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To be completed by Staff 

Atomic Bounce 216 Front St York, Pa 17404 717-600-9344


Is the set up area clear of debris and level?
Is the Item properly anchored with tie-downs in good condition ?
Is the blower securely attached?
Is the blow tube straight and the guard/screen on the blower in good condition?
Is the netting and inflatable free of cuts or tears?
Is the correct size extension cord being used for the inflatable?
Are there mats for entrances and exits?
Do you have a barrier around the blower?
Did you clean the inside and outside of the unit?
Is there a trained operator present?
Has the operator been retrained for the event and Rules discussed?
Any Maintenance to log ?

I agree and understand that all electronic signatures are the legal equivalent of my manual/handwritten signature.

The form has been submitted. 

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