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NIXI CITY PARTICIPANT WAIVER, RELEASE OF LIABILITY, INDEMNITY, PARENTAL CONSENT AND ASSUMPTION OF RISK AGREEMENT

READ CAREFULLY. THIS PARTICIPANT WAIVER, RELEASE OF LIABILITY, INDEMNITY, PARENTAL CONSENT AND ASSUMPTION OF RISK AGREEMENT INCLUDES A RELEASE OF LIABILITY AND WAIVER OF LEGAL RIGHTS. DO NOT EXECUTE THIS AGREEMENT UNLESS YOU HAVE CAREFULLY READ IT IN ITS ENTIRETY AND UNDERSTAND THE CONTENTS HEREIN.

You must be at least 18 years of age in order to sign a waiver. If you are NOT 18 years old, please have your parent or guardian sign this form on your behalf. By signing this document below (either in person or electronically), you will waive certain legal rights, including the right to sue.

THIS PARTICIPANT WAIVER, RELEASE OF LIABILITY, INDEMNITY, PARENTAL CONSENT AND ASSUMPTION OF RISK AGREEMENT (hereinafter the “Agreement”) is made and entered into as of the date of execution of this Agreement by and between Nixi City LLC, d/b/a Nixi City and/or Nixi City Play Cafe located at 1437 Northwest Richmond Beach Road, #E Shoreline, WA 98177 (hereinafter “Nixi City”) and the participant, who is executing this Agreement personally, and on behalf of himself or herself and any and all minor children specified herein below (collectively hereinafter “the Participants”).

In consideration of Nixi City allowing you and/or the Child/minor and/or the Child's Parents, Guardians and/or Caretakers to use their play facilities (hereinafter referred to as the “Premises”) for the play activities (“Activity”) for the duration of the term you are on the Premises, I hereby for myself, the Child as well as our heirs, executors, administrators, assigns or anyone else who might claim on their behalf warrant and expressly agree to the following:

1. ACKNOWLEDGEMENT OF RULES AND POLICIES. The Participants represent that they each read, understand, and expressly agree to follow all rules and policies of Nixi City. Nixi City and its employees have the right to terminate my use of the Nixi City facilities if I violate said rules and regulations.

Rules & Policies

  • Shoes are not permitted in the play area and must be removed and stored in the storage cubbies outside the play area. We are a shoe-less facility for the health and safety of all guests.
  • Socks must always be worn by all participants in the play area.
  • Food and drinks are not permitted in the play area.
  • Parents are required to supervise their children at all times. I UNDERSTAND AND AGREE THAT NIXI CITY DOES NOT PROVIDE SUPERVISION, CHILDCARE, OR MONITORING SERVICES. PARENTS AND GUARDIANS RETAIN SOLE RESPONSIBILITY FOR THE SUPERVISION, CONTROL, AND SAFETY OF THEIR CHILDREN AT ALL TIMES. Never leave your child unattended.
  • Nixi City is not responsible for any lost, broken or stolen items. We have the right to donate items that have been left unclaimed for over 30 days.
  • For the health and safety of all the children, visitors and staff, if anyone has visible signs of illness (coughing, runny nose, fever etc.) they will be asked to return when they are no longer symptomatic. If you visit our facility and we notice visible signs of illness, we reserve the right to ask you to return on a different day.
  • Climbing up slides is not permitted. Throwing toys and objects in the play area is not permitted.
  • Report any safety concerns or damaged toys or structure to the staff.
  • Nixi City may update rules, pricing, and policies at any time
  • Failure to follow rules may result in removal without refund.

Sickness Policy

  • For the health and safety of all children, visitors, and staff we ask that only "well" children and adults enter our facility. If you or your child has a fever, a sore throat, runny nose, is coughing or sneezing or exhibiting any other typical cold, flu, or COVID-like symptoms, please keep your child at home.
  • If you visit our facility and we notice visible signs of illness, we reserve the right to ask you to return on a different day.
  • In consideration of being allowed to participate in any or all of the services and activities within the Nixi City, the undersigned acknowledges, appreciates, and agrees that participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, participant for myself, and/or on behalf of my spouse, and minor child(ren)/ward(s) KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, agree to comply with the stated and customary terms and conditions for participation with respect to protection against infectious diseases.
  • If I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of a Nixi City employee.

2. PHYSICAL CONDITION. I ACKNOWLEDGE, agree, and represent that the Participants understand the nature of Nixi City Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activities. I further agree and warrant that if at any time I believe conditions to be unsafe or I do not feel well, I will immediately discontinue further participation in the Activity.

3. CONSENT. I, AS PARENT OR LEGAL GUARDIAN OR OTHERWISE LEGALLY RESPONSIBLE FOR THE MINOR CHILD(REN) IDENTIFIED BELOW, KNOWINGLY AND VOLUNTARILY CONSENT TO THE CHILD’S PARTICIPATION AND EXECUTE THIS AGREEMENT ON THE CHILD’S BEHALF, INTENDING TO BIND MYSELF AND THE CHILD TO THE FULLEST EXTENT PERMITTED BY WASHINGTON LAW. By signing this Agreement, I represent that I have legal authority over and custody of the child or am otherwise responsible. I further agree that all the terms of this Agreement shall apply to myself and/or the child(ren) regardless if the Agreement states “I” “Me” or “My”.

4. ASSUMPTION OF THE RISKS AND RELEASE. I FULLY UNDERSTAND AND EXPRESSLY ACKNOWLEDGE THAT PARTICIPATION IN NIXI CITY ACTIVITIES INVOLVES INHERENT AND NON-INHERENT RISKS, INCLUDING RISKS ARISING FROM THE ORDINARY NEGLIGENCE OF THE RELEASEES AND THAT: (a) Nixi City ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“RISKS”); (b) these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the activity, the condition in which the activity takes place, or THE NEGLIGENCE OF THE “RELEASEES” NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I KNOWINGLY, VOLUNTARILY, AND EXPRESSLY ASSUME ALL SUCH RISKS, WHETHER ARISING FROM INHERENT RISKS, OPEN AND OBVIOUS CONDITIONS, OR THE ORDINARY NEGLIGENCE OF THE RELEASEES, AND ACCEPT FULL RESPONSIBILITY FOR ALL RESULTING LOSSES, COSTS, AND DAMAGES as a result of my participation in the Activity. 

5. COVENANT NOT TO SUE. I HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE Nixi City, their respective owners, administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owner and lessors of premises on which the Activity takes place, (each considered one of the “RELEASEES” herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE ORDINARY NEGLIGENCE OF THE RELEASEES, whether developed or undeveloped, known or unknown, past, present or future, arising out of the Participants’ utilization of the attractions and participation in activities at the premises, including travel to and therefrom. This excludes GROSS NEGLIGENCE OR INTENTIONAL MISCONDUCT, TO THE FULLEST EXTENT PERMITTED BY WASHINGTON LAW.

6. INDEMNIFICATION. I agree to indemnify and defend Nixi City against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my, my family's, or my guests use of or presence upon the facilities of Nixi City. 

7. FEES. I agree to pay for all damages to the facilities of Nixi City caused by any negligent, reckless, or willful actions by me, my family, or guests of mine (the Participants). 

8. APPLICABLE LAW. THE PARTIES AGREE THAT EXCLUSIVE VENUE AND JURISDICTION FOR ANY CLAIM ARISING OUT OF OR RELATED TO THIS AGREEMENT SHALL LIE IN THE STATE COURTS LOCATED IN KING COUNTY, WASHINGTON, UNLESS SUBJECT TO THE ARBITRATION PROVISION HEREIN.

9. NO DURESS. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this Agreement if I so desire. I further agree and acknowledge that Nixi City has offered to refund any fees I have paid to use its facilities if l choose not to sign this Agreement. 

10. ARM'S LENGTH AGREEMENT. This Agreement and each of its terms are the product of an arm's length negotiation between the Parties. In the event any ambiguity is found to exist in the interpretation of this Agreement, or any of its provisions, the Parties, each of them, explicitly reject the application of any legal or equitable rule of interpretation, which would lead to a construction either "for" or "against" a particular party based upon their status as the drafter of a specific term, language, or provision giving rise to such ambiguity. 

11. ENFORCEABILITY. IF ANY PROVISION OF THIS AGREEMENT IS FOUND INVALID OR UNENFORCEABLE, SUCH PROVISION SHALL BE MODIFIED, REFORMED, OR SEVERED ONLY TO THE EXTENT NECESSARY TO RENDER IT ENFORCEABLE UNDER WASHINGTON LAW, AND ALL REMAINING PROVISIONS SHALL CONTINUE IN FULL FORCE AND EFFECT.

12. DISPUTE RESOLUTION. Any and all claims arising from or related to Participants utilization of the attractions and participation in activities at the premises, including travel to and therefrom, shall be subject to mediation as a condition precedent to binding dispute resolution. A request for mediation shall be made in writing, delivered to the other party to this Agreement. Mediation shall proceed in advance of binding dispute resolution proceedings, which, if necessary, shall be stayed pending mediation. The parties shall share the mediator’s fee and any related fees equally. The mediation shall be held in the jurisdiction where Nixi City is situated, unless as otherwise mutually agreed upon by the parties to this Agreement. Agreements reached in mediation shall be enforceable as settlement agreements in any court having proper jurisdiction. Any and all claims subject to, but not resolved by mediation shall be subject to arbitration which, unless the parties mutually agree otherwise, shall be administered by the American Arbitration Association in accordance with its applicable rules. A demand for arbitration shall be made in writing, delivered to the other party to this Agreement, and filed with the person or entity administering the arbitration. The party filing a notice of demand for arbitration must assert in the demand all claims then known to that party on which arbitration is permitted to be demanded. A demand for arbitration shall be made no earlier than concurrently with the filing of a request for mediation, but in no event shall it be made after the date when the institution of legal or equitable proceedings based on claims arising from or related to Participants utilization of the attractions and participation in activities at Nixi City, including travel to and therefrom, would be barred by the applicable statute of limitations. For statute of limitations purposes, receipt of a written demand for arbitration by the person or entity administering the arbitration shall constitute the institution of legal or equitable proceedings based on said claims. The award rendered by the arbitrator or arbitrators shall be final, and judgment may be entered upon it in accordance with applicable law in any court having proper jurisdiction. This agreement to arbitrate is duly consented to by the parties to this Agreement and shall be specifically enforced under applicable law in any court having proper jurisdiction. The parties hereby waive their right to seek relief in a court of law or to have claims decided by a jury or a judge, or to maintain other available court action or administrative proceedings. IF THIS ARBITRATION PROVISION IS FOUND UNENFORCEABLE IN WHOLE OR IN PART, THE PARTIES AGREE THAT ANY SUCH CLAIM SHALL BE RESOLVED EXCLUSIVELY IN THE STATE COURTS OF KING COUNTY, WASHINGTON, AND THE REMAINING PROVISIONS SHALL REMAIN IN FULL FORCE AND EFFECT.

13. PHOTO AND VIDEO RELEASE. I grant to Nixi City AND ITS SUCCESSORS AND ASSIGNS, THE IRREVOCABLE, PERPETUAL, ROYALTY FREE, WORLDWIDE, SUBLICENSABLE AND UNRESTRICTED RIGHT TO USE AND PUBLISH MY NAME, VOICE, LIKENESS, IMAGE, VIDEO, ANY PHOTOGRAPHS OF ME, OR ANY MATERIALS IN WHICH I MAY BE INCLUDED, FOR EDITORIAL, TRADE, ADVERTISING, AND ANY OTHER PURPOSE AND IN ANY MANNER AND MEDIUM; and to alter and composite the same WITHOUT RESTRICTION AND WITHOUT MY INSPECTION OR APPROVAL. I hereby release Nixi City from all claims and liability relating to any of the foregoing, including but not limited to any claims based on rights of privacy or publicity. 

14. SECURITY CAMERAUSAGE. I understand that security cameras installed around and within Nixi City are for the safety of all participants and may be referenced if needed.    

15. PANDEMIC. COVID-19 has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. Nixi City has put in place preventative measures to reduce the spread of COVID-19; however, Nixi City cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending Nixi City could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending Nixi City and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Nixi City may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Nixi City employees and other customers and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with me or my child(ren)’s attendance at Nixi City. On my own behalf, I hereby release, covenant not to sue, discharge, and hold harmless Nixi City, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Nixi City, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after I/We patronize Nixi City. With respect to my minor child(ren), I acknowledge and agree to their assumption of the inherent risks of exposure to infectious disease to the fullest extent permitted by Washington law, but do not waive any independent claims belonging to the child

16. SUBSEQUENT VISITS. The parties agree that this Agreement shall apply with equal force and effect to all of the Participants present, and future visits to and use of Nixi City facility and play area. This agreement remains in effect unless revoked in writing via email or other written notice delivered to Nixi City.

I HAVE CAREFULLY READ THIS NIXI CITY PARTICIPANT WAIVER, RELEASE OF LIABILITY, INDEMNITY, PARENTAL CONSENT AND ASSUMPTION OF RISK AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I FULLY UNDERSTAND THAT BY SIGNING BELOW, I AM GIVING UP SUBSTANTIAL RIGHTS AND DO SO VOLUNTARILY. I AM AWARE THAT THIS IS A BINDING CONTRACT AND AM SIGNING IT WITHOUT INDUCEMENT, ASSURANCE OR GUARANTEE, AND ENTIRELY OF MY OWN FREE WILL AND ACCORD.

I, THE MINOR’S PARENT AND/OR LEGAL GUARDIAN OR OTHERWISE RESPONSIBLE, UNDERSTAND THE NATURE OF NIXI CITY’S ACTIVITIES and understand and agree that the above Agreement shall apply to I/we and any Child (minor) named below and have discussed any applicable terms of the Agreement with the Child(ren).

THE UNDERSIGNED EXPRESSLY INTENDS THIS AGREEMENT TO RELEASE NIXI CITY FROM LIABILITY FOR ITS OWN ORDINARY NEGLIGENCE TO THE MAXIMUM EXTENT PERMITTED UNDER WASHINGTON LAW.

First Participant's Name
First Name*
Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
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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*
Last Name*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
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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