Indoor Playground
4217 Gate City Blvd, Greensboro, NC 27407
Call Us
336.855.0056

test 3

Bumper Jumpers Wavier - Jason Gurley


bjs

3900-H W. Market St, Greensboro, NC 27407
Phone # 336-315-5115




Please fill in your name (Parents or Legal Guardian) (required) :
Jason Gurley

Please fill in your email (required) :
[email protected]

Please fill in your phone number (Emergency Contact) (required) :
8289893970

Child Name 1 (required) :
Nevaeh

Child Name 2 :

Child Name 3 :

Child Name 4 :

In consideration of being allowed to enter into the play area and/or participate in any party/program or any other event at Bumper Jumpers Indoor Playground, the undersigned, on his or her own behalf and/or on behalf of the participant(s) identified Below, acknowledges, appreciates and agrees to Bumper Jumpers Terms and Conditions

Bumper Jumpers Terms and Conditions

I want to receive promotional emails.

Your signature (required) :

Leave this empty:

Signed by Jason Gurley
Signed on: July 25, 2016

:: Bumper Jumpers :: http://www.bumperjumpers.com
Signature Certificate
Document name: Bumper Jumpers Wavier - Jason Gurley
Unique Document ID: 4d0ebe0b12d6bdc8ecf91107ee420a8409e726e6
Jason Gurley
Party ID: c072c4cc-9092-4ab3-9876-4999b6254f2a
IP Address: 71.85.129.221
Digital Signature:
Jason Gurley
Multi-Factor
Digital Fingerprint Checksum
8c297ede4ef3f64475904ffd01a96339
Timestamp Audit
2016-07-12 23:35:17 EDTBumper Jumpers Wavier Uploaded by Bumper Staff - [email protected] IP 71.85.129.221
2016-07-25 00:00:43 EDTDocument signed by Jason Gurley - [email protected] IP 71.85.129.221
2016-07-25 00:00:43 EDTThe document has been signed by all parties and is now closed.
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