Confirmation of Informed Assumption of Risk


READ, UNDERSTAND, AND ACKNOWLEDGE


By signing this document, I agree to hold harmless Skydive Indianapolis and all associated companies and persons for any and all reasons. *

Please enter your name below (First Name & Last Name).


ⓘ Enter your first name & last name(s).


Date of Birth *



ⓘ Enter your date of birth.


Your email. *

Please use an email you have access to.


ⓘ Enter a valid email.


I understand skydiving may result in serious injury or death. *


ⓘ Please click to intial before continuing.


I have read, understood and signed or digitally signed the waiver of legal rights. *


ⓘ Please click to intial before continuing.


I understand that I may request a physical copy of the waiver of legal rights at any time. *


ⓘ Please click to intial before continuing.


I have viewed and understood the video waiver. *


ⓘ Please click to intial before continuing.


As per Title 14 of the Code of Federal Regulations (CFR) § 91.17 - Alcohol or drugs* and § 105.7 - Use of alcohol and drugs*. I acknowledge that Skydive Indianapolis reserves the right to refuse to allow me to make a skydive if I am intoxicated or appear to have consumed alcohol &/or drugs (which may pose a safety risk) within 8 hours prior to attempting to make a skydive. *


ⓘ Please click to intial before continuing.


I understand that at any point I have the right to refuse to skydive, however, due to the high costs associated with skydiving, once the aircraft boarding process has been completed, all fees paid become non-refundable. *


ⓘ Please click to intial before continuing.


Weight In Pounds (lbs) *

If unsure about weight in pounds (lbs) please ask staff member


ⓘ Weight in lbs (MAX 235lbs - You will be weighed).


Would you like to purchase video and/or photos of your skydive? *

Please select one.



ⓘ Please choose an option.


Phone Number. *

Please enter valid cellphone number.


ⓘ Enter valid phone number.


Your video &/or photos will be uploaded to our online cloud service, this process can take up to 48hrs, if you have not received anything within this time frame, please visit skydiveindianapolis.com/en/connect to download using your email address. As a complimentary service, your video purchase also includes having the edited video posted to the Skydive Indianapolis YouTube Channel, where you can share it with your friends and family. If you do NOT wish to have your video uploaded to YouTube check the box below, but understand that your video may still be used in other Skydive Indianapolis promotional content.





Videography Packages *

Please select one.




ⓘ Please choose a videography pacakage.


By filling out this form & clicking submit, I, hereby authorize "BUCKETLIST HOLDINGS LLC, D.B.A SKYDIVE INDIANAPOLIS" to take any photographs or videos (Content) of me or anyone who may be in my party as they deem appropriate and to use the Content for any purpose which may include, among others, advertising, promotion, marketing and packaging for any product or service. I agree that the Content may be combined with other images, text, graphics, film, audio, audio/visual works; and may be cropped, altered, or modified. I agree that I have no rights to the Content and that all rights to the Content belong to "BUCKETLIST HOLDINGS LLC, D.B.A SKYDIVE INDIANAPOLIS". *

Sign your name below.


ⓘ Enter your first name & last name(s).