Below is a copy of the declaration which is completed online. 
Once a ticket is purchased a web link is emailed to you. 

Full Name _____________________________________________________________________________
Email Address __________________________________________________________________________
Address ____________________________________________________________POST CODE__________
Mobile Phone Number ____________________________________________________________________
Gender  Male/ Female ____________________________________________________________________
Date of Birth ___________________________________________________________________________ 

FOR PARTICIPANTS WHO ARE OVER 18 YEARS OLD
- I wish to participate in indoor trampolining activities including, but not limited to trampolining, trampoline park access, fitness classes, dodgeball, aeroball, basketball, performance trampoline and the climbing bouldering wall (collectively hereinafter called ”the Activities”) organised UA Cheshire Trampoline Park LTD (”the Company”) within 12 months of the date of completion of this form.
- I am eighteen 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 (which can be seen on our website at www.uacheshire.co.uk and ‘Unit 9 Navigation Park, Winsford Ind Estate, CW7 3RL’) 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 anti-slip grip socks whilst participating in the Activities. I confirm that if I am using my own anti-slip grip socks or pre-used anti-slip grip socks that they are in a good condition and fit for purpose and acknowledge that UA Cheshire Trampoline Park LTD cannot be held responsible for the efficiency of these socks.
- 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 condition which, could through participation in the Activities, result in injury to myself.
- I certify that to the best of my knowledge I am not pregnant.
-  I acknowledge that the maximum permitted weight for participation in the Activities is 120kg/18st 9lbs and confirm that I do not exceed this weight.  

ONLY TO BE ACKNOWLEDGED IF YOU HAVE AN UNDER 18 YEAR OLD THAT YOU ARE RESPONSIBLE FOR 
 I am the parent/guardian of the child who is under 18 years of age. I consent to allow that child to participate in indoor trampolining activities including, but not limited to trampolining, trampoline park access, fitness classes, dodgeball, aeroball, basketball, performance trampoline and the climbing bouldering wall (collectively hereinafter called ”the Activities”) organised by UA Cheshire Trampoline Park LTD (”the Company”) within 12 months of the date of completion of this form.  

- I declare that if I am not the parent or guardian of the child I have authority from the child’s parent or guardian to sign this risk acknowledgement & waiver form.
- I acknowledge the risk on their behalf.
- I confirm that I am responsible for the child in my care and undertake to ensure that he/she undertake the Activities in accordance with the safety rules made available prior to participation (which can be seen on our website at www.uacheshire.co.uk and ‘Unit 9 Navigation Park, Winsford Ind Estate, CW7 3RL’) and advice that I and he/she 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 prior to or during the session. 
- I agree to ensure the child wears anti-slip grip whilst participating in the Activities. I confirm that if the child wears their own anti-slip grip socks or pre-used anti-slip grip socks that they are in a good condition and fit for purpose and acknowledge that UA Cheshire Trampoline Park LTD cannot be held responsible for the efficiency of these socks.
- I acknowledge that I am responsible for the safety & supervision of the child named (and the safety of our possessions) and that UA Cheshire Trampoline Park LTD do not provide supervision of children whilst using the premises or if left unattended on the premises. I will ensure that I pay particular attention to any under 16 year olds and will supervise them at all times.
- I certify that to the best of my knowledge the child is in good physical condition and do not have any medical condition which might have the effect of making it more likely that he/she be involved in an incident which could result in injury to him/her or others (if in any doubt, please check with the child’s parent or guardian).
- I certify that the child has no pre-existing medical condition which, could through participation in the Activities, result in injury to them.
- 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 certify that to the best of my knowledge the child is not pregnant.
- I acknowledge that the maximum permitted weight for participation in the Activities is 120kg/18st 9lbs and confirm that the child does not exceed this weight.
- I agree that I will not attempt to use any of the activity equipment or participate in the Activities whilst accompanying the child unless: I am a registered participant; I have signed a risk acknowledgement & participant declaration 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 (which can be seen on our website at www.uacheshire.co.uk and ‘Unit 9 Navigation Park, Winsford Ind Estate, CW7 3RL’) 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.

TO BE ACKNOWLEDGED BY ALL
- I acknowledge that the Activities are dangerous and there is a risk of personal injury when undertaking such Activities and participation can result in death or serious injury.
- I acknowledge 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, 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 acknowledge 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.
- 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) and I waive all and any claims against the Company in this respect.
- I acknowledge and accept that CCTV images of all park entrants will be monitored and recorded throughout the premises for the purposes of crime prevention and public safety.
- I understand that UA Cheshire Trampoline Park LTD 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 I/he/she/they is/are responsible for my/his/her/their own actions and or involvement in using the Activities.
- I understand that UA Cheshire Trampoline Park LTD do not provide direct supervision of participants when using the Activities.
- I understand that UA Cheshire Trampoline Park LTD do not provide training or tuition to participants in the use of the Activities.
- I understand that UA Cheshire Trampoline Park LTD 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.

PRINT NAME_________________________________________________
SIGNATURE__________________________________________________
RELATIONSHIP TO CHILD/REN____________________________________
DATE_______________________________________________________