WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT

I, ____________________, located at _____________________

( Parent/Guardian ) (Street Address)

City ________________ State __________________ ZIP __________

ACKOWLEDGE that as a parent or guardian of the participants named below, understanding that all reasonable precautions have been taken to assure that Jumpamania LLC is safe as possible, I am aware that participating in the activities in the play areas and inflatable equipments creates a risk of injury and I freely assume all such risks both and unknown even if arising from negligence of others. I agree to Release, Defend , Indemnify, Not Sue and Hold Harmless Jumpamania LLC, their principal, officers, owners, employees, equipment manufacturers, sponsors, agents, and other participants, from any and all claims, damages, (including medical expenses, attorneys’ fees), injuries ( including disabilities, paralysis, and death ), and expenses arising out of, or resulting from my voluntary attendance/participation at Jumpamania LLC or the voluntary attendance/participation of those for whom I have signed below. I have permission from the minor’s family and other responsible party to cover minor under this agreement.

I, as a parent/guardian of the participants below, willingly agree to comply with all stated and customary terms, posted safety signs, rules and verbal instructions as condition for any party and/or program at Jumapamania LLC. I warrant and certify that all participants ( minor/children ) are physically fit and able to participate in all activities at Jumpanamia LLC.

Should it be necessary, in the opinion of a member of the staff at Jumpamania, LLC to render first aid and/or assistance to participants, I hereby grant permission to the staff of Jumpamania LLC to render such aid and assistance if I am not present. I agree to release Jumpamania LLC from all claims, damages, injuries and expenses arising from such assistance including any claims arising from contact needed to administer assistance.

I HAVE CAREFULLY READ THIS PARTICATION AGREEMENT, ASSUMPTION OF RISK ACKNOWLEGEMENT AND RELEASE OF LIABILITY AND FULLY UNDERSTAND ITS CONTENTS, BY SIGNING THIS AGREEMENT AND RELEASE, I AGREE TO ALL OF THE ABOVE.

Participant Name ______________________ Date of Birth ________________

______________________ ________________

Parent/Guardian or

Participant ( if over 18 years of age) Signature _____________________________ Date ___________

Emergency Contact Number: (___) ____________