Last-minute Registrants: Please print, sign, scan and send waiver below to firstname.lastname@example.org. Without a signed waiver on record, your child will not be allowed to enter Freaky Friday!
Acknowledgment of Responsibility, Express Assumption of Risk, and Release of Liability for use of Amusement Devices
In consideration for me, or the minor child in my care, being permitted by the Fun Ones Moon Jump, Inc. to participate in the use of the equipment and/or attractions, I waive, release, and discharge any and all claims for personal injury, death or property damage which said individual may sustain or which may occur as a result of the individuals participation in said activity. This release is intended to discharge in advance the Fun Ones Moon Jump, Inc. (it’s officers, employees, or agents) from and against any and all liability arising out of or connected in any way with the participation of the individual in the said activity(ies), even though that liability may arise out of negligence or carelessness on the part of the Fun Ones Moon Jump, Inc.. (it’s officers, employees, or agents).
Each of us understands that the described activity may be of a hazardous nature and/or include physical and/or strenuous exercise or activity; that serious accidents occasionally occur during the above described activity; and that participants in the described activity occasionally sustain mortal or personal injuries as a consequence thereof. Knowing the risks involved, nevertheless each of us agrees to assume all risks of injury and to release and hold harmless the Fun Ones Moon Jump, Inc. and Highcrest Middle School PTO (its officers, employees, or agents) who through negligence or carelessness might otherwise be liable to me or said minor child. It is further understood that this waiver, release and assumption of risk is to be binding on the heirs and assigns of the undersigned.
Each of us further agrees to indemnify and to hold the Fun Ones Moon Jump, Inc. (its officers, employees, or agents) free and harmless from any loss, liability, damage, cost or expense which they may incur as a result of any injury and/or property damage that I or said minor child may sustain while participating in said activity.
I agree that in the event an individual requires medical or surgical treatment in connection with the described activity, such supervisor may authorize treatment. I also agree to pay all medical, hospital, or other expenses, which said individual, may incur as a result of such treatment. I confirm my understanding that:
- This Agreement is intended to be as broad and inclusive as is permitted by law. If any provision or any part of any provision of this Agreement is held to be invalid or legally unenforceable for any reason, the remainder of this Agreement shall not be affected thereby and shall remain valid and fully enforceable.
- To the fullest extent allowed by law, I agree to WAIVE, DISCHARGE CLAIMS, AND RELEASE FROM LIABILITY the Fun Ones Moon Jump, Inc., its officers, directors, employees, and agents from any and all liability on account of, or in any way resulting from Injuries and Damages, even if caused by negligence of the Fun Ones Moon Jump, Inc. its officers, directors, employees, and agents in any way connected with this Activity. I further agree to HOLD HARMLESS the Fun Ones Moon Jump, Inc., its officers, directors, employees, and agents from any claims, damages, injuries or losses caused by my own negligence while a participant on the Activity. I understand and intend that this assumption of risk and release is binding upon my heirs, executors, administrators and assigns.
- I have read this document in its entirety and I freely and voluntarily assume all risks of such Injuries and Damages and notwithstanding such risks, for myself or the listed minor, who is in my care, to participate in the Activity.
Guest’s Name:_____________________ [ ] Guest / Guardian Signature:________________________ Date:______________
Guest’s Name:_____________________ [ ] Guest / Guardian Signature:________________________ Date:______________[wp_e_signature_sad doc=”600″]