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PARTICIPATION AGREEMENT RELEASE AND ACKNOWLEDGMENT OF RISK

In consideration of the services of IMAGINE PLAY LLC, its agents, owners, officers, employees, and all other persons or entities acting in the capacity on its behalf (hereinafter referred to as 'IMAGINE PLAY'), I hereby agree to release and discharge IMAGINE PLAY, on behalf of myself, my heirs, assigns, personal representative and estate as follows:

1.  I understand and acknowledge this Release and Acknowledgement applies on the date above and will remain in effect for all future visits until I revoke this agreement in writing to IMAGINE PLAY at 10481 Grant Line Rd. #155, Elk Grove, CA 95624.

2. The persons listed above are about to engage in an activity which bears known risks and unanticipated risks that could cause injury, or illness, up to and including death.  I expressly agree and promise to accept and assume all the risks for myself and my child(ren) of all activities involved in my child(ren) play at IMAGINE PLAY.

3. I hereby voluntarily release, forever discharge, and agree to hold harmless and indemnify IMAGINE PLAY from any and all liability, claims, demands, actions or right of action, which are related to, arise out of, or are in any way connected with my or my child(ren)s participation in any activities, climbing, jumping, sliding.  I understand all participation is voluntary and no one is forcing me or my child(ren) to participate.  I am electing for myself and my child(ren) to participate in spite of any and all risks involved.

4. I am signing this document electronically and I acknowledge that if anyone is hurt or property is damaged during my participation in this activity.  I understand I will have no right to make a claim or file a lawsuit against IMAGINE PLAY, IT'S AGENTS, OWNERS, OFFICERS, EMPLOYEES, OR ANY OTHER PESON OR ENTITY ACTING IN ANY CAPACITY ON ITS BEHALF EVEN IF THEY OR ANY OF THE NEGLIGENTLY CUASED AN INJURY OR DAMAGE.  Should IMAGINE PLAY, or anyone acting on its behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and reimburse them for such fees and costs.

5.  I certify that I have health, accident, and liability insurance to cover any bodily injury or property damage I may suffer while participating in activities at IMAGINE PLAY or I will personally bear the costs of any such injury or damage to myself or my dependent minor(s).  In case of an emergency, I also understand I am responsible for taking the appropriate action to seek medical treatment and all costs associated with this treatment.  If I fail to seek appropriate medical treatment for my minor child, IMAGINE PLAY reserves the right to obtain any and all treatment which is deemed appropriate for the welfare of the child, and the costs of this treatment are my responsibility as the parent/guardian signing this waiver on behalf of the minor.

6. I understand IT IS SOLELY my responsibility to care for my child(ren) and supervise all of their activities while at IMAGINE PLAY.  I AGREE TO ENSURE MY CHILD BEHAVES IN A MANNER THAT IS SAFE AND COURTEOUS AND THAT HE/SHE DOES NOT POSE A RISK OF INJURY TO THEMSELVES OR OTHER PARTICIPANTS AT IMAGINE PLAY.  

7.  I UNDERSTAND THAT FAILURE TO PROPERLY SUPERVISE MY CHILD(REN), ALLOWING THEM/MYSELF TO ENGAGE IN UNACCEPTABLE CONDUCT OR BEHAVIOR WILL RESULT IN THE REMOVAL OF MYSELF OR MY CHILD WITHOUT A REFUND OR CREDIT TO ME.  I UNDERSTAND THAT IF A IMAGINE PLAY STAFF MEMBER HAS TO CORRECT MY CHILD'S BEHAVIOR/CONDUCT, MY  CHILD AND I MAY BE ASKED TO TERMINATE PLAY AT IMAGINE PLAY.

8. I UNDERSTAND MY CHILD MAY NOT CHEW GUM AND PLAY ON THE MATS OR IN THE PLAY STRUCTURE.   I ALSO UNDERSTAND THAT I MAY NOT BRING FOOD ONTO THE PLAY ARE FLOOR. FOOD MUST REMAIN IN THE SITTING AREA. I UNDERSTAND THAT IMAGINE PLAY DOES SERVE PEANUT PRODUCTS AND THAT MY CHILD IS NOT ALLERGIC OR AT RISK.  I agree that I am financially responsible and may be charged a cleaning fee if my child or I consume any gum, food or drinks inside IMAGINE PLAY.

My electronic authorization indicates that I have had a sufficient opportunity to read this entire waiver, that I have read it, I understand it and that I understand it affects my legal rights and agreed to all of the above.   I am also authorizing on behalf of my minor child(ren) the ability to participate at IMAGINE PLAY in its activities and to use is equipment and facilities. I further agree to indemnify and hold harmless IMAGINE PLAY from any and all claims that are brought by, or on behalf of the minor(s), and which are in any way connected with such use or participation by the minor.

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*
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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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

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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