Neighborhood Acrobat: Waiver, Liability Release, and Hold Harmless Agreement

Today's Date

Date

Name of Participant 1

First NameLast Name

Date of Birth

Date

Name of Participant 2 (if applicable)

First NameLast Name

Date of Birth

Date

Name of Participant 3 (if applicable)

First NameLast Name

Date of Birth

Date

Emergency Contact's Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

The undersigned acknowledges and agrees that the use of equipment provided by Neighborhood Acrobat, as well as participation in any activity with Neighborhood Acrobat, either on my own or under the instruction/supervision of Neighborhood Acrobat employees, is entirely voluntary, at the sole discretion and judgment of the undersigned, and at his/her/their own risk.

The undersigned participant acknowledges and agrees that this Waiver and Release of Liability and Hold Harmless Agreement covers, without limitation, all injuries which may occur as a result of the participant’s use of all amenities and equipment provided by Neighborhood Acrobat, as well as his/her/their participation in any activity with Neighborhood Acrobat, or as a result of unforeseen malfunctioning of any equipment.

With this knowledge and understanding, the participant states as follows:

The participant hereby waives, releases, remises, covenants not to sue and forever discharges Neighborhood Acrobat and any of its employees of any and all liability, claims, demands, actions or rights of actions, or damages of any kind, including, but not limited to those related to, arising from, or in any way connected with participation in Neighborhood Acrobat’s programs, including those allegedly resulting from or in any way related to the negligent acts of Neighborhood Acrobat and/or its employees, or the malfunction of equipment.
The participant accepts full financial responsibility for any injury to him/her/themselves or to any other participant, whether due to his/her/their own negligence or not, and agrees to hold harmless and indemnify Neighborhood Acrobat and its employees from any loss, liability, claims, damages, or costs, including court costs and attorney fees, that may be sought against Neighborhood Acrobat due to his/her/their participation.
The participant understands that this Waiver and Release of Liability and Hold Harmless Agreement shall apply to any and all services and activities with Neighborhood Acrobat from this date forward.

By signing below, you are acknowledging and agreeing, including on behalf of your child if under 18, to release and discharge Neighborhood Acrobat and its employees from any and all claims, causes of action and damages, and are agreeing voluntarily to waive any right that you may otherwise have to bring a legal action against Neighborhood Acrobat and its employees for personal injury or property damage.

NOTICE TO THE CHILD’S PARENT OR GUARDIAN:

You are agreeing to let your minor child engage in a potentially dangerous activity. You are agreeing that, even if Neighborhood Acrobat uses reasonable care in providing this activity, there is a chance your child may be seriously injured by participating in this activity because there are certain dangers inherent in the activity that cannot be avoided or eliminated. You are giving up your child’s right and your right to recover from Neighborhood Acrobat in a lawsuit for any personal injury to your child, including death. You have the right to refuse to sign this form, and Neighborhood Acrobat has the right to refuse to let your child participate if you do not sign this form.

Signature