Leap for Love 2022 Registration Form

This is the OFFICIAL registration form for Leap for Love 2022! Please note, we will call you in the next few business days to get your credit card information by phone. 

You will be charged $215 by Skydive New England depending on your chosen drop zone. This is your tandem jumping fee and will be promptly reimbursed when you meet your $3,000 fundraising minimum. You do not need to send a receipt, as the skydive centers will keep records for us. 

We recommend using Facebook and/or our secure fundraising platform called Classy to streamline fundraising for your epic Leap. Within a few days of joining our Leap 2022 Team, Kerry will send you information on how to set up your personalized fundraising link on Facebook and/or Classy. In past years, setting up individual Facebook fundraisers has been the MOST effective way to quickly meet Leap fundraising goals.

If you have any questions, anxieties, fears, or concerns call or email our Fearless 2022 Leap Leader, Captain Kerry Powlovich at Kerry@LucysLoveBus.org or 781-454-8535. 

We can’t wait to fly the friendly skies with you!!!

With love, heart palpitations, and also heartfelt thanks,
Captain Kerry and Co-Pilot Stephanie

Registration Information

The following questions are required by Skydive New England and Danielson to reserve your tandem jump

Billing information

We will call you for your credit card information, but if you include your billing information it will save some time!

We are holding this event on September 10th at Skydive New England in Lebanon, ME. Please answer the below question in hopes we can continue as planned, keeping in mind:

If COVID19 restrictions don't allow us to jump on September 10th, or if you are not comfortable skydiving on September 10th, you will receive a voucher to tandem skydive at Skydive New England at a later date of your choosing (if you meet the fundraising minimum). We'll be holding a socially distant celebration at Skydive New England on September 10th to celebrate, even if we can't jump! Please click here to see all that Skydive New England is doing as part of their COVID19 precautions.

PARTICIPANT RELEASE OF LIABILITY AND ASSUMPTION OF RISK

In consideration of being allowed to participate in the Leap for Love, including related events and activities (together, for purposes of this document, the "Event"), I, the undersigned, acknowledge, appreciate, and agree that:

·       I understand that photographs may be taken of me in connection with the Event. I hereby consent to the taking of such photographs and the publication of such photographs;

·       I willingly agree to comply with the terms and conditions for participation in the Event, as contained herein and in the Event brochure. If, however, I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such hazard to the attention of the nearest official immediately;

·       The risk of injury from participation in the Event is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist;

·       I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES (defined below) or others, and whether or not covered by my personal health or other type of insurance; and I assume full responsibility for my participation in the Event; and,

·       I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS LUCY'S LOVE BUS CHARITABLE TRUST, operator of the Leap for Love, Skydive New England, its officers, officials, directors, agents and/or employees, other participants, volunteers, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises and/or vehicles, property and/or equipment used to conduct the event (together, the "Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, OR LOSS, OR DAMAGE to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS REGISTRATION FORM, INCLUDING THE RELEASE OF LIABILITY AND ASSUMPTION OF RISK PROVISIONS CONTAINED HEREIN, I FULLY UNDERSTAND ITS TERMS, AND I UNDERSTAND THAT I WILL BE GIVING UP SUBSTANTIAL RIGHTS BY SIGNING IT. NEVERTHELESS, I SIGN THE FORM FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.