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Little Sprouts Play Land, LLC 

LIABILITY WAIVER AND HOLD HARMLESS AGREEMENT

I, as parent or legal guardian of the child whose name is set forth below (each referred to as a “Participant” and collectively referred to herein as the “Participants”) and in consideration of the Participants being permitted to participate in the Activities (as defined below) conducted by Little Sprouts Play Land, located at 12013 FM2305, Belton Texas 76513(“Little Sprouts Play Land”) I agree as follows:

  1. Activities – Activities shall be defined as the various activities offered to Participants by Little Sprouts Play Land, an indoor playground.
  2. Assumption of Risk – I understand that the Activities entail the risk of severe bodily injury to the Participants. Injuries that could result may vary, but may include (a) minor injuries such as scratches, bruises and sprains; (b) major injuries such as eye injury or loss of sight, joint or back injuries and concussions; and catastrophic injuries, including paralysis and even death. I understand that, Little Sprouts Play Land LLC cannot eliminate all risks or guarantee the safety of the Participants while Participants participate in the Activities. I have made my own investigation of these risks, understand these risks, and assume them knowingly and willingly on behalf of myself and my minor Participant child. Notwithstanding these risks and other hazards that may be foreseeable but not specifically identified herein, I, for myself and any minor Participant child, and our respective heirs, personal representatives and assigns, understand, acknowledge, and expressly and voluntarily assume all risks and full responsibility for any injury arising out of or related to the Activities.
  3. Release, Discharge and Agreement Not To Sue – I, for myself and any minor Participant child and our respective heirs, personal representatives and assigns, do hereby release, discharge and agree not to sue Little Sprouts Play Land or its managers, members, employees and/or other agents, for any injury to or death of any Participant arising, directly or indirectly, from participation in the Activities. This release, discharge and covenant not to sue shall relate to any and all claims or legal rights now existing or arising in the future, including claims and legal rights arising out of any negligence of Little Sprouts Play Land and/or its managers, members, employees and/or other agents and any other breach of a legal duty arising out of common law, statute, contract or otherwise.
  4. Indemnification And Hold Harmless – I agree to indemnify Little Sprouts Play Land and hold Little Sprouts Play Land harmless from, without limitation, any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees and costs, incurred due to claims brought by any party as a result of or arising out of my or my minor Participant child’s involvement in the Activities and agree to reimburse Little Sprouts Play Land for any such costs, expenses and fees as they are incurred.
  5. Parent Or Legal Guardian Certification And Consent – I hereby certify that I am the parent or legal guardian of the minor Participant children whose name(s) appear below, and I have authority to waive rights on behalf of the minor Participant(s). I have read and I understand all of the provisions of this document and the risks of the Activities. I understand that the Activities could cause injury and even death. I acknowledge that I have read and understand the terms of this document and I am freely and voluntarily signing this document.
  6. I hereby grant the Little Sprouts Play Land permission to use myself or my children in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.
First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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