Attachment_1_Appendix_1.docx

Appendix 1

RELEASE, INDEMNIFICATION, AND HOLD HARMLESS AGREEMENT AND

AGREEMENT NOT TO SUE

I, ______________________________, hereby certify that I will be participating in parachute activities conducted by or on behalf of the United States Air Force and/or using equipment and aircraft owned or leased by the United States Air Force for parachute activities at the following location:_________________________________________.

I understand and agree that my participation in these parachute activities and/or the use of United States Air Force owned or leased equipment and aircraft for parachute activities involves the risk of serious bodily injury, death, or damage to property. I fully understand and appreciate the following:

a. The risks associated with parachute activities include, but are not limited to: equipment malfunctions, collision with other participants, collision with trees, power lines, towers, buildings, fences, and other manmade and natural obstructions, impact with terrain/hard landing, drowning, aircraft crash/accident, and high winds or wind gusts.

b. Parachute activities may involve a substantial risk of serious injury, death, or damage to property as a result of my own actions or inactions, the actions or inactions of others including agents, contractors, officers, service members, and employees of the United States Air Force and the United States Government, the conditions of Government facilities and the natural environment, the known or unknown condition of any government-furnished equipment, and the inherent dangers of parachute activities.

c. Parachute activities require me to be in overall good physical health and condition. Persons who are not in overall good physical health and condition should not participate in parachute activities. Participants in parachute activities should consult their physician before engaging in such activities to be certain they are qualified to do so. Anyone suffering from any injuries, conditions, ailments or pre-existing conditions that could affect their qualifications or jump status may not participate.

I hereby declare that I am certified and qualified for the level and type of parachute activities in which I will be participating. [If applicable] My United States Parachute Association (USPA) license number is_______________.

In consideration for my participation in these parachute activities and/or use of Air Force owned or lease equipment and aircraft for parachute activities, I voluntarily, willingly, and knowingly ASSUME ANY AND ALL RISKS, known and unknown, in any way associated with these parachute activities.

Furthermore, I, for myself, my heirs, administrators and assigns, hereby RELEASE, INDEMNIFY, AND HOLD HARMLESS the United States Air Force, the United States Government, and/or any of their officers, agents, or employees, acting officially or otherwise, from and against any claims, demands, actions, liens, rights, subrogated or contribution interests, debts, liabilities, judgments, costs, and attorney’s fees, arising out of, claimed on account of, or in any manner predicated upon my participation in these parachute activities and/or use of United States Air Force owned or leased equipment and aircraft for parachute activities, including any loss or damage to property or the personal injury or death of any person, including myself, which may occur as a result of my participation in these parachute activities, even where that loss, personal injury, or death is caused or contributed to, in any manner, by the United States Government.

I, for myself, my heirs, administrators and assigns, hereby covenant and agree that I will never institute, prosecute, or in any way aid in the institution of any demand, claim, or suit against the United States Government for any destruction, loss, or damage to property, personal injury or death which may occur as a result of my participation in these parachute activities and/or use of United States Air Force owned or leased equipment and aircraft.

This Release, Indemnification, Hold Harmless Agreement and Agreement Not to Sue shall be interpreted according to federal law. It is to be construed as broadly and inclusively as permitted by relevant federal law. If any portion of this document is held to be invalid, the balance shall continue in full force and effect. The term United States Government as used herein includes the United States Air Force, the United States Government, and/or any of their officers, agents, or employees, acting officially or otherwise.

PARTICIPANT’S SIGNATURE DATE