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Name
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Contact Phone
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Email
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Address
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City
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State
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Zip Code
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Branch(s) of Service
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Enlistment Date
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EAOS
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Please upload a legible copy of your DD214 (scan or photo)
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Status of Discharge
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Service Related Disability
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Current Medications
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List Medications
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Briefly tell us why you think this program will benefit you.
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DOB
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Weight (lbs)
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You will be weighed
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First Freefall Skydive?
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** For your safety & that of your tandem instructor, individual weights are restricted to a max of 230lbs. Skydiving is inherently risky. You will be required to acknowledge and sign away your legal rights absolving WW-ATP, Vacationland Skydiving Et al, and Maine Veteran’s Project Et al, in addition to anyone else associated with the execution of this program or involved directly or indirectly, of any liability. Sobriety is an absolute must to participate. Any person under the influence of alcohol or drugs – including medicinal marijuana will not be permitted to skydive.
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Please verify you are human(*)
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