WAIVER OF LIABILITY – Jump-n-Jack’s Inflatable Fun & Party Center

A COMPLETED WAIVER IS REQUIRED TO PLAY AT JUMP-N-JACK’S. NO EXCEPTIONS. SOCKS ARE REQUIRED TO PLAY. NO OUTSIDE FOOD OR BEVERAGES PERMITTED. In consideration of being allowed to enter into the play area and/or participate in any parties or programs at Jump-n-Jack’s, the undersigned, on his or her own behalf and on behalf of the minor identified below, acknowledges, appreciates and agrees that: I, for myself, my child or ward sign this Waiver and Assumption of Risk in consideration of the opportunity to use the facility, or to participate in any parties or activities at/by Jump-n-Jack’s Inflatable Fun & Party Center. I, for myself, my child or ward acknowledge and understand that there are dangers and risks associated with the activities at/by Jump-n-Jack’s Inflatable Fun & Party Center and agree to assume all risk of personal injury, including the potential for paralysis and death. I, for myself, my child or ward agree to follow the safety instructions provided and acknowledge that failure to do so may result in expulsion from Jump-n-Jack’s Inflatable Fun & Party Center. I, for myself, my child or ward, and on behalf of my or their heirs, assigns, personal representatives and next of kin, HEREBY HOLD HARMLESS Jump-n-Jack’s Inflatable Fun & Party Center, its owners, members, officers, employees, equipment manufacturers and sponsoring agencies from all liability for any such personal injury, disability, death or loss or damage to person or property to the fullest extent of the law. By the execution of this agreement, it is my intention to assume all risk of injury and do hereby surrender and waive any rights to sue or exercise any legal right to seek damages against Jump-n-Jack’s, its owners, agents, employees, officers, directors, trustees and all other persons acting on its behalf. I, for myself, my child or ward consent to the publication of personal pictures which may be taken by Jump-n-Jack’s Inflatable Fun & Party Center personnel or their representative. Publication may include but not be limited to, marketing materials and website. I acknowledge that my or my child’s participation in activities at Jump-n-Jack’s or utilizing a Jump-n-Jack’s inflatable at any location is strictly voluntary. I hereby certify that I am over 18 years of age; I have carefully read the foregoing covenant not to sue and acknowledge that I understand and agree to all of the above terms and conditions. Prior to signing this agreement, I have the opportunity to ask any and all questions. I am aware that by signing this agreement, I assume all risks and waive and release all substantial rights that I may have and possess. I understand that this document is a contract and that I have read it thoroughly and fully understand the terms. PLEASE PRINT NEATLY Participants Name: _______________________________ Birth date: ______________Age: _____ Participants Name: _______________________________ Birth date: ______________Age: _____ Participants Name: _______________________________ Birth date: ______________Age: _____ Participants Name: _______________________________ Birth date: ______________Age: _____ Participants Name: _______________________________ Birth date: ______________Age: _____ Participants Name: _______________________________ Birth date: ______________Age: _____ Parent/Guardian Name: _____________________________________________________ Parent/Guardian of Child: (signature) _______________________________________________ Address (incl city & zip code): ______________________________________________________________________ Email address:____________________________________________________Phone: (____)____________________ By providing your email address you are opting-in to receive email from Jump-n-Jack’s and you may ask to stop receiving emails from us at any time. We pledge not to sell, rent or distribute your information. Date of Consent: ____/____/201__ Consent Expires: ______/______/ 2013 (Valid for 6 months) Food Allergies: _______________________________