Group Name (if applicable)
Select Group (If Applicable)
Millard South Post Prom
Name of Adult - Must be at least 18 years of age
Contact Information
Address
DOB
Drivers License
DL State
How many children do you need to add to this waiver?
None
1 child
2 children
3 children
4 children
5 children
6 children
7 children
8 children
Waiver
"TERMS AND CONDITIONS NOTE: Driver pick-up time is approximate. Driver may arrive as early as the “end’ of the “Rental Period†or as late as 11 pm to pick up the equipment. Customer is responsible for all the equipment until it can picked up by our driver. Same Driver will return for unit; If not, call office immediately. 1. Safety/Operating Instructions: In addition to the information set forth in this agreement, customer acknowledges that there are safety and operating instructions on the equipment delivered and agrees to read those instructions and operate the equipment, or allow the equipment to be operated or used, in accordance with those instructions. Customer further acknowledges and understands that Bryan Hill Entertainment Inc. has not agreed to nor have they provided any operators with this rented equipment, and that customer, is solely responsible for the correct and safe operation of this equipment. Customer understands that children’s safety depends upon customer providing AT ALL TIMES correct operation of and the use of the equipment, especially the MOON BOUNCE Unit. Customer further agrees to keep all equipment away from swimming pools(s) and customer understands and agrees that they will not operate any electrical equipment near water. By entering into this agreement, Customer acknowledges that there is a risk of injury or damage arising out of the use of this equipment. Customer voluntarily agrees to keep and maintain all safety rules for the correct, safe operation and installation and use of all equipment, and to assume any and all risk of injury or damage. In particular, customer will not permit the equipment to be operated by anyone who is not fully qualified and who has not received instruction from customer on the safe operation and use of the equipment, nor shall customer allow any person to use or operate the Equipment when it is in need of repair or when it is in an unsafe condition or situation. 2. General Release/Indemnity/Hold Harmless: Customer will take all necessary precautions regarding the items rented, and protect all persons and property from injury or damage. Customer acknowledges that they are in charge of the operation, installation and use of the Rental Equipment, or to any claims by any other person(s) injured by or on account of the Rental Equipment, while the equipment is in the possession of the Customer. Customer agrees to defend, indemnify and hold harmless Bryan Hill Entertainment Inc. from and against any and all liability, claims, judgments, attorneys fees, and costs, of every kind and nature, including, but not limited to, injuries or death to persons and/or damage to property, whether or not such claimant is known or unknown to Customer, which arises out of the use, maintenance, installation, operation, instruction, possession, or rental of any of the Rental Equipment, however caused, but with such claim arising while or such injury or damage occurring while such Rental Equipment is in the actual or constructive possession of Customer. These General Release, Indemnity and Hold Harmless provisions apply to, but are not limited to, any injury, death, damage, claim or liability which may arise on account of the negligence, whether active or passive, of Bryan Hill Entertainment Inc. or Bryan Hill Entertainment Inc.’s suppliers, agents, employees, contractors, drivers or installers. Customer further acknowledges that Bryan Hill Entertainment Inc. is not a food supplier or handler, and that any food related items, such as popcorn, which may be supplied with the Rental Equipment, is a straight pass through by Bryan Hill Entertainment Inc. to Customer. Since this additional service is provided to Customer as a courtesy by Bryan Hill Entertainment Inc. and so long as Bryan Hill Entertainment Inc. advises Customer, in writing, after Customer requests, with the name and address of the supplier of any specific item, Custome
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, AND I FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT AND SUBMITTING THIS FORM, AND I AM SIGNING IT AND SUBMITTING THIS FORM FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
IP: 54.224.52.210
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