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jumpstreet RELEASE AND PARENT/GUARDIAN WAIVER OF LIABILITY

PLEASE READ THIS DOCUMENT CAREFULLY. BY SIGNING IT, YOU ARE GIVING UP LEGAL RIGHTS

Today's Date: May 25, 2019

In consideration for being permitted in jumpstreet® and the related activities (collectively, activities) conducted by and at jumpstreet®, INC..

ASSUMPTION OF RISK:  I agree that I and/or my child/ward am voluntarily participating in the activities offered by jumpstreet® including, but not limited to, the use of the equipment,facilities and the premises.  I am assuming on behalf of myself and/or child/ward, all risk of personal injury, death, or disability to myself and/or child/ward that may result from participation, or any damage, loss or theft of any personal property which me and/or child/ward may incur. I understand that the jumpstreet® facility has trampolines, inflatables and  a mechanical bull ride and that using trampolines, inflatables and mechanical bull ride have inherent risks. Further, I have explained these risks to my child/ward.   In spite of the risks mentioned above I freely want to participate and as such I assume all of the responsibility for injury or death that may result.

RELEASE OF LIABILITY: I understand that myself and/or child/ward will be engaging in recreational and sporting activities within the meaning of A.R.S. §331551 while using the jumpstreet® facility and it is my voluntary and informed decision to release any future lawsuits or claims that they may have against the releasees.  Therefore, I agree on behalf of myself and my child/ward and our personal representative, successors, heirs, and assigns to hold jumpstreet®, INC. and its affiliates, instructors, officers, directors, agents, employees, designers, licensors, and members, as well as the property owner and tenants of the property and the owners, manufacturers and installers of the equipment comprising the jumpstreet® facility (collectively, the Releasees) harmless from any and all claims or causes of action arising out of me and my child/wards participation at the jumpstreet® facility.

I expressly release and forever discharge Releasees from any and all liability, claims, demands or causes of action whatsoever arising out of any damage, loss, personal injury, or death to me or my child/ward, while participating in any of the activities offered at the jumpstreet® facility.  This includes, without limitation, use of trampolines, inflatables, receiving instruction, strenuous bodily movement, and any other activities in and around the jumpstreet® facility. This release is valid and effective whether the damage, loss, or death is a result of any act or omission on the part of any Releasees or from any other cause.  This Waiver and Release of Liability includes, without limitation, injuries, or accidents, which may occur as a result of the: (a) use or misuse of the facility in any way by anyone, (b) use of any equipment that malfunctions or breaks, (c) improper maintenance of the facility, grounds, or any equipment, (d) instruction or supervision, or (e) slipping, tripping and /or falling while in the facility or on the surrounding premises.  This Release of Liability also expressly includes a release for any and all claims arising out of or under the A.R.S. Title 12 of §331551  LIABILITIES AND DUTIES ON PROPERTY USED FOR EDUCATION AND RECREATION.

I further grant jumpstreet®, INC. the right to photograph, videotape, and/or record me and/or my child/ward and to use my or my childs/wards name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising, and promotional materials without reservation or limitation. I will inspect the portions of the facility that I intend to use prior to my using and will immediately report and defect to management. I am in good physical condition for the activity in which I will be participating and certify that I do not have any medical condition that may preclude me from safely participating.

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF ALL LIABILITY AND A WAIVER OF ANY RIGHT THAT I MAY HAVE ON BE HALF OF MYSELF AND OR MY CHILD/WARD TO BRING A LEGAL ACTION OR ASSERT A CLAIM FOR INJURY OR LOSS OF ANY KIND AGAINST jumpstreet®, INC..  SHOULD ANY CLAIM BE MADE, I UNDERSTAND AND AGREE THAT I WILL BE RESPONSIBLE FOR ALL ATTORNEYS FEES AND DEFENSE COSTS INCURRED BY jumpstreet®, INC. IN CONNECTION WITH OR IN THE DEFENSE OF THAT CLAIM.

This Release and parental/guardian Waiver is made in accordance with A.R.S. §331551. I have read the above, considered its effects, understand its content, and agree, on behalf of myself and my child/ward, to the terms as stated above.  This agreement specifically contains an indemnity agreement whereby I agree to reimburse the Releasees against any damages (including attorneys fees and costs) incurred as a result of any lawsuit, claim, or action brought by myself, my child/ward, or any other party, related in any way  to me or my childs/wards use of the jumpstreet® facility.  I further understand that no person has permission to use the jumpstreet® facility without an effective and validly signed Release and parental/Guardian Waiver of Liability.

I understand that I am voluntarily giving up me and or my childs/wards right to bring a lawsuit or claim against the abovementioned Releasees.  I further understand and accept the above risks related to these activities.

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
* Adult's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Adult's Information

City *

Address *

Zip Code *

State *

Phone Number *
Party or Group Information

When is your party date? *
What Time is your Party or Group Event?*

Please provide the first name of the Birthday child or the group name as provided by your group coordinator. *
Which location is the party or event located at?
Click to customize pull down*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
* Adult's Name

First Name*

Last Name*
* Adult's Date of Birth*
* Adult's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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