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Release executed on (date), by (name), of (address).
I, (name of releasor), hereby acknowledge that I have voluntarily applied to participate in parachuting instruction and training, culminating in a parachute jump at (place of instruction).
I am aware that parachute instruction and jumping are hazardous activities, and am voluntarily participating in these activities with knowledge of the danger involved and hereby agree to accept any and all risks of injury or death.
Initial here: _____.
As lawful consideration for being permitted by (name of instruction facility) or one of its affiliated organizations to participate in these activities and use their facilities, I hereby agree that I, my heirs, distributees, guardians, legal representatives and assigns will not make a claim against, sue, attach the property of, or prosecute (name of instruction facility) and/or any of its affiliated organizations for injury or damage resulting from the negligence or other acts, howsoever caused, by any employee, agent or contractor of (name of instruction facility) or its affiliates, as result of my participation in parachuting activities. In addition, I hereby release and discharge (name of instruction facility), and its affiliated organizations from all actions, claims or demands I, my heirs, distributees, guardians, legal representatives or assigns now have or may hereafter have for injury or damage resulting from my participation in parachuting activities.
I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract between myself and (name of instruction facility) and/or its affiliated organizations, and I have signed it of my own free will.
Signature of Witness
STATE OF -------)
) ss: [date]
COUNTY OF ------)
On [Date] before me, [Name of Notary], notary, personally appeared [Name of Person(s) Involved], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
[Name of Notary Public]
My commission expires: [date]