Hopper’s House

Hopper’s House Waiver:

In consideration of being allowed to enter into the play arena and/or participate in any party, drop-in care and/or other programs offered at Hopper’s House, the undersigned, on his or her own behalf, and/or on behalf of the participant(s) identified below, acknowledges, appreciates, and agrees to the following conditions:

____ I willingly agree to comply with the stated and customary terms, rules, and conditions for participation in any party, drop-in care, or other programs offered at Hopper’s House.

____ If while participating I observe any hazard to anyone, I will bring it to the attention of the nearest employee immediately.

____ I am aware that there is a risk of injury from the inflatable equipment and/or rock wall, and while particular rules, equipment, and personal discipline reduce the risk, the risk does exist.

____ I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of other participants; and, I for myself, and on behalf of my heirs, assigns, personal representatives, and next of kin, herby hold harmless, Hopper’s House, LLC of Apex, NC and their affiliates, officers and members, agents, employees, and other participants, and sponsoring agencies with respect to any and all injury, disability and or loss or damage to person or property to the fullest extent of the law.

Child’s Name/ Date of Birth:________________________ D.O.B.__/__/____

Address: Street____________________________ City ___________ Zip ________

Email (to receive online coupons) ______________________________________

Parent/Guardian Name (Print) _________________________________________

Parent/Guardian Signature _____________________________________________

Date __________________________________________________________________