FREEFALL UNITED INC. A31560R DROP ZONE: POSTAL ADDRESS: PO Box 241, Niddrie, Victoria, 3042 Parachuting Contract and Indemnity PARACHUTING IS DANGEROUS The following document must be read carefully. IN ORDER TO PARTICIPATE IN A JUMP WITH FREEFALL UNITED, YOU MUST COMPLY WITH THE FOLLOWING:- Freefall United - CHECK - You must be a current financial member of the APF. _______ (expiry date: ) - You must have at least a current B-Licence _______ - You must have a current display licence _______ - The organisers must approve your gear. _______ "Gear" means Reserve____ Main_____ Container______AAD_____ Your details: FAMILY NAME: GIVEN NAMES: ADDRESS: TELEPHONE NUMBER: (ah) (bh) APF No.: DATE OF BIRTH: CURRENT LICENCE LEVEL: OCCUPATION: EMERGENCY CONTACT: NAME: PHONE: (ah) (bh) ADDRESS: RELATIONSHIP: BY SIGNING THIS DOCUMENT I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD THE FOLLOWING PARTS OF THIS DOCUMENT AND THAT ALL THE ANSWERS I HAVE GIVEN ARE TRUE: (Or if I have not read or understood them, I have had them read to me or explained to me) The Waiver: yes I have read this/ no I have not The Declaration and conditions: yes I have read this/ no I have not (please cross out any part which does not apply) If you wish to have an independent person explain this document to you, now is the time to do it. You may take this document away to have it explained if you wish. Date of signing: Signed........................................................ Witness (witness signature).................................................... Name & address of witness - please print: -2- DECLARATION AND CONDITIONS 1. Health Declaration:- Are you prescribed any drugs which may impair reaction time or judgement? Yes/No (circle one) Are you taking/do you take, any drugs which may impair reaction time or judgement? Yes/No (circle one) If yes to either, state what drugs:........................................................ Have you received any medical attention in the last 12 months, as follows: Yes/No (circle one) If yes, give details:...................................................... Do you suffer from any medical conditions, allergies to any treatment drug or any condition which may affect your ability to observe or participate in any parachuting or related activities, or of which the club should be aware? Yes/No (circle one) If yes, give details:...................................................... NB: you are required to advise any relevant medical condition to the Drop Zone Safety Officer prior to participating in any parachuting or observing activities with the Club. 2. Exclusion of applicant Have you ever been excluded from parachuting in the past by a medical practitioner or any other person or entity, including the Australian Parachute Federation, any Area Council or parachuting club? Yes/No (circle one) If yes, give details:...................................................... ** The club reserves the right for any reason to refuse you permission to undertake or complete any jump.** WAIVER Please initial each paragraph as you read it 1. Who this contract binds. "the participant" means the individual who signs this document and the attached contract and who agrees to be bound by its terms and the terms and declarations contained in the application and includes a guardian of that individual if the individual is under 18 years of age. These terms and conditions apply to the participant whether participating in parachuting activities or not, and whether flying in an aircraft as a passenger for the purpose of parachuting activities or not. "the providers" are the persons named and described in Schedule 1, and refers to them jointly and severally. -3- 2. I accept this contract I, the participant, hereby agree that parachuting is dangerous and agree to be bound by the terms of this Contract with Freefall United and the providers. The providers agree to permit me to use their premises, aircraft and facilities for parachuting, to coach or tutor me in parachuting and related activities, including high altitude low opening jumps and including observing parachuting from an aircraft or from the ground, as well as any other related activities upon and subject to the following terms and conditions:- 3. Parachute at your own risk. The participant acknowledges that parachuting is dangerous and that parachuting, parachute instruction, observation, flying in any aircraft used for parachuting (whether as a parachutist or as an observer) or participating in activity carried on by the providers can lead to injury or death or damage to property and he or she ACCEPTS ALL RISK associated with parachuting or any other activities involving the providers. 4. Waiver and Indemnity In all cases, (except where inconsistent with paragraph 5 below): the participant, on behalf of him/herself and all of his/her executors, administrators, dependants and any other personal representatives, hereby absolves and indemnifies the providers and all of their servants, agents, employees or any other person under their control (together called "the indemnified")from all liability, demands, actions, suits, claims, proceedings, costs and expenses, howsoever arising, which may be made or taken against any of those persons for any injury or damage (whether fatal or otherwise, whether mental or physical, whether temporary or permanent and whether relating to the person or to the property of the participant) howsoever caused, (whether by the negligence of any of the indemnified or otherwise) resulting from or relating to any parachuting activities, including high altitude low opening jumps, training, coaching or tutoring, parachute descents, flying in any aircraft being used for or in connection with parachuting (whether as a parachutist, an observer or otherwise) or in any way arising from any activity carried on by the indemnified. 5. Consumer's rights Where the participant is a consumer as defined by any relevant Commonwealth or State law such as the Trade Practices Act 1974 (Cth) or any similar state laws, such as the Fair Trading Act 1985 (Vic) then certain terms and rights will be implied into any contract for the supply of goods and services for the benefit of that person. Such terms and rights and any liability of the providers flowing from such terms and rights cannot be excluded, restricted or modified by contract. The terms of this Contract shall apply save where they are inconsistent with such legislation, in which case they are to be read subject to such legislation. 6. Club fees The participant will pay on demand any and all stated fees for any service provided. Those fees may be notified to me verbally or by way of letter or memorandum or notice displayed at the drop zone or any other premises of the providers. (These fees do not necessarily include any fee payable for membership of Freefall United.) -4- 7. AUSTRALIAN PARACHUTE FEDERATION Fees and regulations The participant will pay on demand any and all prescribed or stated fees applicable to join the Australian Parachute Federation. The participant will not be permitted to undertake any of the parachuting or related services offered by the providers until and unless the participant has joined the Australian Parachute Federation and holds at least an appropriate "B-licence" or recognised equivalent. The participant agrees that this agreement is conditional on him or her complying with all Operational Regulations and reasonable requirements of the Australian Parachute Federation. 8. Health conditions The participant warrants that he or she does not suffer and has not at any time suffered from any blackouts, epilepsy, seizure, convulsion, fainting or dizzy spells and is not receiving any treatment for any illness, disorder or injury which would make it unsafe to participate in any parachuting or flying activities. The participant warrants that the health statement contained in this document is true and all relevant medical conditions (as described herein or otherwise) will be notified to the Drop Zone Safety Officer before undertaking any parachuting or flying activities. 9. Exclusion from other clubs etc The participant warrants that he or she has not at any time been excluded from parachuting or flying by a medical practitioner or any other person or entity including the Australian Parachute Federation, any Area Council or any parachuting club. 10. No compulsion Nothing in this Contract compels any of the providers to provide any service to the participant. 11. Governing Law This Contract is governed by the laws of the State of Victoria & the Courts of Victoria shall have exclusive jurisdiction to entertain any action relating to this Contract. 12. Statement of Understanding I, the participant, have read (or have had read to me) the above conditions and I understand these conditions and I consent to the activities proposed. I agree that I have had the opportunity to obtain any advice I may wish to obtain about it and that I sign it freely and understanding its effect. SCHEDULE 1 - Definition of "the providers" As well as Freefall United (which reference includes both as an unincorporated club and as an incorporated association), the providers in respect of this agreement include (but not limited to): (a) the president and office-holders from time to time and at all times of Freefall United; (b) the members from time to time of Freefall United; (c) Les Facer and Les Facer Aviation Pty Ltd; (d) the staff, instructors, tutors, coaches, drop zone safety officers, jumpmasters,target control officers, packers, riggers or other employees, agents or contractors of any of the above bodies at any time (whether acting for remuneration or otherwise); (e) aircraft operators, pilots or engineers, any related servants, agents, contractors or employees of any of the above bodies from time to time.