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WAIVER OF LIABILITY,RELEASE
AND ASSUMPTIONS OF RISKS
I understand and acknowledge that the activity to be engaged in through my use of an interactive
amusement games(s) and /or other amusement equipment brings with it both known and unanticipated risks to my self,my child
or ward. Those risks include, but are not limited to falling, slipping,crashing and colliding and could result in injury,
illness, disease, emotional distress and/or the potential for paralysis and death.
I, for myself, my child or ward agree
to the follow safety instructions provided and acknowledge that failure to do so may result in expulsion from the event without
compensation.
I, for myself, my child or ward, and on behalf of my heirs, assigns personal representatives and next of
kin, hereby voluntarily release,indemnify, hold harmless and discharge Jump Indoors of Charleston, LLC, its owners, members,officers,employees,
equipment manufacturers and sponsoring agencies from any and all liability claims, demands,actions or rights of actions whether
personal to me or to a third party which are related to arise out of or are any way connected with use of the interactive
equipment including those allegedly attributable to negligent acts or omissions. I agree to reimburse any reasonable attorney's
fees costs which may be incurred by Jump Indoors of Charleston in the defense of any such liability claim, demand action
or right of action.
In the event that I file a cause of action against Jump Indoors of Charleston, I agree to do so solely
in the state of South Carolina and I further agree that the substantive law of the state shall apply in that action without
regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable,
the remaining portions shall remain in full force and effect.
I acknowledge and certify that I have sufficient opportunity
to read this entire document,that I understand its content and that I execute it freely, intelligently and without duress
of any kind and agree to bound by its terms.
Participants Name:____________ Birth Date:_______ Age:_____
Participants
Name:____________ Birth Date:_______ Age:_____
Participants Name:____________ Birth Date:_______ Age:_____
Address_______________________
City______________Zip_______
Parent/Guardian of Participant(signature)__________________
Date if Consent_____/_____/_____
Emergency #______
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