Saturday June 8th 2013

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Coleen Smith
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1 Saturday June 8th 2013 What kind of skydive will I be doing? A Tandem skydive allows you to enjoy one minute of adrenaline-fuelled freefall from 13,500 feet harnessed to a BPA-qualified instructor; you simply need a short 20 minute briefing beforehand, as it is the instructor who opens and lands the parachute. It will be the most exhilarating experience of your life! How much do I have to fundraise? To take part and effectively jump for free you need to raise a minimum amount of 300. This covers the cost of the skydive at a special discounted rate offered by APA Netheravon of 200 per person and a minimum donation to the Pilgrim Bandits Charity of 100. Every extra penny that you raise over the minimum comes straight to the charity also, so please try to raise as much as you possibly can! How to take part 1) Complete the Registration Form then post or scan and it to admin@pilgrimbandits.org We require everyone s name, age, weight and height and contact details to book. 2) You can reserve your place by paying a deposit of 50 per person which will be deducted from the cost of the Tandum Jump 3) Start fundraising! You will be provided with official sponsorship forms to collect donations from friends and family and you can also register to fundraise online On the day of your tandum jump you will need to: Arrive at the airfield at the designated time on Saturday June 8th 2013 and Register in at reception If you are aged 40+ or have a medical condition you will also need to hand in your BPA medical form signed and stamped by your doctor. If you are aged 16 or 17 then you will need a parent present to sign consent on three forms. Pay the balance of 150 for the skydive to APA Netheravon. Complete 20 minutes of training with your instructor Kindly note that this amount can only be paid in cash or by debit (or credit card with a 3% fee).we do not accept personal cheques. If you have fundraised online then please contact us in advance to confirm amount raised. We will not allow anyone to continue if the minimum amount of sponsorship has not been raised in cash or online. You will also need to hand in your Min sponsorship amount in cash or proof of raised online to the Pilgrim Bandits Representative CHARITY SKYDIVING TERMS - By taking part in a skydive for charity you are bound by the following. That if you intend to cover the cost of the skydive with sponsorship money you will aim to meet the minimum fundraising target set by the charity, otherwise you will cover the remaining amount yourself and/or pull out of the event and refund all monies to the sponsors. To make every effort to exceed the minimum target To send on any additional funds raised directly to the charity within the timeframe agreed. Failure to do so is considered theft.. To make clear to sponsors if you are not paying for the skydive yourself and that the cost will be covered with their sponsorship money Skydiving is an adventure sport and participation involves a risk of injury or death and you voluntarily accept all the risks inherent That the organisers will not accept any liability or responsibility for you taking part in a skydive. Enjoy your Tandem Skydive from 13,000ft!

2 Who can take part in a Tandem Skydive? AGE RESTRICTIONS - Tandem Skydiving Overall age range: 16 years and older. There is no upper age limit for tandem skydiving. Age 16-17: Parental consent will be required. This is in the form of parental/guardian signature on the A PA Netheravon membership form, BPA Tandem medical form and BPA membership agreement form. This form is attached Form 106 Age 18-39: Students will be required to sign a tandem student self-declaration medical on arrival. Age 40 and over: Students must have a BPA Tandem medical form stamped by their doctor. WEIGHT RESTRICTIONS - Tandem Skydiving Maximum weight: 16 stones (100kg) for both males and females MEDICAL CONDITIONS AND NOTES Please Read Carefully Certain medical conditions (for example, epilepsy, some cardiovascular and neurological conditions and some forms of diabetes) or recurring injuries (for example, recurring dislocations) may preclude you from participating in a skydiving course. If you are in any doubt, please contact the parachute centre or consult the notes on the BPA Tandem medical form for more detailed information. We reserve the right to refuse training or to postpone a jump if weather conditions or other factors are deemed not suitable for an individual student at the Centre Chief Instructor's discretion. It should be noted that not all weather conditions may be suitable for all students. What about insurance? The only type of insurance included is the mandatory membership to the British Parachute Association. There is no medical or personal accident insurance included. However if you would like to take out a one-off tandem jump policy then this is your choice. Contact details You can contact Adam at the Pilgrim Bandits Charity on or admin@pilgrimbandits.org If you need any information about the skydive itself or the age, weight and medical restrictions then you can contact Army Parachute Association at Netheravon directly by phoning they are in the best position to answer any questions. Please be aware that this is a weather dependant sport and if the 8th is raining we will attempt on the Sunday June 9th

3 BRITISH PARACHUTE ASSOCIATION LTD To bring with you on the day if your over 40 signed by your Doctor Under 18s need this signed and witnessed by their Parents TANDEM PARACHUTIST DECLARATION OF FITNESS I hereby declare that I am physically fit. I do not, and have not, suffered from any of the following conditions, which I understand may lead to a dangerous situation with regard to myself or other persons during parachuting: Epilepsy, fits, severe head injury, recurrent blackouts or giddiness, disease of the brain or nervous system, high blood pressure, heart or lung disease, recurrent weakness or dislocation of any limb, diabetes, mental illness, drug or alcohol addiction. I further declare that in the event of contracting or suspecting any of the above conditions, or in the event of sickness absence over twenty consecutive days, incapacitating injury or confirmation of pregnancy, I will cease to parachute until I have obtained medical approval. Name in CAPITALS Date of Birth Weight Signature Date BPA Number Height (May be issued on day of Course) Signature of Witness Name of Witness in CAPITALS (All parachutists require their Declaration Witnessed, for parachutists under 18 years of age, the Witness MUST be the parent or guardian) IF YOU CANNOT SIGN THE DECLARATION BECAUSE OF ANY OF THE ABOVE CONDITIONS, OR IF YOU ARE AGED 40 OR MORE, YOU MUST OBTAIN THE DOCTORS CERTIFICATE BELOW BEFORE PARACHUTING. THIS IS NOT N.H.S. WORK AND YOUR DOCTOR MAY CHARGE YOU FOR THIS. DOCTOR S CERTIFICATE I understand that the applicant wishes to make a Student Tandem parachute descent but is unable to sign the above declaration/aged 40 or over*. In my opinion the applicant is physically and mentally capable of parachuting as a tandem student and is medically safe to do so.... Signature Date of Signature Date of Expiry (Doctors Stamp) (see Validity, over) * Delete as applicable Form 115(i ) (Issue 8, Aug 2006) If it applies to you Bring with you on the day

4 BRITISH PARACHUTE ASSOCIATION 5 Wharf Way, Glen Parva, Leicester LE2 9TF. Tel: Leicester (0116) Fax: Leicester (0116) VAT Reg No: TITLE (Mr. Mrs. Miss etc.) & SURNAME FORENAME(S) ADDRESS POST TOWN COUNTY COUNTRY POSTCODE/ZIP TELEPHONE (Home) (Work) DATE OF BIRTH Day Month Year SEX: Male/Female* MARITAL STATUS: Married/Single* BPA Number allocated *delete as applicable I, the applicant for membership, whose full details appear above, hereby apply for membership of the British Parachute Association Limited ("BPAL") and I agree as follows: 1. In this agreement the expression "the Association" shall include where the context so admits BPAL, any affiliated or associated Parachute Club, Centre or other organisation (whether incorporated or not), any instructor, rigger or packer (whether or not employed at any club or centre), any other individual or corporate member of BPAL and any club or centre and any servant or agent of BPAL or any club or centre. References to the masculine gender shall include the feminine and the singular shall include the plural. 2. In consideration of you accepting me as a member of BPAL, I agree that for so long as I shall be and remain a member of BPAL and at all times when I am taking part in any parachuting or related activity at a BPAL associated club or centre I shall be bound by (a) the BPAL Memoranda and Articles of Association (b) all the Association's rules and regulations particularly safety regulations (c) all lawful instructions given to me by instructors and those put in charge of me on behalf of the Association. 3. I authorise BPAL to apply part of my membership fee towards the purchase of Third Party Liability Insurance through the Association's scheme effective from time to time. Such insurance shall cover my personal and public liability for death or injury to persons and damage to property caused during the course of any parachuting activity undertaken by me. The value and limit of such insurance shall be such minimum figure as BPAL may from time to time determine. I understand that BPAL membership insurance is not valid in the USA or Canada or at any club or centre in the United Kingdom which is not affiliated to BPAL. Instructors who are members of BPAL cannot claim indemnity under the BPAL third party insurance scheme if any club or centre for whom they are working at the relevant time is not a participating club or centre which has made a contribution to the premiums payable by BPAL for such third party liability insurance. Such instructors are therefore advised to effect their own third party liability insurance at their own expense. 4. I understand that any training supervision or equipment with which I am provided at any club or centre which is associated to BPAL will be of an adequate and safe standard. Nevertheless I fully understand and freely acknowledge that sport parachuting is inherently dangerous regardless of the standard of training, supervision and equipment employed. I voluntarily accept all the risks inherent in the sport and I agree to carry out all parachute jumps and all activities connected with parachuting strictly in accordance with any instructions or tuition which I may at any time receive from any person authorised by any club or centre which is associated to BPAL to give me such instructions or tuition. 5. I agree for myself and my personal representatives to indemnify and hold harmless the Association against any claim or claims whether on my own account or from Third Parties arising out of any accident or incident resulting in any loss or damage (including bodily injury and death) and whether or not caused by my negligence or arising in consequence of my membership of BPAL or my participation in any form of parachuting or related activity. 6. I agree to notify BPAL within three working days of any accident or incident involving a Third Party and resulting from any approved sport parachute jump made by me. 7. I declare that I am: 18 years of age or over/under 18 years of age* (delete as appropriate) I acknowledge that the minimum age for sport parachuting is 16 years. SIGNED Dated If under 18 years of age the following must also be completed by the parent or guardian of the proposed member. To: The British Parachute Association Limited I (Name) of (Address) being the parent/legal guardian of the proposed member who is now aged years hereby confirm that I have given my permission for the proposed member to make parachute descents and that I agree to be bound in the same terms as those contained in the agreement signed by the proposed member and set out above. SIGNED: Dated Form 106 Issue 2, Jan 2000 Bring with you on the day

Sponsorship Form Charity Number 1136166 Return to Office ; Pilgrim Bandits Charity 17 Barrswood Road New Milton Hants BH25 5HS Name Event Date Gift Aid; if you are a UK taxpayer we can claim 28p for

5 Sponsorship Form Charity Number Return to Office ; Pilgrim Bandits Charity 17 Barrswood Road New Milton Hants BH25 5HS Name Event Date Gift Aid; if you are a UK taxpayer we can claim 28p for every pound you donate at no extra cost to you. Please just tick the Gift Aid box. Thank you. Name Address & Telephone Number Amount pledged Amount given Date Collected Gift Aid Pilgrimbandits Charity Number

Fields of Life is committed to sharing the Christian faith by collaborating with local

Fields of Life is committed to sharing the Christian faith by collaborating with local communities and churches in East Africa to bring about positive change through the provision of quality education,