Uhgpga 2013 Membership Application Please Write Legibly & Complete All Information
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UHGPGA 2013 MEMBERSHIP APPLICATION PLEASE WRITE LEGIBLY & COMPLETE ALL INFORMATION UHGPGA Membership (Check one) [$5.00 Daily ] [$25.00 Weekly ] [$50.00 Yearly ] [$200.00 Instructor ] Payment Method: PayPal (Visit Club Website) Mail Check To: P.O. Box 711133 [Email Address Required] Salt Lake City, Utah 84171 Name: ________________________________________________ Best phone # to reach you at: _________________________ Alt. phone #: _________________________ Street: _________________________________________________________________ City: ___________________________ State: ______________ Zip: ____________ Email Address*: ___________________________________________(* Require d to receive club emails and when Paying Via PayPal) May we print your information on the Club website? [Yes ] [No ] USHPA Current Membership Is Required: USHPA #: ___________________ Exp. Date: _______________ Place a check mark which wing(s) you fly: Hang Gliders: Paragliders/Speed Wings: Would you like to contribute to Save the Point Fund? [Yes ] [No ] Amount $___________ Emergency Contact Name: Emergency Contact #: WAIVER OF LEGAL RIGHTS: I recognize that hang gliding and paragliding are potentially dangerous activities and that by engaging in hang gliding or paragliding activities, I could suffer injury and/or death. I hereby acknowledge that I shall take full responsibility for and hereby waive any and all claims for any injury, damage or loss that I may suffer while on or above any property used, operated, managed, accessed or insured by the Utah Hang Gliding and Paragliding Association, Inc. or the USHPA, or any other property where I may engage in any hang gliding or paragliding related activity. I further hereby waive any and all claims and legal rights of any kind which I may have related to any accident, injury, damage or loss I may suffer as a result of engaging in any hang gliding or paragliding related activity on or above any of those properties, whether or not such accident, injury, damage or loss is due, in whole or in part, to the negligence or intentional act of any person or entity. I further acknowledge and agree that the foregoing waivers shall be binding on my heirs, survivors, successors, personal representatives, and estate. I have read, understand and will comply with the UHGPGA site rules and right-of-way requirements. I hereby acknowledge and agree that in order to pilot a hang glider or to kite or pilot a paraglider at any UHGPGA insured site, I must and shall be a current member of USHPA with an appropriate rating for the site and the activity that I am engaged in, and that I will display my UHGPGA decal on the right side of my helmet at all times that I am engaged in kiting, launching or piloting a hang glider or paraglider . Furthermore, I understand that to be a member of the UGHPGA, I must and shall also be a current USHPA member and a rated pilot of the aircraft that I pilot. I, therefore, hereby acknowledge and agree that I shall not kite or pilot a hang glider or paraglider on or above any of the properties identified above unless I have a current UHGPGA membership, a current USHPA membership, and an appropriate rating for the site and the activity I am engaged in. I hereby acknowledge and agree that this document constitutes a full waiver of my rights as stated and I hereby affirm and agree that neither I nor any other person or entity on my behalf, shall initiate or pursue any legal remedy against any property owner, UHGPGA, USHPA, or any other person or entity against whom claims have been waived by this document. I further acknowledge and agree that this document shall not be deemed to limit, amend or revoke any waiver or release that I have granted or that I may grant hereafter to any other property owner, person or entity. Signature: __________________________________ Date: ________________________ POMIC Instructor Signature (Students Only): ____________________________________________ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * UHGPGA 2013 TEMPORARY MEMBERSHIP CARD RETAIN THIS PORTION UNTIL YOU RECEIVE UHGPGA HELMET STICKER Name: _____________________________________________________________________________ Address: ____________________________________________________________________________ Phone: _________________________________________ Date: ____________________________ I have read and signed the “WAIVER OF LEGAL RIGHTS,” and I understand that to be a member of the UHGPGA, I must also be a current USHPA member and rated pilot. Otherwise, my UHGPGA membership is void. New Member’s Signature: _________________________________________ Date: ______________ No. M3807 Release, Waiver and Agreement Regarding Use of Metropolitan Water District Property In consideration of my being allowed to make emergency landings on property of the Metropolitan Water District of Salt Lake and Sandy (“District”) and being allowed access to the property to retrieve my equipment, I, on behalf of myself, my heirs and assigns irrevocably release and waiver all claims, causes of action and other rights against the District and its contractors arising from any loss, injury, death or harm while participating in hang gliding, paragliding or associated activities, whether or not the loss, injury, death or harm resulted in whole or part from any negligence of the District or its contractors. I further agree that the District and its contractors have no duty to warn me of any hazard or risk on District property, including construction equipment or activities in or near any landing areas or access roads. Information provided by the District regarding landing areas and road conditions reflects general conditions only. It is my responsibility to visually inspect the landing area and to assess actual conditions before launching. I voluntarily assume all risks, known and unknown associated with my use of the District’s property, even if caused in whole or in part by the action, inaction, or negligence of the District or its contractors. I agree to abide by any rules and regulations of the District regarding my use of its property. I further recognize that temporary closures of the property may become necessary due to construction activities and I agree to abide by such closures. I recognize that the District reserves the right to revoke or suspend permission for my use of its property at any time and for any reason. I agree that if I make a claim against the District or its contractors in violation of this agreement, I will be liable for costs and attorneys fees incurred in defending the claim. I certify that I am at least 18 years of age and that I am a USHPA rated hang glider or paraglider pilot, or a student pilot un der the supervision of a USHPA certified instructor. I acknowledge that I have read this agreement, fully understand the potential dangers of engaging in hang gliding and/or paragliding, am fully aware of the legal consequences of signing this agreement, and that I understand and agree that this document is legally binding and will preclude me from recovery to monetary damages from the above listed entities and/or individuals, whether specifically named or not, for personal injury, bodily injury, property damage, wrongful death, or any other personal or financial injury sustained by me in connection with hang gliding and/or paragliding. Pilot’s name: ________________________________________________________________________ Address: ___________________________________________________________________________ City, State, Zip: _____________________________________________________________________ USHPA Number:* ___________________________________________________________________ *Students may give instructor’s name PERMIT No. M3807 Pilot’s signature ______________________________________________________________________ Pilot has been granted limited permission to enter the property of the Metropolitan Water District of Salt Lake and Sandy (“District”) for emergency hang glider and/or paraglider landing and equipment retrieval purposes only. The District reserves the right to revoke or suspend its permit at any time and for any reason. Otherwise, this permit is valid for one year from the date of issuance, and is subject to the terms and conditions of the Release, Waiver and Agreement Regarding Use of Metropolitan Water District property. Date of Issuance: _________________ ____________________________________ Authorized Representative This information is provided only for the benefit of pilots holding current permit issued by the Metropolitan Water District of Salt Lake and Sandy (“District”) for emergency landings on District property. This information reflects general conditions only. Pilots are responsible to assess actual conditions and assume all risks associated with any of the District’s property. Utah Hang Gliding and ParaGliding Association Rules Rev. 01/03/2013 SOUTH SIDE Rules 1. Must be current USHPA and UHGPGA member. Pilots are to display a current UHGPGA sticker on the right side of their helmet. Flying while not a member places the site in jeopardy, a violation of USHPA SOP 12-7, which is punishable by temporary or permanent revocation of ratings. 2. Must have a current H-2/P-2 or higher USHPA rating. Students & H-1/P-1’s must be under the supervision of an UHGPGA/POMIC approved instructor. 3. The “Ridge Rules” establish right-of-way and are to be followed at all times (see below for complete rules). 4. The hang glider launch/landing area is the area from the