WAIVER OF LIABILITY AND ASSUMPTION OF RISK

**NO SHOE ZONE IN PLAY AREA FOR EVERYONE

**SOCKS ARE REQUIRED BY ALL CHILDREN

**NO ADULTS ON BOUNCERS

LAST NAME

FIRST NAME

DATE OF BIRTH

STREET ADDRESS

CITY

STATE

ZIP CODE

PHONE

ALT PHONE

 I agree, on behalf of myself and (if applicable) my family, heirs, guests and personal representative(s)to the following in exchange for participation in any and all play activities and/or parties at the facility of 2 Froggy Jumps LLC located at (the “Company”):

  1. I agree to assume all the risks and responsibilities surrounding my and (if applicable) my family, heirs, and personal representative(s)’ participation in all play activities and, in advance, release, waive, forever discharge, and covenant not to sue the Company, its board, officers, agents, employees, and volunteers (collectively, the “Releases”) from and against any and all liability for any harm, damage, claim, demand, loss, cause of action, damage, lawsuit, judgment, including attorneys’ fees and cost or expense of any nature that I and (if applicable) my family, heirs, and personal representative(s) may have or that may hereafter accrue to me, arising out of or related to any loss, damage or injury, including but not limited to physical injury, suffering or death, that may be sustained by me and (if applicable) my family, heirs, and personal representative(s)’ or by any property belonging to me and (if applicable) my family, heirs, and personal representative(s)’, whether caused by the negligence or carelessness of the Releases with regard to my use of the facility. It is my express intent that this Release shall be deemed a release, waiver, discharge and covenant not to sue the Releases. I further agree to save and hold harmless, indemnify, and defend Releases from any claim by me and (if applicable) my family, heirs, and personal representative(s)’ arising out of my and (if applicable) my family, heirs, and personal representative(s)’ participation in all activities at the facility.
  2. I agree on behalf of myself and (if applicable) my family, heirs, and personal representative(s)’ to obey and observe any and all posted warnings and rules, and agree to follow any directions or oral instructions given by the representatives, employees or agents of the Company.
  3. In the event of damages, I agree to pay for any and all damages that may be caused by me and (if applicable) my family, heirs, and personal representative(s)’ negligent, reckless, or willful actions.
  4. I am aware of my own and (if applicable) my family, heirs, and personal representative(s)’ personal medical needs and state that there are no health-related reasons or problems that preclude or restrict the ability to participate safely in any activity at the facility. I assume all risk and responsibility for my and (if applicable) my family, heirs, and personal representative(s)’ medical needs, and understand and agree that if I and (if applicable) my family, heirs, and personal representative(s) must be hospitalized or otherwise receive medical care; the Company cannot and does not assume legal responsibility for payment of such costs. I hereby grant permission to the Releases to authorize emergency medical treatment for me and (if applicable) my family, heirs, and personal representative(s)’, and understand and agree that neither the Company nor any of the other Releases assume any responsibility for any injury or damage that may arise out of or in connection with such authorization.
  5. I warrant that I am at least eighteen (18) years of age and fully competent to sign this Release; that I understand the terms contained herein are contractual and not a mere recital; that I have read this Release with full knowledge of its significance; and that I have signed this Release as my own free act.
  6. I agree that this Release shall be construed in accordance with the laws of the State of Illinois. If any term provision of this Release shall be held unenforceable, illegal, or in conflict with any governing law, the validity of the remaining portions shall not otherwise be affected.

WE RESERVE THE RIGHT TO REVIEW YOUR DRIVER’S LICENSE AND/OR OTHER FORMS OF ID TO VERIFY IDENTITY AND AGE

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS.

Signature of Participant 

(18 years and older must sign)

[___________________________________]

Participant Name

____________________________________________________________

Date

____________________________________________________________

Parent(s) or Court-Appointed Legal Guardian(s) must sign below for and agree that they and the minor are subject to all the terms of this document, as set forth above.

Signature of Parent(s) 

(or Legal Court Appointed Guardian)

[___________________________________]

Parent/Guardian Name

_______________________________________________________

Date

_______________________________________________________