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Granite City Jump LLC Waiver of Liability

79 3rd st NE, Waite Park, MN 56387

320-342-2148

 

By completing and signing this form, I understand and agree to the statements presented in the Granite City Jump, LLC waiver. I also agree this will serve as my understanding and agreement with Granite City Jump, LLC for all future visits, regardless of nature. By signing a Granite City Jump, LLC participation waiver as the guardian of named child(ren), I understand the potential risks of playing on inflatable play units, some of which include, but are not limited to: personal injury, disability and or death. I understand and asume, as guardian, any and all risks, damage or injury as a result of participation at Granite City Jump, LLC. In agreement for admission, I hereby release, waive, and forever discharge any and all rights to legal recourse regarding participation at Granite City Jump, LLC and that of its owners, agents, employees, officers, directors, and/or all other personal entities acting on it's behalf, from any and all claims, damages, liability, actions, costs or expenses including, but not limited to: attorney fees, court fees, or arbitration that may arise out of participation or use of the Granite City Jump, LLC facitlity. I understand that use of the Granite City Jump, LLC facility is strictly voluntary and that by signing a waiver, I agree to abide by this agreement, and release all rights to legal recourse that i may have or possess. I also agree this will serve as my understanding and agreement with Granite City Jump, LLC for all future visits, regardless of nature.

 

 

First Participant's Name

First Name*

Last Name*

Phone*
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*
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*

Phone*
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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