"I hereby declare to my best knowledge, that I do not suffer from any heart condition, I have not undergone any operations and I have had no accidents or illnesses which could present risk during the bungee jump."
Or, please find enclosed a medical certificate stating that I have the required fitness to carry out the bungee jump .)

Certified, Dated :............................................Place..................................... ..........................................................
(For groups, specify the name of the organisation or the person responsible)
Signature :

Parental autorisation for minors :
I, the undersigned,............................. give my son/daughter.............................. permission to carry out the bungee jump.
Parent's signature:

General Condition

Reservations : Telephone or send this form to VOLTIGE BUNGY, if possible, 15 days before the desired date of the bungee jump. Any cancellation less than 15 days before the date booked will result in the deposits being retained. VOLTIGE BUNGY reserve the right to cancel the activity in the event of any important circumstances , for security reasons or for an insufficient number of participants. In the case of cancellation on our behalf, all money payed will be reimbursed.

Prices : The price includes transport from the resort of Deux Alpes to the cable car, the use of the cable car cabin, the bungee jump and your return to the resort.

The Jump : Any jump turned down at the last minute will not be reimbursed. Any disrespect of security regulations will relieve VOLTIGE BUNGY of any responsibilities.