BOUNCEVILLE MELBOURNE LLC

PARTICIPATION WAIVER, RELEASE OF LIABILITY, ASSUMPTION OF RISK & INDEMNIFICATION AGREEMENT

1988 N Wickham Road, Melbourne, Florida 32935 | 321-241-4912

PLEASE READ CAREFULLY BEFORE SIGNING. This agreement affects legal rights. In consideration of being permitted to enter and/or participate in activities at Bounceville Melbourne LLC ("Bounceville"), I, for myself and, when applicable, as the parent or legal guardian of the minor participant(s) identified below, acknowledge and agree to the following:

  1. ACKNOWLEDGMENT AND ASSUMPTION OF RISK Participation at Bounceville may include use of inflatable bounce houses, slides, obstacle courses, toddler play areas, games, and other recreational equipment and activities. These activities involve inherent and other risks, including falls, collisions, awkward landings, loss of balance, equipment movement or malfunction, cuts, bruises, sprains, strains, fractures, head or neck injury, and other serious injury. Injuries may occur even when rules are followed and reasonable care is used. I knowingly and voluntarily assume these risks to the fullest extent permitted by Florida law.
  2. RULES, SAFETY INSTRUCTIONS AND SUPERVISION I and all minor participants for whom I sign will follow posted rules, staff instructions, age/height restrictions, equipment-specific limits, and safety requirements. Bounceville may stop or deny participation when conduct is unsafe or rules are not followed. A parent/guardian or responsible adult remains responsible for appropriate supervision.
  3. HEALTH AND FITNESS TO PARTICIPATE I represent that each participant for whom I sign is physically able to participate safely and has no condition known to me that would make participation unreasonably dangerous. I will not allow participation while impaired by alcohol, drugs, medication, illness, or any condition that makes participation unsafe.
  4. RELEASE AND WAIVER OF LIABILITY TO THE FULLEST EXTENT PERMITTED BY FLORIDA LAW, I RELEASE AND HOLD HARMLESS BOUNCEVILLE MELBOURNE LLC, its owners, members, managers, employees, agents, representatives, landlords, affiliates, insurers, equipment manufacturers and suppliers, and their successors and assigns ("Released Parties"), from claims for bodily injury, death, or property damage arising from participation in or presence at Bounceville, INCLUDING CLAIMS ARISING FROM THE ORDINARY NEGLIGENCE OF A RELEASED PARTY, except to the extent a claim cannot lawfully be waived or released.
  5. INDEMNIFICATION To the fullest extent permitted by law, I agree to indemnify and hold the Released Parties harmless from claims, liabilities, damages, or expenses arising from my conduct or the conduct of a minor participant for whom I sign, including violation of safety rules or damage caused to persons or property, except to the extent prohibited by law.
  6. PERSONAL PROPERTY Bounceville is not responsible for lost, stolen, or damaged personal property except to the extent liability cannot lawfully be excluded.
  7. EMERGENCY CARE If emergency care is reasonably necessary and I am unavailable or unable to consent, I authorize Bounceville staff to contact emergency medical services and permit appropriate emergency evaluation or treatment for a minor participant for whom I am authorized to consent. I am responsible for costs of care to the extent permitted by law.
  8. PHOTO / VIDEO Security cameras may operate in common areas for safety, security, and incident review. This waiver does not grant permission to use a participant's image for advertising or promotional purposes; any such permission may be obtained separately.
  9. FLORIDA LAW; SEVERABILITY This agreement will be interpreted under Florida law. If any provision is found unenforceable, the remaining provisions will remain effective to the fullest extent permitted by law. Nothing herein is intended to waive a right or claim that cannot legally be waived.
  10. ACKNOWLEDGMENT I certify that I have read this entire agreement, understand its terms, have had the opportunity to ask questions, and sign voluntarily.

AGE & AUTHORITY TO SIGN: I certify that I am 18 YEARS OF AGE OR OLDER and that I am the parent or legal guardian of the child(ren) listed below, or I otherwise have legal authority and permission to sign this waiver on their behalf.


PARENT / GUARDIAN & PARTICIPANT INFORMATION

First Namerequired
Last Namerequired
Emailrequired
Phone (Digits Only)required

Addressrequired
Cityrequired
Staterequired
Ziprequired

Child 1 Nametextrequireddb save
Date of Birthtextrequireddb save
Child 2 Nametextoptionaldb save
Date of Birthtextoptionaldb save
Child 3 Nametextoptionaldb save
Date of Birthtextoptionaldb save
Child 4 Nametextoptionaldb save
Date of Birthtextoptionaldb save

Relationship to Minor(s)textoptionaldb save

Emergency Contact Nametextrequireddb save
Contact Relationshiptextoptionalnot save
Contact Phonenumberrequireddb save

Date: 23.09.2026

Time: 10:02 PM

Signature of Adult / Parent / Legal Guardianrequired
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Submission Sequence: 2026-10-05T20:29:29.322Z1
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