Event Liability Waiver

Required for Bouncy House Participation

RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT

Event: Boulevard Lane Community Association Summer BBQ 2025
Date: August 23rd, 2025
Location: Boulevard Lane Park

In consideration of being allowed to participate in the bouncy house and related activities at the Boulevard Lane Community Association Summer BBQ 2025, I acknowledge, appreciate, and agree that:

  1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist;
  2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child's participation;
  3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove my child from participation and bring such to the attention of the nearest official immediately;
  4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Boulevard Lane Community Association, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Child's Name (please print): _________________________________

Child's Age: ________

Parent/Guardian Name (please print): _________________________________

Parent/Guardian Signature: _________________________________

Date Signed: _________________________________

Emergency Contact Phone: _________________________________

BLCA Staff Use Only:

Wristband Color: _____________ Number: _____________

Received by: _____________ Time: _____________

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