VIEWS: 6 PAGES: 2 POSTED ON: 8/5/2012
The Blue Bounce House Mary Alex, Proprietor P O Box 1225 Millbrook, NY 12545 845-337-1890 Dear Parents & Guardians, I have donated the use of an inflatable obstacle course & slide for the students of Elm Drive Elementary School to enjoy on Monday, June 20, 2011. Because there are potential risks involved while playing on a Bounce House unit, I ask that you complete and return the attached hold harmless form in order for your child to participate. Please be assured that the Blue Bounce House has insurance and that we follow all suggested safety measures suggested by the manufacturer and amusement industry. Feel free to visit our website: www.BlueBounceHouse.com to see what services we provide! If you have any questions, please do not hesitate calling me at 845-337-1890. Sincerely, Mary Alex My child, ______________________________________, has permission to participate with the inflatable obstacle course and slide/or bounce house at Elm Drive Elementary School on Monday, June 20, 2011. I understand that there are potential risks to my child including, but not limited to injury, bumps, scrapes, broken bones, head, neck or spinal injuries, paralysis or death. If my child suffers from any risk as an involvement in the use of an inflatable device, I hereby hold harmless The Blue Bounce House its owners and staff, Elm Drive Elementary School and staff, and the Millbrook Central School District staff and Board of Education, from any and all claims that may arise from the use of the inflatable device. ___________________________________________ _______________ Signature of Parent or Guardian Date Teacher__________________________________ Grade______________________ Address___________________________ Town________________ Zip__________ Email_______________________________________ Phone_____________________ Cell Phone________________________ Alt. Phone #___________________________ ___ Please send me special offers throughout the year.
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