Waiver

In Consideration of being allowed to enter the play area and/or participate in any party and/or program at Super Jump of Williamsport, PA, the undersigned, and his or her behalf, and on the behalf of the participant(s) identified below, acknowledges, appreciates and agrees to the following conditions:

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.  I agree that the participant(s) named below and I shall comply with all stated and customary terms, posted safety signs, rules, and verbal instructions as conditions for participation in any party and/or program at Super Jump.  In addition, if I observe any hazard during our participation, I will bring it to the attention of the nearest Super Jump employee or official immediately.

I am aware that there are inherent risks associated with participation in Super Jump programs, parties, and/or use of the play area and inflatable equipment and I, on behalf of myself and the participant(s) named below, knowingly and freely assume all such risk, both known and unknown, including those that may arise out of the negligence of other participants; and,

I, for myself and the participant(s) named below, and our respective heirs, assigns, administrators, personal representatives, and next of kin, hereby release and hold harmless, Super Jump, Inc. and their affiliates, officers, members, agents, employees, other participants, and sponsoring agencies from and against any and all claims, injuries, liabilities or damages arising out of or related to our participation in any and all Super Jump programs, activities, parties, the use of the play area and/or inflatable equipment.

_____________________________________                          ______________________________________                                                                                                                      Participant Name                                                                    Participant Date of Birth

_____________________________________                          ______________________________________                                                                                                                          Participant Name                                                                    Participant Date of Birth

_____________________________________                          ______________________________________                                                                                                                  Parent/Guardian Signature                                                   Date                                                                       

________________________________________________________________________________________                                                                                                                               Parent/Guardian Printed Name

_____________________________________                          ______________________________________                                                             Address                                                                                     City, State ZIP

_____________________________________                          ______________________________________                                                                                                                       Emergency Contact Phone#                                                   Email (Optional)                                                                   

____I do not wish to receive email regarding party promotions, specials, and upcoming events.