Waiver, Release, Hold Harmless, and Indemnification Agreement

Jump, Rattle & Roll

Waiver, Release, Hold Harmless, and Indemnification Agreement

Rev. 02.001

As Consideration for being allowed to enter the play area and/or Participate in any party and/or event at Jump, Rattle & Roll; the undersigned, on his or her behalf, and on the behalf of the Participant(s) identified below, acknowledges, appreciates, understands, and agrees to the following:

1. I represent that I am the parent or legal guardian of the Participant(s) named below or I have obtained permission from the parent/legal guardian of the Participant(s) named below to execute this agreement on their behalf.

2. I acknowledge and understand that there are risks associated with participation in Jump, Rattle & Roll activities and the use of the play area and inflatable equipment including but not limited to: contusions, fractures, scrapes, cuts, bumps, paralysis, or death.

3. I, for myself and the Participant(s) named, willingly assume the risks associated with participation, and I accept that there are also risks, both known and unknown, even if arising from negligence of employees or other participants which I also willingly assume.

4. As Parent / Guardian I take responsibility and agree that the Participant(s) named below and I, shall obey and comply with all stated and customary terms, posted safety signs, rules, and verbal instructions from Staff as conditions for participation in any Party and/or Event at Jump, Rattle & Roll. In addition, if I observe any hazard during our participation, I will agree to bring it to the attention of the nearest Jump, Rattle & Roll, LLC employee or manager immediately.

5. I, for myself, the Participant(s) named, our heirs, assigns, representatives, and next of kin agree to hold harmless and indemnify the owner of Jump, Rattle & Roll, officers, and employees from any and all injuries, liabilities or damages from participation.

6. I additionally agree to indemnify the owner of Jump, Rattle & Roll, officers, and employees for any defense cost or expense arising from any and all claims, injuries, liabilities or damages arising from participation.

7. I am of physical ability to participate and am legally competent to understand and complete this agreement. I hereby execute this agreement without coercion.

8. In case any one or more of the provisions contained in this Waiver and Release of Liability agreement shall be held invalid by a court, that shall in no way affect the legality and enforceability of the remaining provisions contained herein.

We are participating in: {Please Initial and Sign as Appropriate}

______Drop-In (Parent/Guardian Staying the entire Time)

______Drop-Off for Party/Event: My child is participating in an event at Jump, Rattle & Roll. I understand that I am not required to stay and that my child has been told and fully understands all the safety rules. I have left my emergency contact number below to be contacted in the event of an emergency.

Event Primary Accepts responsibility for child while participating and act as Guardian.

Signature of Party Primary:______

Participant Name: ______Date of Birth: ______

Participant Name: ______Date of Birth: ______

Participant Name: ______Date of Birth: ______

Participant Name: ______Date of Birth: ______

Participant Name: ______Date of Birth: ______

Participant Name: ______Date of Birth: ______

Parent / Guardian Name (please print): Today’s Date ______

Parent / Guardian Name (please print): ______

Parent / Guardian Signature: ______

Phone:______

Email (opt-in for weekly emails): ______