Loading...

Assumption of Risk, Release and Waiver of Liability, Indemnity Agreement

In consideration of entering and using the facilities, play area and services at Jungle Jim's Play Centre Inc. ("Jungle Jim's Play Centre" or just "Jungle Jim's") located at 140 Welland Ave Unit 12, St. Catharines, Ontario L2R 2N6.("Premises") the undersigned representative on behalf of himself or herself and the Participants identified below (the "Participants" and each a "Participant") acknowledges and agrees to the following:

1. I represent that I am the Parentor Legal Guardian of the Participants named below or I have obtained permission from the Parent or Legal Guardian of the Participants named below to execute this agreement on their behalf. I agree that the Participants named, and I shall comply with all stated and customary terms, rules, and instructions of Jungle Jim's as a condition of the entry and use of the facilities, play area, programs and services at the Premises.

2. I acknowledge and understand that there are known and unknown risks associated with the entry and use of the facilities, play area, programs and services at the Premises.  I, for myself and the Participants named herein, knowingly and willingly assume any and all known and unknown risks associated with the entry and use of the facilities, play area, programs and services at the Premises which may or may not be expressly stated herein.

3. USE OF THE "JUNGLE JIM'S" FACILITIES, PROGRAMS, SERVICES AND EQUIPMENT IS AT THE UNDERSIGNED AND EACH PARTICIPANT'S SOLE RISK. THE PREMISES ARE PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS. THE UNDERSIGNED REPRESENTS THAT IS HAS INSPECTED THE "JUNGLE JIM'S" PLAY AREA, FACILITIES, PROGRAMS, AND SERVICES AND FINDS AND ACCEPTS THEM AS BEING SAFE AND REASONABLY SUITED FOR ITSELF AND THE PARTICIPANTS . JUNGLE JIM'S EXPRESSLY DISCLAIMS ALL WARRANTIES OF ANY KIND. WETHER EXPRESS OR IMPLIED. THE UNDERSIGNED ON HIS OR HER OWN BEHALF AND ON BEHALF OF THE PARTICIPANTS ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE WHILE IN, ABOUT OR ON THE "JUNGLE JIM'S" PREMISES OR USING THE "JUNGLE JIM'S" PLAY AREA, FACILITIES, SERVICES OR EQUIPMENT. THE UNDERSIGNED ON HIS OR HER BEHALF AND ON BEHALF OF THE PARTICIPANTS HEREBY WAIVE AND RELEASE ANY AND ALL LOSSES, LIABILITIES, DAMAGES OR CLAIMS AGAINST "JUNGLE JIM'S", IT'S OWNERS, MEMBERS, MANAGERS, EMPLOYEES, AND AGENTS (THE "RELEASED PARTIES" AND EACH A "RELEASED PARTY") ON ACCOUNT OF ANY INJURY TO PERSON OR PORPERTY OR DEATH OF THE UNDERSIGNED AND/OR THE PARTICIPANTS, WETHER CAUSED BY NEGLIGENCE OR GROSS NEGLIGENCE OR THERELEASED PARTIES WHUILE THE UNDERSIGNED AND/OR PERTICIPANTS ARE ABOUT OR IN THE FACLITIES. THIS RELEASE ANDD WAIVER IS INTENDED TO BE AS BROAD AND INCLUSIVE AS PERMITTED BY THE LAWS OF THE PROVINCE OF ONTARIO AND THAT IF ANY PORTION HEREOF IS HELD INVALID, IT IS AGREED THAT ANY REMAINING PORTIONS SHALL REMAIN IN FULL FORCE AND EFFECT.

4. THE UNDERSIGNED AGREES TO INDEMNIFY AND HOLD HARMLESS EACH OF THE RELEASED PARTIES FROM ANY AND ALL LOSS, LIABILITY, OR DAMAGE INCURRED AS A RESULT OF HIS OR HER AND/OR A PARTICIPANTS INJURY TO PERSON OR PROPERTY OR DEATH IN, ABOUT OR ON "JUNGLE JIM'S" PREMISES OR USE OF "JUNGLE JIM'S" PLAY AREA, FACILITIES, SERVICES, OR EQUIPMENT WETHER CAUSED BY THE NEGLIGENCE OR GROSS NEGLIGENCE OF A RELEASED PARTY.

5. THE UNDERSIGNED HAS READ AND KNOWINGLY AND VOLUNTARILY SIGNS THIS ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, INDEMNITY AGREEMENT AND ACKNOWLEDGES UNDERSTANDS AND AGREES TO SUCH TERMS.

6. The undersigned representative, on behalf of himself or herself and the participants identified below acknowledges, appreciates, understands, and agrees to the following:

  • I and the children have no illness or injury that may affect the safe enjoyment of "Jungle Jim's" by us or other guests
  • i and the children willingly agree to comply with the stated terms and conditions for participation and to obey the directions of and requests of Jungle Jim's Play Centre Inc. staff.
  • Jungle Jim's is an unsupervised facility. Jungle Jim's staff will attend and assist as is possible but they are not obligated to watch and attend guests. An attending adult must remain on the premises at all times to supervise and be responsible for the children. 
  • No shoes or Bare feet are to be permitted in the play area.
  • All visitors are to be healthy in order to enter our facility.
  • No outside foods or beverages are permitted into the facility.
  • Chewing gum is not permitted in the play area.
  • No loose clothing or jewelry is to be about the neck area entering the play area. (Ex. Scarfs or necklaces due to risk of injury or hanging)
  • No climbing up the slides. Slides are down only areas.
  • No running except in the play structure.
  • Hooded sweater with drawstrings are prohibitted from entry into the Play Area. Hair clips or sharp objects are to remain outside the play area.
  • Please  report any inappropriate behaviours as soon as possible to Jungle Jim's staff so they can ensure a safe and friendly environment.
  • Jungle Jim's reserves the right to refuse admission and request any person or persons to leave the premises to ensure the health and safety of other visitors.
  • Jungle Jim's is nt responsible for any lost or stolen items.
  • No smoking, Vaping, Drugs or alcohol to be permitted on the property. Smoking must be 30feet from Jungle Jim's property by municipal by-laws.

I have read this release and waiver of liability agreement, fully understand its terms, understand that I have given up substantial rights for myself and the children by signing it, and sign it freely and voluntarily, without inducement or coercion.

 

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*
Parent or Guardian's Email Address

Email*

Confirm Email*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!