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Consent for Participation and Release of Liability

In consideration for participation in the activity of indoor activity and playground center for young children organized by Kids Can be Kids LLC Located at 1315 Amelia Plaza, Fernandina Beach, Florida, 32034 and/or use of the property, facilities, and services of Kids Can be Kids LLC.

I, represent that I have legal authority and legal custody over and of the children listed below.

I agree for myself and for the children I have listed on this agreement, to the following:

1. Consent.

I, consent to the participation of the children list, in the activity of indoor activity and playground center for young children and agree on behalf of the children listed on this agreement to all of the terms and conditions of this agreement.

2. Assumption of the Risks and Release.

I recognize that there are certain inherent risks associated with the above-described activity and I assume full responsibility for personal injury to myself and all the children I have listed on this agreement as to having legal authority of, and further release and discharge Kid Can be Kids LLC for injury, loss, or damage arising out of my or the children listed above use of the facilities, absent any negligent act or omission by Kid Can be Kids LLC or its agents, employees, or representatives.

3. Agreement to Follow Directions.

I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by Kids Can be Kids LLC, or its agents, employees, and representatives. In the event any children do not follow any posted rules or direction of staff, we shall have the right to require any offending children to leave the premises at staff’s request. Children shall only be readmitted that day if children agree to follow staff directions.

4. Medical Authorization.

In the event of an injury to the children named in this agreement during the above-described activities, I give my permission to Kid Can be Kids LLC or to their agents, employees, or representatives, to arrange for all necessary medical treatment for which I shall be financially responsible. This temporary authority will begin on date of execution of this Consent and will remain in effect until terminated in writing by the undersigned or when the above-described activities are completed. Kid Can be Kids LLC shall have the following authorization: the power to seek appropriate medical treatment and attention on behalf of my child as may be required by the circumstances, including without limitation, that of a licensed medical physician and/or hospital.

5. Applicable Law.

Any legal or equitable claim that may arise from participation in the above shall be resolved under Florida law.

6. Dispute Resolution.

The parties will attempt to resolve any dispute arising out of or relating to this agreement through friendly negotiations among the parties. If the matter is not resolved by negotiation, the parties will resolve the dispute using the below Alternative Dispute Resolution (ADR) procedure:

Any controversies or disputes arising out of or relating to this agreement will be submitted to mediation in accordance with any statutory rules of mediation. If mediation is not successful in resolving the entire dispute or is unavailable, any outstanding issues will be submitted to final and binding arbitration under the rules of the American Arbitration Association. The arbitrator's award will be final, and judgment may be entered upon it by any court having proper jurisdiction.

7. 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 Kids Can be Kids LLC has offered to refund any fees I have paid to use its facilities if I choose not to sign this agreement.

8. Emergency Contact.

In case of an emergency, please call TBD.

By signing this Consent for Participation and Release of Liability, I give my consent for participation and agree to all the terms and conditions listed above.

Date: April 2, 2025

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
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.
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
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*

Relationship*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's 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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