Step one. Remove the cap.

Fair enough, it came right off. Inside was a valve and a pressure indicator which sort of looked like the diagram in chapter B6 of your manual, but not really.
Step two. Not sure.

The print was blurred. I couldn't find an associated illustration. I'm assuming B7 has something to do with connecting the balloon spout to the helium spigot. I admit to stumbling blindly through the darkness of this passage.
Step three. Inflate?

I guess. Thanks for entrusting me with the most undecorated, boring balloon possible. I was led to believe killing myself might be more dope, fly, phresh, radical, etc. And nowhere was it specified how much gas would be enough, nor how much might be too much.
Step four. Stringsmanship.

Here's where I think the "ribbon" (actually an oversized clown shoelace) comes into play. There were numerous diagrams of knots, slipknots, nooses. Clearly my neck was to be involved, but how?
There's no other way to say it: The string / loop / thing is poorly designed. You provide way too much string. Halfway through the looping process I had to start over.
In an attempt to unloop my way back to step 4, I accidentally re-looped the first loop and these TWO loops were looped together. The result? I myself was looped.
It was a miserable experience. I tried a number of times to step out and away from these loops, back on the right track. In so doing, I almost knocked the helium cylinder over and the balloon was very nearly released!