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Have a SAFE Play!

 

                                                                                               Jungle Gym LLC Waiver & Assumption of Risk

The undersigned Customer, voluntairy makes and grants the Waiver and Assumption of Risk in Favor of the Jungle Gym LLC. (company) regarding the use of rectional facilities, equiptment, materials and/or other assets of the Company.

I do hereby waive and release any and all weather in contract or of personal injury, bodily injury, property damages, or losses thay may arise from my aforementioned use of facilities as I understand and recognize that there are certain risk and dangers and percil connected with such use which I hearby acknowledge.

I fully understand and which I nevertheless accept, assume and undertakeon my behalf or that of my childor other minor child. I further agree to use my Best judgment in undertaking these activities to faithfully adhere to all safety instructions and recommendations, weather oral or written. I hereby certify that I am a competent adult assuming these risks of my own free will, being under no compulsionor or duress.

I also release to said Company. I understand that the company my photograph or otherwise memorialize my activities with said company. I hereby grant my consent to the same and to the company's use of my likeness, photograph in it's endeavors which may include advertisment materials and or commercials.

 

YOU MUST STAY WITH YOUR CHILDREN AT ALL TIME'S

SOCKS ARE REQUIRED FOR ALL CHILDREN PLAYING ON EQUIPTMENT!

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*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
Parent or Guardian'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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