Bungee Jumping Underage Consent Form

Participant Information

Full Name of Participant (Under 18): Date of Birth: Address:

Parent/Guardian Information

Full Name of Parent/Guardian: Relationship to Participant: Contact Number: Address:

Consent & Acknowledgement

I, the undersigned, hereby give permission for the above-named underage participant to take part in bungee jumping. I confirm that I have read and understood the risks associated with bungee jumping and acknowledge that participation is voluntary. I accept full responsibility and agree to all terms and conditions provided by the operator.

Additional Information (if any):

Parent/Guardian Signature:

Date:

Participant Signature:

Date: