Inflatables

Annual Receipts

# of Units?

Are all inflatables properly anchored/secured/tied down? Yes No

Type of flooring in inflatables area:

Do inflatables have signs clearly indicating age, height, or size limitations? Yes No

Are your inflatables inspected by the state and/or your employees? Yes No

How often is the inflatable(s) checked and inspected?

Are daily maintenance records kept? Yes No

Are all inflatables manned by an operator/attendant? Yes No

How many attendants at each inflatable?

Are all attendants over the age of 18? Yes No

If no, please describe:

Describe attendants responsibilities:

Explain the emergency plan in case of unplanned deflation:

How are weight/age limitations enforced?

Are rides of similar size and ability grouped together on inflatable bounces? Yes No

With regard to inflatable rides that allow riders to participate one at a time (e.g. a slide), what is the guideline for letting the next participant go?

Will the inflatable have permanently attached warning labels and safety instructions? Yes No

Inflatable Rentals

Annual sales: $

Will inflatable(s) be set up indoors or outdoors? Indoor Outdoor

Is the inflatable(s) set up on flat ground? Yes No

Describe the plan for weather emergencies (e.g. rain and/or high winds), if outdoors:

Are there procedures to suspend use during inclement weather? Yes No

Are they rented with operators/attendants? Yes No

Do you deliver the inflatables? Yes No

Do you set up the inflatables? Yes No

Do you tear down the inflatables? Yes No

Do you use the manufacturer’s checklist for the set up and use of the equipment? Yes No

Rock Climbing Walls

Annual sales: $

Height of Wall:

Does rock wall meet all CWIG (Climbing wall Industry Group) standards and local codes? Yes No

Does your bouldering wall equal 6 ft or less: Yes No

Are participants allowed to climb on their own: Yes No

What is the check in procedure?

What kinds of verbal contacts or warnings given?

When is safety testing done:

Certification system used:

Are spotters required? Yes No

Does the rock wall include an auto belay system? Yes No

Type of equipment is used? (describe belay system)

Type of landing system? (describe)

Who is responsible for the daily maintenance of the rockwall unit?

Do you have a portable wall? Yes No

# of Attendants:

# of Walls:

Who built the wall(s)?

Does your organization have an inspection policy and/or practices in place for all critical safety equipment? Yes No

How often are the checks done?

Are records kept? Yes No

Are signs posted indicating age/size limitations and operation instructions? Yes No

Where will the rock wall be set up?

Is the rock wall set up on flat ground? Yes No

How many attendants at the rock wall?

Are all attendants over the age of 18? Yes No

Describe attendants responsibilities:

Who is the manufacturer of the rock wall?

Is the cable replacement date verified and current? Yes No

How are weight/age limitations enforced?

How many people are allowed on the rock wall at one time?

Will the rock wall have permanently attached warning labels and safety instructions? Yes No

Will your employees receive formal training on the safe operation of the rock wall? Yes No

Do climbers have to sign a waiver and release of liability prior to climbing? Yes No

Soft Play / Ball Crawl

Annual sales: $

Is there playground equipment? Yes No

Describe:

Number of employees supervising play area:

Are there signs indicating age, height, or size limitations? Yes No

What type of flooring under equipment?