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City of Buffalo, Minnesota
Waiver and Release of Liability
Inflatable Bounce House
Please read carefully before signing
1. I wish to allow my minor child or ward,
First and Last Name
to participate in playing in an inflatable bounce house (the “Activity”) during the
event sponsored by the City of Buffalo, Minnesota (the “City”) on
2. My Child’s participation in the Activity is voluntary. The use of a bounce house carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. I know and am aware of all the dangers associated with my Child’s participation in this Activity and with such knowledge assume on behalf of my Child and myself any and all such risks while participating in the Activity. Such risks include: (1) minor injuries such as scratches, bruises and sprains; (2) major injuries such as joint or back injuries, broken bones and head injuries; and (3) catastrophic injuries including paralysis and death.
3. In consideration of my Child being allowed to participate in the Activity, I understand and agree that neither the City nor any person acting on behalf of the City, may be held liable in any way for any event which occurs in connection with this Activity which may result in harm, death, injury or other damage to my Child, including claims caused by the City’s negligence. This waiver of liability does not waive liability for any injuries that resulting from the willful, wanton or intentional misconduct by the City or any person acting on behalf of the City.
4. I agree to comply with all rules related to the Activity and will instruct my Child to follow all rules. If I observe any unusual or significant hazard during my Child’s participation in the Activity, I will immediately notify the nearest official.
5. I agree to defend, indemnify and hold harmless the City for any expense or liability the City may incur as a result of my Child’s conduct, actions or omissions while performing the Activity.
6. If any court finds any portion of this Waiver and Release of Liability to be contrary to law, invalid, or unenforceable, the remainder of the Waiver and Release of Liability will remain in full force and effect.
7. I certify that I am the parent or legal guardian of the above-named minor and I hereby consent to his or her participation in the Activity. I have read and understand the above waiver and release of liability and I agree to be bound by the terms stated therein.
First and Last name
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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