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In Consideration of being allowed to enter the play area and/or participate in any
party and/or program at Pump It Up of Crystal Lake, IL, the undersigned, on his or her behalf,
and on the behalf of the participant(s) identified below, acknowledges, appreciates
and agrees to the following conditions:
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I represent that I am the parent or legal guardian of the participant(s) named below,
or I have obtained permission from the parent/legal guardian of the participant(s)
named below to execute this agreement on their behalf. I agree that the participant(s)
named below and I shall comply with all stated and customary terms,
posted safety signs, rules, and verbal instructions as conditions for participation
in any party and/or program at Pump It Up. In addition, if I observe any hazard
during our participation, I will bring it to the attention of the nearest Pump
It Up employee or official immediately;
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I am aware that there are inherent risks associated with participation in Pump
It Up programs, parties, and/or use of the play area and inflatable equipment
and I, on behalf of myself and the participant(s) named below, knowingly and
freely assume all such risk, both known and unknown, including those that
may arise out of the negligence of other participants; and,
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I, for myself and the participant(s) named below, and our respective heirs,
assigns, administrators, personal representatives, and next of kin, hereby
release and hold harmless, Jump 4 Kids Entertainment, LLC, DBA Pump It Up of Crystal Lake, IL,
and PIU Management, LLC, their affiliates, officers, members, agents,
employees, other participants, and sponsoring agencies from and against
any and all claims, injuries, liabilities or damages arising out of or
related to our participation in any and all Pump It Up programs, activities,
parties, the use of the play area and/or inflatable equipment.
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| Participant Name |
Participant Date Of Birth |
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| Participant Name |
Participant Date Of Birth |
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| Parent/Guardian Signature |
Date |
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| Parent/Guardian Printed Name |
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| Address |
City, State ZIP |
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| Emergency Contact Phone # |
Email (Optional) |
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