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New Guest Registration Form

In Consideration of being allowed to enter the play area and/or participate in any party and/or program at Climbing Vines, the undersigned, on his or her behalf, and on the behalf of the participant(s) identified below, acknowledges, appreciates and agrees to the following conditions:

I represent that I am the parent or legal guardian of the participant(s) named above, or I have obtained permission from the parent/legal guardian of the participant(s) named above to execute this agreement on their behalf. I agree that the participant(s) named above and I shall comply with all stated and customary terms, posted safety signs, rules, and verbal instructions as conditions for participation in any party and/or program at Climbing Vines. In addition, if I observe any hazard during our participation, I will bring it to the attention of the nearest Climbing Vines employee or official immediately.  I understand that I am responsible for my child’s safety and behavior at all times each visit.

I am aware that there are inherent risks associated with participation in Climbing Vines programs, parties and I, on behalf of myself and the participant(s) named on the reverse, knowingly and freely assume all such risk, both known and unknown, including those that may arise out of the negligence of other participants; and,

I, for myself and the participant(s) named above, and our respective heirs, assigns, administrators, personal representatives, and next of kin, hereby release and hold harmless, Climbing Vines, LLC, and Climbing Vines management, their affiliates, officers, members, agents, employees, other participants, and sponsoring agencies from and against any and all claims, injuries, liabilities or damages arising out of or related to our participation in any and all Climbing Vines programs, activities, parties, and the use of the play area.

I, for myself and the participant(s) named above, will read and abide by all posted rules including, but not limited to: wearing socks inside of the play area, ensuring only children within the age limit (18 months and under) enter the labeled gated area, refraining from running, and refraining from throwing or misusing toys in any way.  I also understand that there is absolutely no food allowed inside of the play area at any time. I understand that in order to play, my child must be well and free of any communicable/ contagious illnesses. 

I understand that I am responsible for monitoring the participant(s) named above during the entirety of our visit. 

NOTE: We reserve the right to deny service to any child or adult who may appear ill, and require a doctor's note for any ill child to return. We also reserve the right to ask any guest who does not adhere to this signed agreement to leave without refund.

 

Dated: December 14, 2018

First Guests Name

First Name*

Last Name*

Phone*
First Guests Date of Birth*
I certify that I am 18 years of age or older
First Guests Signature*
Second Guests Name

First Name*

Last Name*
Second Guests Date of Birth*
Third Guests Name

First Name*

Last Name*
Third Guests Date of Birth*
Fourth Guests Name

First Name*

Last Name*
Fourth Guests Date of Birth*
Fifth Guests Name

First Name*

Last Name*
Fifth Guests Date of Birth*
Sixth Guests Name

First Name*

Last Name*
Sixth Guests Date of Birth*
Seventh Guests Name

First Name*

Last Name*
Seventh Guests Date of Birth*
Eighth Guests Name

First Name*

Last Name*
Eighth Guests Date of Birth*
Ninth Guests Name

First Name*

Last Name*
Ninth Guests Date of Birth*
Tenth Guests Name

First Name*

Last Name*
Tenth Guests 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*

Last Name*

Relationship*

Phone*
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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