BAPA - Mt. Diablo Helmet Sticker Application

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Mt. Diablo Helmet Sticker Application

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In addition to a site introduction, you will be required to fill out the Mt. Diablo Helmet Sticker Application and Waiver:

REVISED December 2000

BAY AREA PARAGLIDING ASSOCIATION (BAPA)

BAPA/MT. DIABLO HELMET STICKER APPLICATION

You are responsible for knowing the Mt. Diablo State Park Site Procedures.

Please fill out the following application and include a check for $12 (made out to "Bay Area Paragliding Association"). Also include the completed "Assumption of Risk and Release" form, and a copy of your valid USHGA rating card showing the required "Advanced" rating.

Your sponsor will give you the required helmet sticker as well as the lock box combination. Your sponsor will be responsible for sending your forms back to BAPA at:

If you have any questions, or wish to become a sponsor, please contact:

Name: __________________________________________________

Address: ________________________________________________

City, State, Zip: ___________________________________________

Telephone: Day ____________________ Eve. _________________

Ham License # ___________________________________________

USHGA (Para 4) #: ___________________ Exp.________

I certify that I am a member in good standing of USHGA and that the foregoing is true and correct, and I have read and understood the BAPA site rules for Mt. Diablo.

Signature: ______________________________ Date:___________

Sponsoring Pilot: ________________________________________

Sponsoring Pilot Signature: _______________________________

MT. DIABLO ASSUMPTION OF RISK AND RELEASE

In consideration of permission to engage in paragliding at Mt. Diablo State Park, I _______________________________, for myself, my personal representatives, heirs, next of kin, spouse, and assigns, do agree as follows:

I. ASSUMPTION OF ALL RISKS OF PARAGLIDING

I understand and acknowledge that the sport of paragliding has inherent dangers and risks of personal injury, death and property damage that no amount of care, caution, instruction, or expertise can eliminate. Nevertheless, I VOLUNTARILY ELECT TO ASSUME ALL RISKS, KNOWN AND UNKNOWN, OF PERSONAL INJURY, DEATH OR PROPERTY DAMAGE CONNECTED WITH MY PARTICIPATION IN THE SPORT OF PARAGLIDING, HOWEVER CAUSED, EVEN IF CAUSED IN WHOLE OR IN PART BY THE ACTION, INACTION OR NEGLIGENCE OF THE "RELEASED PARTIES". __________ (Initial)

II. RELEASE, WAIVER AND DISCHARGE

I hereby release, waive and forever discharge:

all collectively referred to in this document as "released parties", and each of them, their agents employees, directors, members, committees, boards, officers, representatives, and leases from any and all liability and claims for personal injury, my death or property damage, connected with my paragliding activities, however caused, even if caused by negligence of the "released parties", or arising under the doctrine of strict liability.

III. CONSENT TO MEDICAL CARE

I acknowledge that paragliding activities at Mt. Diablo State Park is not covered by any personal accident or general liability insurance policy issued to the "released parties", I hereby give consent to whatever medical care might be provided or available to me.

IV. CONSTRUCTION OF RELEASE

I agree that this "Assumption of Risks and Release" is intended to be as broad and inclusive as permitted by the laws of the State of California and is not intended to be broader than allowed by California including Civil Code Section 1668. If any portion of this document is held invalid, it is agreed that the balance thereof shall continue in full legal force and effect, and shall be construed to be only as broad as allowed by California Law. __________ (Initial)

I have read this document. I am an advanced-rated paragliding pilot. I understand that this is a release of all claims. I assume all risks inherent in paragliding. I voluntarily sign my name showing that I accept all of the terms of this "assumption and release".

Signature _________________ Print Name ________________ Date _______

Address _____________________________________________________

Witness _________________ Print Name ________________ Date _______

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