Leap of Faith Program Registration Form

First Name*

Last Name*

Email Address*

Confirm Email Address*

Mobile Phone*

Phone

Address 1*

Address 2

City*

State*

Zip Code*

Name of your fallen service member*

Branch of fallen*

Date of loss*

What is your relationship to fallen service member?*

Why do you want to attend Leap of Faith and what are your expectations of the experience?*

Have you attended a previous Leap of Faith event?*

I understand that final acceptance to Leap of Faith is contingent on an interview with a team member who will be in contact with you. If accepted, you will receive an acknowledgment letter.*

Yes

I understand that registration is required and any non-registered person will not be allowed at our Leap of Faith event.*

Yes

How will you be traveling? (If by air, please email itinerary to GoldStar@osotAmerica.org no later than two weeks prior to seminar.)*

Are you applying as a tandem parachute jumper or a support person?*

I understand the tandem parachute jump is not guaranteed and may be cancelled due to weather conditions.*

Yes

If you are a support person, who is the jumper you are attending in support of?

Please provide your support person's first and last name.*

Why did you choose your support person. Please describe.*

Parachute jumpers: have you ever tandem skydived before?*

When was the jump?

Where and with which organization did you do your jump?

T-shirt size*

Do you have any allergies or dietary restrictions?*

I understand there is a Leap of Faith Event Fee: $55.00 Refundable Deposit*

The refundable deposit of $55.00 is due 14 days prior to the seminar. Please make checks payable to: OSOT-America (please write Leap of Faith on memo line) 1807 S. Washington St. Suite 110, #359 Naperville, IL 60565.

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