Fill and Sign the Waiver Release Liability 497427095 Form

WAIVER AND RELEASE BY PARENT OF MINOR CHILD FROM LIABILITY FOR BUNGEE JUMPING I,       , on behalf of       (hereinafter referred to as “CHILD) HEREBY WAIVE AND RELEASE, indemnify, hold harmless and forever discharge       and its agents, employees, officers, directors, affiliates, successors and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I or CHILD ever had or may have, arising from or in any way related to CHILD’S participation in any of the events or activities conducted by, on the premises of, or for the benefit of,       provided that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful or wanton misconduct. I understand that the activities that said CHILD will participate in are inherently dangerous and may cause serious or grievous injuries, including bodily injury, damage to personal property and/or death. On behalf of myself, my heirs, assigns and next of kin, I and said CHILD waive all claims for damages, injuries and death sustained to me, CHILD or property, that I or said CHILD may have against the aforementioned released party to such activity. CHILD has the necessary and requisite skills to participate in all facets and activities of and requested of this jumping facility, except as noted below. The nature of the activities has been fully disclosed and any flyer, advertisement, or brochure relating to the participating activities is expressly made a part of this WAIVER AND RELEASE. By this Waiver, I, on behalf of said CHILD, assume any risk, and take full responsibility and waive any claims of personal injury, death or damage to personal property associated with       , including but not limited to bungee jumping, using the facility and its equipment in any manner, form or fashion, practicing and/or engaging in bungee jumping activities or other related “extreme sports” activities on and off the premises. This WAIVER AND RELEASE contains the entire agreement between the parties, and supercedes any prior written or oral agreements between them concerning the subject matter of this WAIVER AND RELEASE. The provisions of this WAIVER AND RELEASE may be waived, altered, amended or repealed, in whole or in part, only upon the prior written consent of all parties. The provision of this WAIVER AND RELEASE will continue in full force and effect even after the termination of the activities conducted by, on the premises of, or for the benefit of,       whether by agreement, by operation of law, or otherwise. I have read, understand and fully agree to the terms of this WAIVER AND RELEASE. I understand and confirm that by signing this WAIVER AND RELEASE that said CHILD and I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law. Medical Conditions. CHILD is subject to the following allergies or medical conditions, and I authorize the facility to disclose these conditions to a physician or other medical professional in the event said CHILD should require emergency medical care:                         - 1 – Copyright 2004 USLegalforms.com Prohibited Activities. As a result of the above-mentioned medical conditions, I, on behalf of CHILD, am prohibiting involvements in the following specific activities:                                     Date       Printed Name of CHILD       Printed Name of Parent (Guardian) Signature of Parent (Guardian) - 2 – Copyright 2004 USLegalforms.com