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Print, complete, and mail this application to the
above address.
Include dues as appropriate (see schedule below).
Tennessee Tree Toppers
PO Box 1286
Dunlap, TN 37327
Omission of requested information may invalidate application.
If "A. Purchase" is checked in paragraph 7 (regarding
purchase of waiver of the RELEASE OF LIABILITY COVENANT NOT TO SUE
AND ASSUMPTION OF RISK provisions), include an additional $300.
Name:
Address:
City:
State:
Zip:
Country:
Phone:
E-mail:
Emergency Contact:
Phone:
Authority of Medical Directive:
USHPA/TTT#:
USHPA rating:
USHPA expiration:
Membership type (circle one)
Life $1000
5 year $250
annual $60
Family $35 (per additional member)
3 day $25
30 day tandem $10
1 day tandem $5
1 flight per year $1
check #:
clearance official:
clearance date:
renewal date:
In consideration for being permitted to use the facilities and equipment
of the Tennessee Tree Toppers, Inc., hereinafter referred to as
the TTT, and to engage in the sport of hang gliding, solo and/or
tandem instruction, and other related activities, (hereinafter collectively
referred to as hang gliding activities), I hereby agree as follows:
I (print name)_______________________________________ hereby RELEASE
AND DISCHARGE the United States Hang Gliding and Paragliding Association and any
of its members, the city of Dunlap, TN and Whitwell, TN, any owners
of land where hang gliding activities are conducted, and the TTT
members (hereinafter collectively referred to as released parties),
from any and all liability, claims, demands or causes of action
that I may hereafter have for injuries and damages arising out of
my participation in hang gliding activities including, but not limited
to, losses CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES (initial
_____).
I further agree that I will not sue or make claim against the released
parties or damages or other losses sustained as a result of my participation
in hang gliding activities (initial____).
I also agree to INDEMNIFY AND HOLD THE RELEASED PARTIES HARMLESS
from all claims, judgements and costs, including attorneys fees
incurred in connection with any action brought as a result of participation
in hang gliding activities (initial____).
I understand and acknowledge that hang gliding activities have inherent
danger that no amount of care, caution, instruction or experience
can eliminate and I EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF
DEATH OR PERSONAL INJURY SUSTAINED WHILE PARTICIPATING IN HANG GLIDING
ACTIVITIES, WHETHER OR NOT CAUSED BY THE NEGLIGENCE OF THE RELEASED
PARTIES (initial ______).
I have been advised and recognize that my hang gliding activities
are not covered by any personal accident of general liability insurance
policy issued to the Released Parties (initial ______).
I hereby expressly recognize that this Agreement-Release of Liability
is contract pursuant to which I have released any and all claims
against the Released Parties resulting from my participation in
hang gliding activities, including any claims caused by the negligence
of the Released Parties. I hereby confirm that I have been
given an option to purchase a waiver of the RELEASE OF LIABILITY
COVENANT NOT TO SUE AND ASSUMPTION OF RISK provisions contained
in this agreement at an additional cost of three hundred dollars
($300). I have chosen to:
A. Purchase ___ B. Not Purchase ___ this waiver. It is understood
that the purchase of the waiver does not constitute contract of
insurance but only waiver of the contractual defenses (initial ______).
I further agree to abide by all of the TTT rules and flight regulations
and to report any noncompliance with these regulations to a TTT
official. I have received a copy of the TTT Bylaws, Site Guide
and Flight Regulations. I HAVE READ THIS AGREEMENT - RELEASE
OF LIABILITY, FULLY UNDERSTAND ITS CONTENTS, AND SIGN IT OF MY OWN
FREE WILL (initial _____).
Signature
Print
Date
Witness
Date
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