Pole in the Park 
Waiver Form

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I understand that I am fully responsible for myself and my physical wellbeing while using any and all equipment provided by Pole Des Moines, LLC and other equipment donated for use under Pole Des Moines, LLC.

I understand and acknowledge Pole Des Moines, LLC will not be held liable for any injuries that may occur while using any equipment provided by or to Pole Des Moines, LLC.

I am 18 years or older.

I understand that everyone with good intentions is welcome to participate, but may be asked to leave for any reason.

I acknowledge that I have read the rules posted by Pole Des Moines, LLC. I understand that any damages sustained to equipment due to improper use may result in paying for said damages. I understand that all rules must be followed, and that I may be asked to leave if I do not adhere to them.