SOFT PLAY EQUIPMENT RENTAL

LIABILITY WAIVER AND HOLD HARMLESS AGREEMENT

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Please read and complete the form below

As parent or legal guardian of the child whose name is set forth below (who is referred to herein as the “Participant”) and in consideration of the Participant being permitted to participate in the Activities (as defined below) conducted by WIGGLE WORM PARTIES SOFT PLAY EQUIPMENT RENTAL (“Wiggle Worm Parties”), the Participant and I agree as follows:

  1. Activities ­ The Participant will participate in various activities offered by Wiggle Worm Parties (the "Activities"), including but not limited to, crawling, walking, climbing, bouncing, etc.

  2. Assumption Of Risk ­ I understand that the Activities entail the risk of severe bodily injury to the Participant. Injuries that could result will vary, but may include (a) minor injuries such as scratches, bruises and sprains; (b) major injuries such as eye injury or loss of sight, joint or back injuries and concussions; and catastrophic injuries, including paralysis and even death. Notwithstanding these risks and other hazards that may be foreseeable but not specifically identified herein, I, for myself and the Participant and our respective heirs, personal representatives and assigns, understand, acknowledge, and expressly and voluntarily assume all risks and full responsibility for any injury arising out of or related to the Activities.

  3. Release, Discharge and Agreement Not To Sue ­ I, for myself and the Participant and our respective heirs, personal representatives and assigns, do hereby release, discharge and agree not to sue Wiggle Worm Parties and its managers, members, employees and/or other agents, for any injury to or death of the Participant arising, directly or indirectly, from participation in the Activities. This release, discharge and covenant not to sue shall relate to any and all claims or legal rights now existing or arising in the future, including claims and legal rights arising out of any negligence of Wiggle Worm Parties and/or its managers, members, employees and/or other agents and any other breach of a legal duty arising out of common law, statute, contract or otherwise.

  4. Indemnification And Hold Harmless – I agree to indemnify Wiggle Worm Parties and hold Wiggle Worm Parties harmless from, without limitation, any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney's fees and costs, incurred due to claims brought by any third party as a result of or arising out of the Participant's involvement in the Activities and to reimburse Wiggle Worm Parties for any such costs, expenses and fees as they are incurred.

  5. Parent Or Legal Guardian Certification And Consent ­I hereby certify that I am the parent or legal guardian of the Participant whose name appears below, and I have authority to waive rights on behalf of the minor Participant. I have read and I understand all of the provisions of this document and the risks of the Activities. I understand that the Activities could cause injury and even death. I acknowledge that I have read and understand the terms of this document and I am freely and voluntarily signing this document.

  6. Severability ­ This document is intended to be as broad and inclusive as is permitted by the laws of the State of Florida and if any provision (or a part of any provision) contained herein is deemed to be invalid, the balance of the provisions shall continue in full legal force and effect, notwithstanding such invalidity.

Rules and Safe Procedures

  • Play at your own risk.

  • Socks must be worn at all times.

  • No shoes, sneakers, flip flops or sandals

  • No food, candy, gum, or beverages in the inflatable area

  • No pushing, shoving, wrestling, horseplay, or piling

  • No uneven size difference of players

  • No face paint, body paint, or glitter

  • Children may not be wet

  • No more than the recommended amount of players on unit at any one time

I AGREE TO RELEASE, DEFEND, INDEMNIFY, NOT SUE AND HOLD HARMLESS TYPE Wiggle Worm Parties, their principals, officers, owners, employees, equipment manufacturers from any claims, damages, (including medical fees, attorney fees), injuries (including disabilities, paralysis and death) and expenses arising out of or resulting from my voluntary attendance/participation at Wiggle Worm Parties.

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Photo/Media Release

I grant and authorize Wiggle Worm Parties the right to take, edit, alter, copy, exhibit, publish, distribute, and make use of any and all picture or video taken of me and the names listed on this form to be used in and/or for legally promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, press kits, and submissions to journalists, websites, social networking sites, and other print and digital communications without payment or any other consideration.  This authorization extends to all languages, media formats, and markets now known or hereafter devised.  This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing.

I understand and agree that these materials shall become the property of Wiggle Worm Parties and will not be returned.

I hereby hold harmless, and release Wiggle Worm Parties from all liability, petitions, and causes of action which I, my heirs, representative, executors, administrators or any other persons may make while acting on my behalf or on behalf of my estate.

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(A form without any selection and including initials shall imply permission.)

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