PARENTAL CONSENT FORM

WESTERN PROVINCE SPORT PARACHUTE CLUB

Trading as SKYDIVE Ceres

Please PRINT this form, COMPLETE it and have it SIGNED

by the required individuals (i.e. yourself and/or your guardian).
Once completed, please either FAX it to (021) 462-5666 or
BRING it with you to the DZ.
DO NOT FORGET THE SIGNED FORM!
NO FORM = NO JUMP

I, the undersigned, the Applicant's Guardian, being the parent or lawful guardian
of Applicant, a minor (hereinafter referred to as the Applicant) hereby consent to
the Applicant becoming a member of the Western Province Sport Parachute Club
trading as Skydive Ceres (hereinafter referred to as the Club) for the period of
this type of membership. I acknowledge that my consent as granted above:

a) Constitutes a consent for the Applicant to take part in all or any of the
activities of the Club including without limitation, a first jump course,
accelerated freefall course, a static-line parachute jump, and any further
parachuting and/or skydiving activities or ancillary related activities presented
by or in conjunction with the Club.

b) Shall endure for the full duration of the Applicants membership of the Club
whether continues or interrupted.

c) Further constitutes permission for the Applicant to complete an Application

for Membership form of the Club and to provide all relevant details relating to
such application form including personal and health related details. I am
aware and specifically consent to the fact that the said application form
contains certain provisions relating to the indemnification of the Club from
any claim relating to damages suffered by the Applicant in the course of the
Clubs activities.

d) Is given with the full knowledge that certain details relating to the Applicants
health may increase or affect the risk attached to the activities of the Club
and I undertake that I shall ensure that any query which I may have in this
regard is brought to the attention of the Safety Officer of the Club in writing.

e) Is given with the full knowledge that the activities of the Club inherently
contain certain risks relating to or ancillary to the sport of parachuting and/or
skydiving.

f) Warrants that there is to the best of my knowledge no impediment

 preventing the Applicant from partaking in the activities of the Club. I further
undertake that should I have required further details relating to the activities
of the Club in order to grant my informed consent thereto as given thereto as
given above, I shall have requested such details in writing from the Safety
Officer of the Club and in granting this consent I declare myself so satisfied.

g) Warrants and undertakes in favour of the Club that the Applicant partakes in
the activities of the Club voluntarily and with full knowledge of the risks
associated with parachuting and/or skydiving and accordingly the Club shall
not be liable for any claims for damage relating to the involvement of the
Applicant in the Clubs activities, howsoever or from whatsoever cause arising
whether caused by the negligent action or inaction of any of the Clubs
members or officers or agents or otherwise.

In the interpretation of this consent form, the invalidity of any one provision or
part thereof shall not affect the validity of the remainder of this consent. No
warranty or representation not reduced to writing and/or reflected herein shall
be binding on the Club.

Place Signed :

Date Signed :

Surname and First Names of Applicant :

Surname and First Names of Applicants

Guardian :

Signature of Applicant's Guardian :

Surname and First Names of Witness :

Signature of Witness :