Sky High Waiver Kids Play Waiver (1) Name(Required) First Last Additional Names First Phone(Required)Email(Required) Waiver By signing this form I will not hold Chillax Recovery LLC, Sky High Fun Rentals, employees, managers, or all other people associated with these businesses responsible for any injury or damage to personal property. I take full responsibility for all situations I am involved with at 2488 W 500 N Vernal UT 84078. When signing this document I am also taking responsibility for all individuals that I have brought onto the property. They also will agree to the same terms of this waiver when signed by myself. Waiver I affirm that I have stated all of my known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the practitioner's part should I fail to do so. I also understand that any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session,, and I will be liable for payment of the scheduled appointment. Understanding all of this, I give my consent to receive care.I have read and agreed to the above staments.(Required) I agree Permission to use photograph/video (optional) I have read to and agree to the followingI grant to Chillax LLC, its representatives and employees the right to take or use photographs/video of me and my property in connection with the above-identified subject. I authorize Chillax!, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Chillax May use such photographs of me with or without my name and for any lawful purpose, including for example such purpose as publicity, illustration, advertising, and web content.Signature(Required)By checking this box you are approving this to be used as your electronic signature. Signature of Parent or Guardian for clients under the age of 18. I agree that if I check this box it will be used as my signature. Date(Required)
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