Please Fill Out The Form, Save a Copy, and Send it to

Jumpin’ Jim’s LLC

RELEASE OF LIABILITY

This document affects your legal rights. You must indicate that you have read & understand it by supplying your signature in the designated area at the bottom of the form.

DUTY OF THE PATICIPANT: It is recognized that some activities offered by Jumpin' Jim's, LLC are hazardous to participants regardless of all feasible safety measure, which can be taken. It is the participant's duty to act as a reasonably prudent person when engaging in the recreational activities afforded by and the entertainment equipment provided by Jumpin' Jim's, LLC

I hereby covenant & agree to the following:

a.Not to act in any way which shall interfere with the running or operation of Jumpin' Jim's, LLC when such activities conform to the rules and regulations of the State of New Jersey.

b. I will not use any of Jumpin' Jim's, LLC equipment or facilities or services if I do not have the ability to use such facilities, equipment, or services safely without instructions, until I have requested and received sufficient instruction to permit safe usage.

c.I, nor my guests, shall engage in any harmful conduct or willfully or negligently engage in anytype of conduct, which contributes to any cause of injury to any person.

d.I, nor my guests, shall embark in any self initiated activity without first informing Jumpin' Jim's, LLC of my intentions and receiving written permission from Jumpin' Jims, LLC to engage in that activity, or any revised version of that activity.

e.I will not enhance, amend, or supplement any of Jumpin' Jim's, LLC equipment either to repair &/or improve its performance or presentation.

ACKNOWLEDGEMENT & ACCEPTANCE OF RISK: I understand and acknowledge that the activity which I am about to voluntarily engage in as a participant &/or volunteer bears certain known risks and unanticipated risks which could result in injury, death, illness or disease, physical or mental, to my property, or to spectators, or to other third parties. I, being aware of the aforementioned, do accept full responsibility and risk for any and all injury, death, illness, disease, or damage to persons or property arising from any and all negligent notions. My participation in this activity is purely voluntary in nature, with no presence of force or intimidation, & I elect to participate in spite of the known and unknown risks.

RELEASE: In consideration of the services and/or property provided, I, for myself and any minor children for which I am the parent, legal guardian, or otherwise responsible, and heirs, personal representatives or assigns, do hereby release Jumpin' Jim's, LLC, its principals, directors, officers, agents, employees, and volunteers from any liability and waive any claim for damages arising from any cause whatsoever (except that which is gross negligence). I further agree to reimburse Jumpin' Jim's, LLC for all attorney's fees and

ENTIRE AGREEMENT: I understand that this is the entire agreement between myself and Jumpin' Jim's, LLC its agents or employees, and that it cannot be modified or changed in any way by the representatives or statements of any employees of Jumpin' Jim's, LLC or by me.

My signature below indicates that I have read this entire document and understand it completely & agree to be bound by its terms.

SIGNATURE / DATE
EVENT DATE & LOCATION