In consideration of being able to participate in various activities in/on House of Bounce facility,
the undersigned, on his or her own behalf, and on behalf of any executors, heirs, successors and
As signs here by acknowledges and agrees as follows:
1. The undersigned knowingly and fully assumes all risks, known and unknown, associated with
participation in activities at House of Bounce and waives all claims for damage to person or
property arising from such participation. This release and waiver covers risks of death, serious
injury and property loss whether arising from (a) negligence or carelessness on the part of the
persons or entities being released and other participants, or (b) dangerous or defective equipment.
2. The undersigned certifies that he or she is physically fit and may participate in the activities
available at House of Bounce and has not been advised otherwise by a qualified medical person.
3. The undersigned on his or her behalf and on behalf of any executors, heirs, successors and
assigns hereby releases, discharges and holds harmless any authorized entity doing business as
House of Bounce and its officers, agents, employees, representatives, and all affiliates, from any
and all claims, damages or liability arising from death, disability, personal injury, property
damage or theft, or actions of any kind.
4. The undersigned agrees to comply with the rules and conditions of participation expressed or
posted during a House of Bounce. If the undersigned observes any significant hazard during such
participation, the undersigned will promptly inform an employee of House of Bounce; and
5. The undersigned acknowledges that this release and waiver of liability form will be used and
relied upon by the House of Bounce and that it will govern the undersigned’s actions and rights.
Parent/Guardian Acknowledgment
The undersigned parent and/or guardian does hereby represent that he/she is, in fact, acting in
such capacity and agrees to save and hold harmless and indemnify each and all of the parties
referred to above of all liability, loss, cost, claim or damage whatsoever which may be imposed
upon said parties because of any defect in or lack of such capacity to so act, and releases said
parties on behalf of the minor and the parents or legal guardian. This waiver will expire 12
months from the date it is signed.
3684 N. Main
Joplin, MO 64834
417-625-1082