PARTICIPANT AGREEMENT, RISK ACKNOWLEDGEMENT AND INJURY WAIVER FORM – Space Inflaters
THIS IS AN IMPORTANT DOCUMENT AND MUST BE READ & UNDERSTOOD BEFORE SIGNING
Before participating at Space Inflaters, all participants must register to participate by completing the form below.
Participants under the age of 16 must have the form completed by a parent or legal guardian OR a person with authority to complete the form on behalf of the child’s parent or legal guardian.
FOR THOSE AGED 16 YEARS AND OVER
In order to participate in arena activities including, but not limited to all bounce sessions, under 3’s soft play, disco, (collectively herein called “Activities”) organized by Space Inflaters its franchisees, agents, owners, officers, directors, principals, volunteers, participants, clients, customers, invitees, employees, independent contractors, insurers, facility operators, land and/or premises owners and any and all other persons and entities acting in any capacity on its behalf (collectively “Space Inflaters” also known as “the Company”), I agree as follows
I am aged 16 years old or older.
I agree that I will undertake the Activities in accordance with the safety rules made available to me prior to participation and the advice given in the pre-participation safety briefing to be undertaken prior to participation, together with any oral instructions or advice given to me prior to or during the session.
I agree to wear any safety equipment and/or clothing required by Space Inflaters in accordance with their safety instructions and that I will follow the directives of Space Inflaters, its management and staff at all times.
I acknowledge that I am responsible for my own safety (and the safety of my possessions) while undertaking the Activities.
I certify that to the best of my knowledge that I am in good physical condition and I do not have any medical condition which might have the effect of making it more likely that I will be involved in an incident which could result in injury to myself or others.
I certify that I have no pre-existing medical conditions which, could through participation in the Activities, result in injury to myself or damage to my health.
I acknowledge the following contra-indications to safe jumping on medical grounds and certify that I have no pre-existing medical conditions which, could through participation in the Activities, result in injury to myself or damage to my health:
If in any doubt as to your ability to participate safely in the Activities, please seek advice from your GP.
Customers with Down’s Syndrome and neck instability prior to taking part in such activities, will be asked to obtain evidence that a GP or Pediatrician has screened them using the screening test developed by the British Gymnastics Association for Atlanto-Axial Instability. Approval for participation that is signed by the GP or Pediatrician must be provided before taking part in any activities.
Customers with Dwarfism should not perform gymnastics skills which involve repeated jumping or rebounding.
Customers with Epilepsy –
Flashing lights might be used in some jumping sessions that might affect some people with epilepsy. Customers with uncontrolled epilepsy will be asked to obtain their GP’s approval for before bouncing and other forms of sports participation taking into account the following:
• The type and severity and frequency of seizures
• The presence or absence of warning signs
• Known trigger factors (e.g. cold parks, stress, excitement, noise or dazzling lights
Bouncing should only take place when:
• Accompanied by a person aged 16 years or over, who must have knowledge of the condition and be able to recognize an attack.
Bouncing should NOT take place if:
• A person with uncontrolled epilepsy feels unwell
• During peak conditions
ON BEHALF OF THOSE UNDER 16 YEARS OLD
I am the parent/guardian of the child/ren listed who is/are under 16 years of age. If I am not the participant’s parent/legal guardian, I can confirm that I am aged 16 years or above and declare that I have the authority from their parent/legal guardian to sign this participant agreement/acknowledgement of risk and injury waiver form. I acknowledge the risk on their behalf.
In order to participate in arena activities including, but not limited to all bounce sessions, under 3’s soft play, disco, (collectively herein called “Activities”) organized by Space Inflaters, its franchisees, agents, owners, officers, directors, principals, volunteers, participants, clients, customers, invitees, employees, independent contractors, insurers, facility operators, land and/or premises owners and any and all other persons and entities acting in any capacity on its behalf (collectively Space Inflaters also known as “the Company”), I agree as follows:
I confirm that I am responsible for the child/ren in my care and undertake to ensure that he/she/they undertake the Activities in accordance with the safety rules made available prior to participation and the advice that I and he/she/they will be given in the pre-participation safety briefing to be undertaken prior to participation, together with any oral instructions or advice given to me and he/she/them prior to or during the session. I agree to ensure that the child/ren in my care will wear any safety equipment and/or clothing required by Space Inflaters in accordance with their safety instructions and that I will follow the directives of Space Inflaters, its management and staff at all times. I acknowledge that I am responsible for the safety & supervision of the child/ren listed (and the safety of our possessions) and that Space Inflaters do not provide supervision of children whilst using the premises or children attending unaccompanied or if left unaccompanied on the premises. I certify that to the best of my knowledge the child/ren is/are in good physical condition and do not have any medical condition which might have the effect of making it more likely that he/she/they be involved in an incident which could result in injury to him/her/themselves or others (if in any doubt, please check with the child/ren’s parent or guardian).
I certify that the child/ren have no pre-existing medical conditions which, could through participation in the Activities, result in injury to them or damage to their health.
I acknowledge the following contra-indications to safe jumping on medical grounds and certify that the child/ren have no pre-existing medical conditions which, could through participation in the Activities, result in injury to myself or damage to health:
• Forces and actions that could aggravate physical conditions;
• Excessive participant weight > 120kg/19 stone
(which could increase forces on the participant’s body, would/could lead to an increased risk of bone and joint damage and would be
an indicator of general lack of fitness and appropriateness of the Activity for the participant)
• Circulatory conditions
• Heart or lung conditions
• Recent surgery
• Back or neck conditions (including Rodded back and Brittle bones)
• High blood pressure
• Spine, musculoskeletal or head injury
• Down’s syndrome and neck instability
• Dwarfism
• Pregnancy
If in any doubt as to the ability to participate safely in the Activities, please seek advice from your GP.
Customers with Down’s Syndrome and neck instability prior to taking part in such activities, will be asked to obtain evidence that a GP or Pediatrician has screened them using the screening test developed by the British Gymnastics Association for Atlanto-Axial Instability. Approval for participation that is signed by the GP or Pediatrician must be provided before taking part in any bouncing activities.
Customers with Dwarfism should not perform gymnastics skills which involve repeated jumping or rebounding.
Customers with Epilepsy –
Flashing lights might be used in some jumping sessions that might affect some people with epilepsy. Customers with uncontrolled epilepsy will
be asked to obtain their GP’s approval for trampolining and other forms of sports participation taking into account the following:
• The type and severity and frequency of seizures
• The presence or absence of warning signs
• Known trigger factors (e.g. cold parks, stress, excitement, noise or dazzling lights
Trampolining should only take place when:
• Accompanied by a person aged XX years or over, who must have knowledge of the condition and be able to recognize an attack.
Bouncing should NOT take place if:
• A person with uncontrolled epilepsy feels unwell
• During peak conditions
I understand that the Activities provided are not segregated for use solely by children. I understand that the Activities are used by multiple age groups including adults at the same time as children and are not restricted to any one age group.
I acknowledge that it is my responsibility to assess the suitability of the Activities & the multiple age group use for children in my care.
I am aware that some activities are age, height and or ability restricted and I will ensure that the child/ren in my care is/are advised accordingly.
I agree that I will not attempt to use any of the activity equipment or participate in the Activities whilst accompanying the child/ren unless:
I am a registered participant;
I have signed a risk acknowledgement & waiver form as a participant in the Activities;
I am aware of and have agreed to undertake the Activities in accordance with the safety rules made available to me prior to participation and the advice given in the pre-participation safety briefing to be undertaken prior to participation, together with any oral instructions or advice given to me prior to or during the session.
YOUR ACKNOWLEDGMENT
I understand that Space Inflaters do not assess the abilities of individual participants or the suitability of the Activities for use by individual participants.
I further understand that all participants, parents and guardians must make their own assessment of whether the Activities are suitable for use by individual participants and individual participants ability to participate in the Activities prior to use.
I understand that the Activities are used by multiple age groups at the same time and are not restricted to any one age group.
I understand that the Activities are physically demanding and involve jumping and other strenuous actions sometimes involving height, speed, and unpredictable surfaces.
I understand that the Activities are a high-impact, full body activity which requires intense focus, awareness of my body’s strengths and limitations, awareness of the environment around me, and extreme caution at all times.
I understand that the Activities are dangerous and there is a risk of personal injury when undertaking such Activities and participation can result
in serious injury or death.
I//he/she/they use the Activities entirely at my/their own risk.
I understand that participation in the Activities can result in personal injury including, but not limited to, friction burns, cuts, abrasions, bruising, muscle strains, twists, sprains, dislocation, broken bones and paralysis and accept that these injuries can occur through general use of the equipment and not always or necessarily as a result of defective equipment or negligence of the Company.
I understand and accept that the Activities require a moderate level of fitness and can be physically demanding and require physical effort and I/he/she/ they should not undertake the Activities unless I/he/she/they am(is/are) physically able to.
I understand that I/he/she/they is/are responsible for my/his/her/their own actions and or involvement in using the Activities.
I understand that I/he/she/they is/are not permitted to hold/cradle babies and/or small children whilst using any of the Activities, as this may result in severe injury to both parties.
I understand that Space Inflaters do not provide direct supervision of participants when using the Activities.
I understand that Space Inflaters do not provide training or tuition to participants in the use of the Activities.
I understand that Space Inflaters do not assess any participant’s skill levels, abilities, competency or the suitability of the Activities for use by them.
I understand that use of the Activities requires at minimum, a basic athletic and jumping ability.
I/he/she/they will not attempt flips or other extreme moves unless I/he/she/they know I am/he/she/they are competent, capable and have previous experience and the appropriate training.
I/he/she/they will not attempt any manoeuvre beyond my/his/her/their own skill level.
In the unlikely event of an accident, or loss or damage to any personal effects, I acknowledge that the Company will not be liable for any direct or indirect loss, damage or injury arising from or in connection with the Activities (except for death or personal injury caused by the Company’s negligence), or with my/our failure to comply with the safety instructions and/or directions of Space Inflaters and I waive all and any claims against the Company in this respect.
By entering Space Inflaters and participating in the Activities, I hereby consent to Space Inflaters taking photographs and/or recording me in connection with Space Inflaters and using the photograph and/or recording for all purposes, including advertising and promotional purposes. I waive my right to inspect or approve the use of the photograph and/or recording and acknowledge and agree that the rights granted to this release are without compensation of any kind.
I understand that I may withdraw this consent at any time by advising Space Inflaters, contact details for whom can be found in the Privacy Policy referred to below.
I acknowledge that I have read and fully understand the above prior to my signing below and I confirm acceptance of Space Inflaters Rules, terms and conditions and Privacy Policy as outlined here.
You are personally responsible for your own well-being.
I confirm that I am not under the influence of drugs or alcohol and accept that I must not participate in any Activities if I have consumed any alcohol or drugs prior to attending.
I acknowledge that Space Inflaters did not give me medical advice relating to my (or the child/ren within my care) condition and ability to use the facilities.
I acknowledge and accept that CCTV images of all park entrants will be monitored and recorded throughout the premises for the purposes of public safety and crime prevention.
I acknowledge that I (and the child/ren in my care if applicable) have been provided with safety rules and advice of the Company in relation to the Activities and that I have read and fully understand the above and accept the terms of participation freely and voluntarily without any inducement prior to signing/submitting this form.
ACTIVITY RULES
I agree/the under 16 participant named above agrees that I/they shall not participate in any activities or use any equipment provided by Space Inflaters unless I/they have undertaken Space Inflaters safety induction procedures and processes in relation to the activities and confirm thatI/they will comply with the following rules at all times whilst on the premises:
• Participants will comply with the height, weight, age restrictions and contra indications to safe jumping policy (described above) specified by Space Inflaters.
• Participants confirm to their knowledge they are not pregnant. Pregnant women should not participate in the bounce arena Activities.
• Participants will at all times wear any prescribed and/or required protective equipment/clothing, whilst participating in the Activities.
• Participants will remove all jewellery, as well as any sharp or valuable objects (including, but not limited to, keys, mobile phones, money, etc.) from their pockets, before participating in the Activities.
• Participants will not eat or drink whilst participating in the Activities.
• Participants will at all times only carry out the Activities that are within their skill level and of which they are able to retain control at all times.
• Participants will not attempt to wrestle, play rough or fight on the inflatables
• Participants will not attempt to climb, sit on or dismantle the safety apparatuses, including but not limited to walls, netting and padding, throughout the trampoline and other Activities areas.
• Participants will only rest in the designated seating and rest areas of the arena floor.
• Participants may not hold babies/small children in their arms or in carry cots while using any of the Activities except for the café, seated areas, ablution facilities, reception and walkway areas.