Group Name (if applicable)
Select Group (If Applicable)
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
" Type name at bottom acknowledging you agree to the above requirements : 1.)____ I have been shown how inflatable is secured. 2.)____ I have been shown how to turn on /off blower. 3.)____ I have been instructed not to allow any horseplay, flips, wrestling or any other unsafe activities both in and around the inflatable. 4.)____ I have been advised of the following… No shoes or sharp objects in or around the inflatable unit(s); No food, drinks or gum; No eyeglasses or jewelry. 5.)____I understand that adult (18 years old & up) operators must be provided to watch the games at all times. 6.)____I have been advised that children of the same size or age group only may use the unit(s) at any given time, no adults. 7.)____I agree to remove any person from the inflatable who is violating posted rules of operation. 8.)____I have received both written and verbal instruction on the safe operation of the inflatable and agree to follow all safety rules. ï± ï± I understand that I am responsible for the equipment until the rental company arrives to pick it up. ï± ï± I understand that while children are in the inflatable equipment, a responsible adult must be supervising. ï± ï± I will ensure that all riders remove their shoes and any sharp objects before entering the inflatable. Sharp objects include eyeglasses, toys, jewelry, and any item that could scratch the unit or another rider. ï± ï± I understand that food and drinks are not allowed inside the inflatable, including gum. ï± ï± I understand that no kind of spray string is to be used near the inflatable because it can severely damage the vinyl. ï± ï± Unless the inflatable is specifically designed to be a water ride, the inflatable should not get wet. ï± ï± I will not allow riders to do flips, climb the netting or roof areas, or roughhouse in the inflatable. I will remove riders who do not follow directions to ensure the safety of all riders. ï± ï± I will not allow riders to sit or play on the safety step. ï± ï± I understand that riders should be sorted by size to prevent injuries. Only children of approximately the same size should be in the inflatable at any time. ï± ï± I agree not to exceed the recommended number of riders or weight limit. See rental agreement for specifics. ï± ï± Safety and evacuation procedures in case of unit deflation have been reviewed with me. ï± ï± I am aware of how the weather can affect the inflatable and I have reviewed the procedures and understand what to do in the event of bad weather (rain or wind) ï± ï± I understand that riders must slide in a sitting position, feet first. Jumping and flipping from the top of the slide is not permitted and can cause injuries. Agreed to all above statements _________________________________ Responsible Party Signature Natalie and DeMarcus Lykes Rental Company Representative "
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: 18.222.184.162
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