain aware that lack of access to the medical record could result in important conditions being overlooked.

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I have carefully read this Statement and I am fully understand its contents, intend to be bound by it, and sign it of my own free will.


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