Party Waiver

I / We, the parent(s)/guardian(s) of the mentioned minors understand that Sparklicious Mount Kisco, LLC; Sparklicious Westport, LLC & Sparklicious Enterprises, LLC (“Sparklicious”) are businesses that makes their facilities, programs and activities (“Activities”) available to persons only on the condition that they agree and assume complete responsibility for any injury or damage. I acknowledge that Sparklicious Activities may involve risk, and assume those risks for my child. I/We, hereby release Sparklicious, its members, officers, principals, agents, assigns, employees, and staff from any and all liability arising from the Activities. I acknowledge that participation in any Sparklicious Activities is conditional upon compliance with all applicable rules and policies established at Sparklicious. I further acknowledge that Sparklicious sponsored Activities and participants may be photographed, filmed or videotaped from time to time, and hereby consent to use of my child’s picture and likeness for Sparklicious related promotional purposes without further consideration.

First Participant's Name

First Name*

Last Name*

Phone*

First Participant's Date of Birth*

First Participant's Signature*

Second Participant's Name

First Name*

Last Name*

Second Participant's Date of Birth*

Third Participant's Name

First Name*

Last Name*

Third Participant's Date of Birth*

Fourth Participant's Name

First Name*

Last Name*

Fourth Participant's Date of Birth*

Fifth Participant's Name

First Name*

Last Name*

Fifth Participant's Date of Birth*

Sixth Participant's Name

First Name*

Last Name*

Sixth Participant's Date of Birth*

Seventh Participant's Name

First Name*

Last Name*

Seventh Participant's Date of Birth*

Eighth Participant's Name

First Name*

Last Name*

Eighth Participant's Date of Birth*

Ninth Participant's Name

First Name*

Last Name*

Ninth Participant's Date of Birth*

Tenth Participant's Name

First Name*

Last Name*

Tenth Participant's Date of Birth*

11 Participant's Name

First Name*

Last Name*

11 Participant's Date of Birth*

Parent or Guardian's Email Address

Email*

Confirm Email*

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Birthday child's name, party date & location

Birthday Child's Name*

Party Date*

Party Location*

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.

Parent or Guardian's Name

First 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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Agree To This Document