Fill and Sign the Personal Injury Injured Form

IN THE CIRCUIT COURT OF       COUNTY, MISSISSIPPI       , A MINOR, BY AND THROUGH PARENTS,       and       , PLAINTIFF VS. NO.             DEFENDANT COMPLAINT COMES NOW PLAINTIFF,       , a minor, by and through his/her parents,       and       , and files this his/her complaint against defendant,       , and would show unto this honorable court the following, to wit: I. That Plaintiff is a minor being       years of age, residing with his/her parents       and       who are adult resident citizens of       County, Mississippi. II. The Defendant,       , is an adult resident citizen of       County, Mississippi, who may be served with process of this court at       ,       , Mississippi       . III. That on or about the       day of       ,       , Plaintiff was in the care of the defendant during a day of preparation for       , at which time defendant directed Plaintiff to clean windows in the home of defendant, was using a swivel bar stool to stand upon to reach the top of a glass door he/she was cleaning, the top of the stool swiveled and the plaintiff fell resulting in traumatic injuries. IV. The defendant had a duty to the child to use reasonable care to protect him/her from harm. The defendant failed to direct the plaintiff in what method should be used to reach the top of a glass door, which caused a breach of that duty. V. Defendant negligently allowed the plaintiff, a child of tender years, to use a swivel barstool to stand on which resulted as the proximate cause of the injuries sustained by the plaintiff. VI. As a direct result of the negligence of the defendant, plaintiff received severe injuries, pain and suffering, and medical and hospital expenses. WHEREFORE, Plaintiff, sustained serious, painful and permanent injuries to his/her body, from which he/she has suffered, and will continue to suffer, with much pain, from which he/she has incurred, and will continue to incur, hospital, medical and drug expenses. WHEREFORE, Plaintiff demands judgment against defendant for all damages allowed by law and in an amount to be determined by a jury. RESPECTFULLY SUBMITTED,       , A Minor BY: _____________________________________       , Attorney for the Plaintiff OF COUNSEL: _________________________________________