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BOUNCE HOUSE

RELEASE OF LIABILITY WAIVER

CAUTION: PLEASE READ CAREFULLY BEFORE SIGNING

PARENTS/GUARDIAN MUST SIGN FOR MINOR CHILDREN

Be Advised That This Is A Release Of Liability And Waiver Of Certain Legal Rights.

Be it hereby known:

I understand that participating in the use of the bounce house/slide combo supplied by Miller Horse Farm involves risk, danger and hazards that may cause serious personal injury or death and injuries are a common ordinary occurrence.  I voluntarily elect to participate in playing in the bounce house/slide combo supplied by Miller Horse Farm and I fully understand this involves jumping on air-filled entertainment toy(s) and other yard games.  I fully understand the health and safety risks associated with these types of activities and I therefore assume all risk of injury and /or death associated with these activities.  I certify that I have adequate insurance to cover any injury or damage that I or my minor(s) may cause or suffer while participating or else I agree to bear the costs of such injury or damage. I further certify that my minor has no medical or physical condition and does not suffer from any disabilities that place him/her or others at risk or otherwise physically inhibit participation in these activities. Also I accept full responsibility for Risks, known and unknown and I agree to indemnify Miller Horse Farm and all of their owners, Noah Smith, directors, officers, agents, representatives, employees and volunteers; and individually, Glory Smith, Joy Fowler, Ellen Haver, Melissa Rexroad, and Deirdre Strook as the instructors, and also landowners and adjacent landowners, and other local government/city agencies with whom the previously mentioned parties contract or do business, from any costs or liability associated with any accident or illness involving the below named participant or any guest or member of my family.  This Waiver and Release also applies to claims arising out of, or relating to, negligence by Miller Horse Farm.

I Agree

I do hereby for and on behalf of myself, my minor child(ren), and my heirs release and forever discharge and agree not to bring any action or suit against Miller Horse Farm, their owners, directors, officers, agents, representatives, employees and volunteers, and individually Glory Smith, Joy Fowler, Ellen Haver, Melissa Rexroad, and Deirdre Strook as the instructors, and other local government/city agencies with whom the previously mention parties contract or do business from any and all claims and demands of every kind, nature and character which I or my minor child may have, or may hereafter acquire, for any and all damages.  Losses or injuries, or death, which may be suffered or sustained by me or my minor with any activities in any way related to the afore mentioned and all such claims are hereby waived and released, and I covenant not to sue therefore.  I understand and fully assume all risks and hazards incidental to playing on or in a bounce house/slide combo and related activities.

I acknowledge that I have read, understand, and fully agree to the terms of this waiver and release and its contents. I understand and confirm that by signing this waiver and release, I have given up considerable future legal rights. I sign this waiver and release voluntarily, under no duress or threat of duress, without inducement, promise, or guarantee being communicated to me. My signature is proof of my intent to execute a complete and unconditional waiver and release of all liabilities in force under the law.  The individual participating in the use of the bounce house/slide combo inflatables is a minor, I am signing as a parent or legal guardian of said minor. I represent that I have the full authority to do so, realizing that this release is binding upon the minor child as well as myself.

MHF Code of Conduct: Miller Horse Farm “Horse 101” Camp encourages a safe and healthy atmosphere. Children must follow all instructions of MHF staff. MHF reserves the right to refuse a child to play on or in the bounce house/slide combo if he/she does not follow the instructions given or behaves in a way that endangers his/her safety or the other children in the bounce house. MHF reserves the right to refuse a child to return for any of the above mentioned behaviors that will endanger the child/children's safety. No refunds will be given. Any use of MHF facility is at OWN RISK!

All participants will take off their shoes and be checked for sharp objects on childrens clothing or in pockets.  MHF is not responsible for an injury or death of a participant in MHF activities. In consideration of my child’s participation in the sponsored activity, I hereby release, hold harmless, and discharge MHF, its elected official, officers, employees, agents, representatives, and assignees from any and all claims for personal injuries and damages. Parent, or legal guardian, agrees to pay legal fees incurred by MHF in defense of any claim made by parent, or legal guardian, against MHF.

I have read and agree to the MHF Code of Conduct and accept responsibility for any acts on behalf of my child in violation of this code.

I Agree

AUTHORIZATION FOR MEDICAL TREATMENT

I hereby authorize any medical treatment deemed necessary in the event of any injury to my minor(s) while participating in any activity offered by Miller Horse Farm. I either have appropriate insurance or, in its absence, agree to pay all costs for medical services as may be incurred on my minor(s) behalf.

I Agree

PHOTO RELEASE: I give permission for photographs taken of me or my minor while participating in this activity to be used in marketing and/or public relations material.

I Agree

By signing this document, I acknowledge that if my minor(s) is hurt or property is damaged during his/her participation in this activity, I may be found by a court of law to have waived my right to maintain a law suit against Miller Horse Farm on the basis of any claim from which I have released Miller Horse Farm herein.

I Agree

The Participant hereby voluntarily enters into this Contract and Agreement this date: April 26, 2024

THIS IS BINDING LEGAL AGREEMENT AFFECTS IMPORTANT LEGAL RIGHTS.  I HAVE READ AND UNDERSTOOD THIS DOCUMENT AND AGREE TO BE BOUND BY IT.  Parent /Guardian’s Initial:


 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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