Jumperoo LLC
5050 Harrison Avenue #3
Butte, MT 59701
(406) 723-JUMP (5867)
Voluntary Release
Acknowledgement of Risk
This Document affects your legal rights.
You must read and understand it before initialing and signing it.
I, the named participant being eighteen or older in age, or the parent/legal guardian of the named participant(s) under the age of 18, in
consideration of the services of Jumperoo LLC, and the owners, operations and employees of such entities, and the right to engage in
these activity as a participant and/or volunteer, hereby acknowledge, agree, promise and covenant with Jumperoo LLC, and the
owners, operations and employees, and all other entities affiliated therewith, on behalf of myself, my heirs, assigns, personal
representatives and estate as follows:
Acknowledgment and acceptance of risks and responsibility: I acknowledge having heard and understood all verbal, written and
posted information regarding rules and safety instructions including prohibiting the use of our equipment by anyone over the age of 15
years old, unless otherwise stated by the manufacturer. I willingly agree to abide by all stated and customary rules and conditions for
attendance and participation in all activities, programs, and parties at Jumperoo LLC. I understand and acknowledge that the activity I
am about to voluntarily engage in as a participant and or volunteer bears certain known risks and unanticipated risks which could
result in minor or major injury. I voluntarily agree, covenant and promise to accept and assume all responsibilities, and risk for injury
including but not limited to paralysis, death, illness, disease, physical or mental injury, damage to myself or to the minor(s) identified
below, or damage to my property arising from the participation in any activity at Jumperoo LLC (including risks arising from the
negligence of other participants). I further acknowledge that the undersigned is in good physical and mental health, and not suffering
from any condition, disease or disablement which would or could potentially affect participation in any and all activities at Jumperoo
LLC. In addition, if I observe hazard during our participation, I will bring it to the attention of the nearest Jumperoo LLC operator or
employee immediately.
Release and Indemnity: I, for myself and the minor(s) identified below, voluntarily release and forever discharge and covenant not to
sue Jumperoo LLC, and the owners, operators and employees of such entities, from any and all liability, claims, demands, actions or
rights, which are related to, arise out of, or in any way connected with the participation in any and all activities at Jumperoo LLC. I
further agree, promise and covenant, on behalf of myself and the minor(s) identified below, to hold harmless and to indemnify
Jumperoo LLC, and the owners, operators and employees, and all other persons or entities from all defense costs, including attorney’s
fees, or from any other costs incurred in connection with any claim or lawsuit filed against Jumperoo LLC, the owners, operators or
employees as a result of the participation in any and all activities.
My signature below indicates that I have read this entire document, understand it completely, and agree to be bound by its
terms, for myself and for all minors listed below. By signing below, I certify that I am the legal parent or guardian of the child
for whom I am signing. My signature indicates my agreement for this visit and all future visits occurring within on year from
the date of signature. This document cannot be modified or changed in any way by Jumperoo LLC, its operators, employees or the
undersigned.
Participants: (Please Print)
Name: __________________________________________________ Date of Birth: ______________________
Sibling: _________________________________________________ Date of Birth: ______________________
Sibling: __________________________________________________Date of Birth: _____________________
Sibling: __________________________________________________Date of Birth: _____________________
Parent/legal guardian signature: _____________________________________________Date:____________
Parent/legal guardian printed name: _________________________________________________________
Phone Number: _______________________________ Address: ____________________________________
SOCKS ARE REQUIRED AT JUMPEROO LLC