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Kid's Choice Sports Center Participation Waiver applicable to any and all activities in the facility.

The Undersigned is a visitor, participant, or guest of Kid's Choice Sports Center ("KCSC" or "Center"). KCSC's main business is to provide a facility for various sports activities for both adults and children. From time to time it is possible for a participant or visitor to suffer athletic or other injuries relating to his/her usage of the facilities in the normal course of their presence in the center.

By your signature below, you hereby release KCSC and its' Owners, Landlord, Licencees, Employees, and other Agents from all claims arising from your presence or participation in the Center, including, but not limited to, personal injury, accidents, and other unintentional causes. Your entrance and use of the facility means that you accept this responsibility.

KCSC is not able to keep medical or emergency information on file. Therefore, if you have any medical conditions or situations that might reasonably affect your participation, it is your responsibility to notify the management of the Center, who will have the sole discretion to deny admittance, based upon this information.

If you are a minor under the age of 18, your parent, or legal guardian, or caregiver, must give consent by execution of this WAIVER, for you to participate.

This WAIVER shall be prominently posted in the Center and in other places throughout the facility. It is the responsibility of the guest, participant, or visitor to execute this WAIVER upon entering the Center, and prior to participating in an activity. Failure to so so shall imply that you consent to the terms and conditions of the WAIVER. 

KCSC shall endeavor to keep all prior executed WAIVERS on file in the Center in order to eliminate the necessity of making multiple copies. It is agreed that an executed WAIVER that is on file in the Center remains applicable during all subsequent visits.

By your signature below, you hereby release KCSC and its' Owners, Landlord, Licencees, Employees, and other Agents from all claims arising from you or your child's participation in the Center, including, but not limited to, personal injury, accidents, and other unintentional causes. Your child's use of the facility means that you accept this responsibility.

If your child has any medical conditions or other special needs that might reasonably affect his/her participation, it is your responsibility to notify the management of the Center. Kids Choice Sports Center reserves the right to deny participation in the Program, if in it's sole discretion, your child cannot be reasonably accommodated by the staff or the facilities of the Center.

Kid's Choice Sports Center Day Camp is not required to be licensed by the Commonwealth of Virginia as a childcare or daycare facility. We are a children's sports center that provides physical and entertainment activities. We DO NOT provide childcare. Children are free to enter and leave the premises without permission or supervision.

If I cannot be reached, I authorize the Kid's Choice Sports Center After School Program representatives to obtain emergency medical treatment, at my expense, for my child in the case of serious illness, emergency or injury. I give my consent to the emergency facility and physician to administer necessary treatment to my child. I also give consent to transport by ambulance if required.

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 on specials, camps, parties, parents night out and other programs by e-mail.
Additional Information

Home Zip Code *

Phone *
What activities would you like to participate in?
Bounces
Day or Weekly Camps
Field Activity
Laser Tag
Open Play
Party (Birthday or other)
Swim
Toddler Town
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*
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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