CAMP WATER TRAMPOLINE QUESTIONNAIRE

Number of water trampolines: ________
Please describe your water trampoline and any attachments for it:_____________________
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Are users required to sign waiver/assumption of risk forms? 􀂉Yes 􀂉No
Is the water trampoline maintained at all times (when in use) in at least 6’ of water? 􀂉Yes 􀂉No
Is the water trampoline supervised at a ratio of at least 1 lifeguard to 4 patrons? 􀂉Yes 􀂉No
Are all lifeguards trained in the operation/rules of water trampoline usage? 􀂉Yes 􀂉No
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How will the patrons get to the water trampoline? _________________________________
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What is the maximum number allowed on the water trampoline at one time?________
Will diving off the water trampoline be permitted? 􀂉Yes 􀂉No
Are life jackets required by all users of the water trampoline? 􀂉Yes 􀂉No
Is the unit permanently anchored in the lake? 􀂉Yes 􀂉No
If yes, how is the unit anchored? _______________________________________________
Will pulling of the water trampoline by a motorboat be allowed? 􀂉Yes 􀂉No
Will the water trampoline ever be used on land? 􀂉Yes 􀂉No
Are rules posted for all users of the water trampoline? 􀂉Yes 􀂉No
If yes, where are the rules posted? _______________________________________________
How is the unit protected from unauthorized use? _________________________________
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Is the unit checked daily for seaworthiness? 􀂉Yes 􀂉No
Are logs kept? 􀂉Yes 􀂉No

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Signature Date