Date Night Drop N' Go Liability Waiver
Welcome to Date Night! Your children are in great hands; all staff members at Bitterroot Bouncers are healthcare professionals, CPR certified and skilled in first aid! Children must be potty trained in order to participate in our Drop & Go program. Please feed children dinner prior to coming and with enough time to let their stomachs settle before bouncing. Staff must be able to reach parents at any given time in the event that there is an emergency.
By signing this agreement, parents give written consent to allow staff to send their child to the ER via ambulance in the event that an emergency occurs and staff are unable to reach parents. Staff will always try to reach parents first unless the child requires immediate lifesaving measures at which time staff will first and foremost tend to the child and once stable, contact the parents/guardians. By signing below, adults give written permission to leave their children at Bitterroot Bouncers with staff for Date Night from 6:00pm-9:30 pm. Parent/Guardian are assuming the responsibility for potential injuries while their child is bouncing and participating in Date Night. Parent/Guardian agrees to the terms that Bitterroot Bouncers, Inc. is not and cannot be held liable for any injuries or accidents their child assumes while participating in Date Night. Children must be picked up no later than 9:30pm, no exceptions.
I/We, understand and acknowledge that playing and/or riding on an amusement device such as bouncy houses entails both known and unknown risks including, but not limited to, physical injury from falling, slipping, crashing or colliding, emotional injury, paralysis, distress, damage or death to any participant. I/We hereby voluntarily and expressly release, indemnify, forever discharge and hold harmless BITTERROOT BOUNCERS, INC from any and all liability, claims, demands, causes or rights of action whether personal to me or to a third party, which are in any way connected with participation in this activity, including those allegedly attributable to negligent acts or omissions. Should BITTERROOT BOUNCERS, INC or anyone acting on behalf of BITTERROOT BOUNCERS, INC be required to incur attorney’s fees and costs to enforce this agreement, I/we expressly agree to indemnify and hold harmless BITTERROOT BOUNCERS, INC for all such fees and costs. In the event I/we or any of my participants file a lawsuit against BITTERROOT BOUNCERS, INC, it is agreed to do so solely in the state of Montana. I/We 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. In consideration of being permitted by BITTERROOT BOUNCERS, INC to use it’s equipment and facilities, I/we and my participants agree to indemnify and hold harmless BITTERROOT BOUNCERS, INC from any and all claims which are brought by me/us and/or my participants and which are in any way connected with such use or participation. A set of Rules and Directions are displayed on the units and displayed on wall in facility. I/We agree to follow and utilize these rules at all times during operation and use of the unit(s). Closed circuit video surveillance is present in this facility for purposes of safety and liability. I/We acknowledge and consent to being recorded while inside this facility. I/We consent/allow BITTERROOT BOUNCERS, INC to use any recorded video for promotional purposes. I/We understand it is my/our responsibility to notify BITTERROOT BOUNCERS, INC staff if I/we do not wish to be part of promotional events that utilize said videos. I/We acknowledge and certify that I/we have had sufficient opportunity to read the entire Waiver and Acknowledgement of Risks, which I/we understand it’s content and that I/we execute it freely without duress of any kind and agree to the terms herein stated.
Child #1 Name & Age
Child #2 Name & Age
Child #3 Name & Age
Child #4 Name & Age
Child #5 Name & Age
Does your child(ren) have any allergies or medical problems? If yes, please list which child.
Does your child(ren) have permission to eat popcorn?
Parent/Guardian #1 Name & Phone Number:
Parent/Guardian #2 or Emergency Contact Name & Phone Number:
Electronic signature consenting to above terms (Type Full name):
A copy of your responses will be emailed to the address you provided.
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