Loading...

ACKNOWLEDGMENT AND ASSUMPTION OF RISKS, WAIVER, AND RELEASE OF LIABILITY, MEDICAL CONSENT AND INDEMNITY AGREEMENT

In exchange for participation in the activity of indoor play organized by The Ball Factory, LLC, I agree for myself and (if applicable) for the members of my family, to the following conditions:

1. I represent that I am the parent or legal guardian of the participant(s) named below, or I have obtained permission from the parent/legal guardian of the participant(s) named below to execute this agreement on their behalf. I further represent that the participants are healthy and physically able to participate in any and all undertaken activities.

2. I agree that the participant(s) named below and I shall comply with all stated and customary terms, posted safety signs, rules, and verbal instructions as conditions for play and participation in any party and/or program at The Ball Factory, LLC. I agree to pay for all damages to the facilities of The Ball Factory, LLC caused by me or my family's negligent, reckless, or willful actions. In addition, if I observe any hazard during our participation, I will bring it to the attention of the nearest The Ball Factory, LLC employee or official immediately.

3. I hereby expressly authorize The Ball Factory, LLC to use this waiver as multi-use-waiver until such time as I revoke it in writing with notice to The Ball Factory, LLC.

4. I acknowledge that there are known and unknown risks associated with the Childs participation in the Activities, including slips and falls; impact with toys or equipment on the Premises or with other children; the negligence or carelessness of others including failure to follow the Rules; and negligence on the part of the Rules including failure to take reasonable steps to safeguard the Child from the risks of participating in the Activities and failure to take reasonable steps to operate or maintain the Premises. I accept and fully assume, without limitation, all such risks associated with the Childs participation in the Activities and the possibility of personal injury, death, property damage or loss resulting therefrom.

5. I understand that the Ball Factory may refuse the Childs participation in the Activities for any reason, including, but without limiting the generality of the foregoing:

a. failure by me or the Child to follow Ball Factory's rules, in the sole discretion of the Ball Factory;
b. my failure to remain on the Premises during the Childs participation in the Activities;
c. my failure to adequately supervise the Child or to ensure that the Child is adequately prepared for safe participation in the Activities, in the sole discretion of the Ball Factory; and
d. the Childs suffering from an illness or ailment of any kind that may impair his or her continued participation in the Activities or that may be contagious or potentially harmful to others on the Premises, in the sole discretion of the Ball Factory

6. I acknowledge that any and all personal property left on the Premises is left at my own risk and that the Ball Factory is not liable for lost, damaged or forgotten items.

7. I hereby irrevocably waive, release and fully discharge the Ball Factory from and against any and all liability for loss, damage, personal injury, including death and disability, and costs of any kind and nature whatsoever which I or the Child may suffer now or in the future by reason of or existing out of any causes whatsoever related to or arising out of or from the participation of the Child in the Activities or presence of the Child on the Premises, including negligence, breach of contract, and breach of any statutory duty or other duty of care on the part of the Ball Factory. I accept that this release covers and includes, but is not limited to, all unknown and unforeseen claims, injuries, damages and losses, and any consequences thereof, including aggravation of injuries caused by negligent rescue operations or procedures.

8. The undersigned on his or her behalf and on behalf of any executors, heirs, successors and assigns, hereby releases, discharges, and holds harmless any authorized entity doing business as Ball Factory, including its officers, agents, employees, representatives, and all affiliates, from any and all claims, damages, or liability arising from death, disability, personal injury, property damage, or theft, or any kind of action

9. I do approve the use of any photographs or films taken by The Ball Factory in which I or the Minor is part of and for the use thereof by Ball Factory, LLC in its marketing and promotional materials.

10. I acknowledge that this agreement, along with the rules of the Ball Factory as posted on the Premises, creates and constitutes my continuing obligations respecting the Childs participation in the Activities at any time.

11. Each provision of this agreement is severable. If any provision is found to be unenforceable, such unenforceability shall not affect the validity of the remainder of this agreement.

12. I acknowledge that the Ball Factory, LLC. is not responsible for the provision of child care services for the Child.

Accordingly, I agree that I will remain on the Premises at all times during the Childs participation in the Activities, and I assume sole responsibility for supervision of the Child and for understanding and following Ball Factory's rules associated with the Childs safe participation in the Activities.


I HAVE READ THIS AGREEMENT THOROUGHLY. I UNDERSTAND THAT, BY SIGNING THIS AGREEMENT, I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I, MY CHILD, AND OUR HEIRS, ASSIGNS, EXECUTORS, ADMINISTRATORS, PERSONAL REPRESENTATIVES, AND NEXT OF KIN MAY HAVE AGAINST THE RELEASEES, INCLUDING THE RIGHT TO SUE. I HAVE BEEN AFFORDED THE OPPORTUNITY TO REFUSE THE CHILDS PARTICIPATION IN THE ACTIVITIES BUT I HAVE FREELY AND VOLUNTARILY ELECTED TO SIGN THIS AGREEMENT.

I UNDERSTAND THAT THE RELEASEES ARE RELYING ON THIS FULL RELEASE AND WAIVER OF ALL CLAIMS WHEN ACCEPTING THE CHILDS PARTICIPATION IN THE ACTIVITIES.

I Agree

November 22, 2019

First Participant's Name

First Name*

Last Name*
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*

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*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
ADDT'L INFO

PARENT/GUARDIAN PHONE NUMBER *

ZIP CODE *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they also 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*

Relationship*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver