Loading...

RELEASE AND WAIVER OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT 
The Playground, LLC (“The Playground”): 1930 Greeley Mall, Suite #23, Greeley, CO 80631

Date: December 13, 2018

To promote safety, “The Playground” inspects the property and all equipment on a regular basis.

I hereby certify that I am the adult parent, guardian, legal custodian, legal representative, physical custodian, or the person otherwise responsible for a minor child under the age of eighteen years, and I consent to his/her participation in the entertainment activities offered by “The Playground.”

In consideration for participant child being permitted to partake in the entertainment activities offered by “The Playground”, I, the undersigned, acknowledge and agree to the following:

  1. Assumption of Risk. I fully understand that allowing the participant child to partake in the activities offered by “The Playground” involves risk of, but not limited to, skin lacerations, concussions, broken bones, muscle injuries, other serious injuries, or in extreme circumstances, death. By signing, I understand that these injuries may not only result from participant child’s own actions, inactions or negligence, but also from the actions, inactions or negligence of others and/or the condition of the property, and as the adult responsible for the participant child, I voluntarily agree to assume this risk on behalf of the participant child.
     
  2. Responsibility to Monitor. I understand that should the participant child partake in the activities offered by “The Playground”, it is my responsibility to monitor the participant child at all times. This includes assuring that the participant child is using all equipment in the manor for which it was reasonably intended and following all posted rules. I acknowledge that I am responsible for any property or equipment damage caused by the participant child and/or myself, with the exception of normal wear and tear. I understand that during child’s participation, I am not to leave “The Playground” facility for any reason. I acknowledge that I have read all rules posted in the facility, and agree that both myself, and the participant child under my supervision, will abide by said rules.
     
  3. Use of Party Zone and Piñata Room. I fully understand that should I rent, or otherwise be granted use of, the areas of the facility designated as the “Party Zone” and/or “Piñata Room”, I am fully responsible for any applicable property and/or equipment damage, with the exception of normal wear and tear. I also understand that like all activities offered by “The Playground”, breaking” piñatas involves risk of, but not limited to, skin lacerations, concussions, broken bones, muscle injuries, other serious injuries, or in extreme circumstances, death. By signing, I understand that these injuries may not only result from participant child’s own actions, inactions or negligence, but also from the actions, inactions or negligence of others and/or the condition of the property, and as the adult responsible for the participant child, I voluntarily agree to assume this risk on behalf of the participant child. Like all other activities at “The Playground”, I acknowledge that I am responsible for monitoring the participant child at all times.
     
  4. Covenant Not to Sue. I agree that neither myself nor the participant child, individually or through a legal representative, will make any claim against “The Playground”, or any of its owners, employees, agents, attorneys, insurers and representatives, for any injury, damage, death or any other loss arising from or related to participant child’s participation in the activities offered by “The Playground.”
     
  5. Release and Indemnification. I agree that myself and the participant child, shall forever release, waive, discharge, relinquish and indemnify from any and all actions, causes of action, claims, charges, demands, losses, damages, costs, attorney's fees, judgments, liens, indebtedness and liabilities of every kind and character, whether known or unknown, including foreseen or unforeseen bodily injury and personal injuries and property damage that may be sustained by the participant child or any other person in any way connected to, related to, or arising out of the participant child’s participation in the activities offered by “The Playground”, regardless of any negligence of “The Playground.”
     
  6. Good Health. I warrant that the participant child is in good health and has no physical condition that would prevent them from, or heighten the risks associated with, participating in the activities offered by “The Playground.”
     
  7. Venue. This agreement is governed by the law of the state of Colorado. Participant and “The Playground” agree to subject themselves to the law of this state.
     
  8. Severability. If any provision of this agreement is held to be invalid or unenforceable under Colorado law, the validity of this agreement as a whole shall not be affected, and the other provisions of the agreement shall remain in full force and effect.

I have carefully read this Release and Waiver of Liability and Assumption of Risk Agreement (the “Agreement”) and fully understand its contents. I am aware that I have given up substantial rights by signing the Agreement, and I am signing the Agreement voluntarily. As the adult responsible for the participant child, I have no obligation to allow said child to participate in the activities offered by “The Playground” or sign this Agreement, but I desire to do so.

First Participant's Name

First Name*

Last Name*

Phone*
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*
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:*
Parent or Guardian's Email Address

Email*

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

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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver