Release and waiver of liability, assumption of risk, and indemnity agreement
- I attest that I am the parent or legal guardian of the participant(s) undersigned, or that I have obtained permission from the parent/legal guardian of the participant(s) undersigned to execute this agreement on their behalf and agree to attend to and monitor the activities of all participant(s) undersigned such that all activities are age and ability appropriate
- In consideration of participating in the Bubala Indoor Playground I represent that I understand the nature of this activity and that my child is qualified, in good health, and in proper physical condition to participate in such activity. I acknowledge that if I believe that conditions unsafe, I will immediately discontinue participation of my child in the activity and notify employees of Bubala Indoor Playground. Additionally, I agree that all undersigned and I shall use all play equipment and items appropriately, adhering to all play rules, as well as size and weight limitations; Furthermore, I understand and agree that I will be solely responsible for any and all costs to repair or replace any damage to the facility and/or the equipment therein incurred by the undersigned and myself outside of normal wear and tear. Furthermore, I understand and agree that no outside food is permitted in the facility and will ensure that any food purchased from the facility will be consumed in designated eating areas only.
- I, for myself, and the participant(s) undersigned, acknowledge and understand that there are dangers and risks associated with the activities at/by Bubala Indoor Playground and agree to assume all risk of personal injury, including the potential for paralysis and death, and I, on behalf of myself and the participant(s) undersigned, knowingly and freely assume all such risk, both known and unknown, including those that may arise out of negligence or other participants;
- I hereby release, discharge, and agree not to sue Bubala Indoor Playground, its respective administrators, directors, agents, officers, volunteers, employees, sponsors, advertisers, and if any applicable owners and lessors of the premises on which activity takes place (each considered “Releasees” herein from all liability, claims demands, losses, or damages.
- This release and waiver extends to all acts of negligence by Bubala Indoor Playground and is intended to be as broad and inclusive as permitted by the law, and if any portion of this agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
- I, for myself, and the participant(s) undersigned, consent to the publication of personal pictures, which may be taken by Bubala Indoor Playground personnel or their representatives. Publication may include but is not limited to, marketing materials and websites.
I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY AGREEMENT, FULLY UNDERSTAND ITS TERMS AS A LEGALLY BINDING CONTRACT AND UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS FOR MYSELF AND THE PARTICIPANT(S) UNDERSIGNED BY SIGNING IT, FREELY AND VOLUNTARILY WITHOUT INDUCEMENT. FURTHERMORE, I ACKNOWLEDGE & AGREE THAT I WILL SUPERVISE ALL PARTICIPANT(S) UNDERSIGNED AT ALL TIMES AND CERTIFY THAT ALL OF THE BELOW PROVIDED INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
Child’s Name (PRINTED) Birth Date Gender 1._________________________________________ ____/_____/____ ________
2. _________________________________________ ____/_____/____ ________
3. _________________________________________ ____/_____/____ ________
Adult/Guardian (PRINTED) :________________________________________
Date of Consent: ___________________
Phone #: ___________________________
City: _________________________ State: _______ Zip: _____________
Adult/Guardian Signature(s): _________________________________________