Fill and Sign the Assumption Risks Form

R elease , Waiver of Liability, and Assumption of all Risks of Bodily Injury for the Privilege to Use a Trampoline The undersigned does hereby represent that I am the parent or legal guardian of ___________________________________ (name of minor) and am authorized to execute this Release, Waiver of Liability and Assumption of Risk. I do further agree and represent that ___________________________________ (name of minor) is qualified, in good health, and in proper physical condition to safely use that certain trampoline located at _________________________________________________________ (street address, city, state) and owned by ________________________, hereinafter sometimes referred to as Trampoline Owner. I do further covenant and represent that I have read this document; I have inspected the trampoline and the surrounding area owned by Trampoline Owner, and that I voluntarily signed this Release, Waiver of Liability and Assumption of Risk Waiver and Release. In consideration of ___________________________________ (name of minor) being allowed to use the trampoline and surrounding area for recreational purposes, I, on behalf of myself and ___________________________________ (name of minor), release the Trampoline Owner, his/her employees, (wife, husband, children and members of household) (collectively Releasees) from all liability to me or ___________________________________ (name of minor) for any loss or damage to property, physical injury or death to ___________________________________ (name of minor) whether caused by Releasees or otherwise that result, directly or indirectly form the use by _______________________________ (name of minor) of the trampoline and surrounding area owned by Trampoline Owner located at _________________________________________ (street address, city, state). I further agree to indemnify, save and hold Releasees harmless from any loss, liability, attorney fees, damage, or costs that they (or any of them) may incur arising out of or related to the use of said trampoline and surrounding area by ___________________________________ (name of minor) whether caused by the negligence of the Releasees or otherwise. I further agree and warrant that if at any time I believe conditions to be unsafe regarding the use of said trampoline and surrounding area I will inform Releasees in writing and immediately discontinue allowing ___________________________________ (name of minor) to use said trampoline. Both ___________________________________ (name of minor) and I fully understand that use of a trampoline involves risks and dangers of serious bodily injury, including permanent disability, paralysis, and death (Risks). I fully understand that these Risks and dangers may be caused by the actions or inactions of ___________________________________ (name of minor) or the actions or inactions of others participating in trampoline activity. Both ___________________________________ (name of minor) and I understand that use of the trampoline and surrounding area will not be supervised by any of Releasees, and I fully accept and assume all such risks and all responsibility for losses, costs, and damages either I or ___________________________________ (name of minor) incur as a result of such trampoline activity. I grant to the Trampoline Owner ( and his wife) the authority to act as guardian(s) in granting permission for emergency treatment/hospitalization (including anesthesia) if believed necessary for ___________________________________ (name of minor) in the event of his or her injury as a result of any trampoline activity on the premises of Trampoline Owner . I understand that should such a health emergency arise, such parties will attempt to notify me, but that if I cannot be reached by telephone, such medical treatment as deemed necessary by competent medical personnel is hereby authorized. This Agreement shall be governed by the laws of the State of ____________and the Parties agree that any legal action relating to or arising out of this agreement shall be brought in binding Arbitration in ___________________________ (city, state) and subject to the Rules of the American Arbitration Association . WITNESS my signature this the _____ day of ___________ 20___. _______________________________________ Parent or Legal Guardian of ___________________________________ (name of minor)