Loading...

 

BUDDY'S INDOOR PLAYHOUSE, INC. 

 

In exchange for participation in activities and parties at and organized by Buddy's Indoor Playground, Inc, I, for myself, my child/children or chaperone/chaperones sign this Waiver and Assumption of Risk in consideration of the opportunity to use the facility, or to participate in any parties or activities at/by Buddy's Indoor Playhouse, Inc.

I, represent that I am the parent/parents or legal guardian or chaperone of the participant(s) named below acknowledge and understand that there are dangers and risks associated with the activities at/by Buddy's Indoor Playhouse, Inc. I recognize that there are certain inherent risks associated with the use of the playground, parties, activities, I assume full responsibility on behalf of my or their heirs, assigns, personal representatives and next of kin, HEREBY HOLD HARMLESS Buddy's Indoor Playhouse, Inc., its owners, member(s), officers, employees, equipment manufacturers and sponsoring agencies from all liability for any such personal injury, disability, death or loss or damage to person or property to the fullest extent of the law. This Waiver and Assumption of Risk form shall apply to all risks, known and unknown, even if resulting from negligent actions of other guests or employees of Buddy's Indoor Playhouse, Inc.

I, for myself, my child/children or chaperon(s) understand that my execution of this waiver on the initial visit will authorize Buddy's Indoor Playhouse, Inc., to enter this waiver into its database and use it as a continuous, mutli use waiver for my child/children. I hereby expressly authorize Buddy's Indoor Playhouse, Inc. to use this Waiver as a multi use waiver until such time as i revoked it in writing.

ACKNOWLEDGMENT AND ASSUMPTION OF RISK RELATED TO CORONAVIRUS (COVID-19) AND COMMUNICABLE DISEASES


The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
Other communicable diseases, such as common colds, seasonal flu, hand, foot and mouth disease, and many others, are also believed to spread from (1) proximity to, (2) person-to-person contact, and/or (3) contact with surfaces that have come into contact with an infected individual.
Buddy's Indoor Playhouse, LLC has put in place preventative measures to reduce the spread of COVID-19 and other communicable diseases; however, Buddy's Indoor Playhouse LLC, cannot guarantee that you or your child(ren) will not become infected with COVID-19 or any other communicable disease or illness. Further, attendance at Buddy's Indoor Playhouse, could increase your risk and your child(ren)'s risk of contracting COVID-19 or any other communicable disease or illness.


RELEASE AND WAIVER OF LIABILITY
By signing this agreement, I hereby release, waive, discharge and covenant not to sue Buddy's Indoor Playhouse, LLC, its members, managers, officers, servants, agents, employees and volunteers, from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or relating to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, whether caused by the negligence of the Releasees, or otherwise, while participating in any activity at Buddy's Indoor Playhouse.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 or any other communicable disease or illness by attending Buddy's Indoor Playhouse and that such exposure or infection may result in person injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 or other communicable diseases or illnesses at Buddy's Indoor Playhouse, may result from the actions, omissions, or negligence of myself and others including, but not limited to Buddy's Indoor Playhouse, LLC employees, volunteers and other playground guests participants and their families.

I ,   the undersigned on my behalf and, if applicable, my child/ward named below (hereinafter “RELEASOR“), hereby acknowledge that I and my child/ward, desire to voluntarily participate in the activities and services provided by Buddy's Indoor Playhouse, LLC. Buddy's Indoor Playhouse and its affiliates, instructors, officers, managers, agents, employees, designers, licensors, and members, as well as the property owner and tenants of the property and the owners, manufacturers and installers of the equipment comprising the Buddy's Indoor Playhouse facility (collectively, “Buddy's Indoor Playhouse and Party Venue” or “RELEASEES”), including but not limited to, the use of the equipment, facilities, trampolines, inflatable jump houses, receiving instructions, strenuous bodily movement, and the premises (hereinafter collectively referred to as “BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES”), and further agree and acknowledge as follows: ASSUMPTION OF RISK: I, the undersigned, understand and acknowledge that BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES have varying effects on individuals based upon their size, age, physical condition and/or state of health. I further recognize, acknowledge and agree that it is my sole decision whether to consult with medical professional prior to participating in BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES and that BUDDY'S INDOOR PLAYHOUSE recommends that participants consult with a medical professional prior to participating in BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES, especially if a member has had a recent injury, surgery, pregnancy or other health conditions. I, and/or my child/ward, have either consulted a physician and received medical advice and consent to participation in BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES or have waived such advice and consent of physician and accept any and all RISKS. I am assuming, on behalf of myself and/or child/ward, all risk of personal injury, death, or disability to myself and /or child/ward that my result from participation, or any damage, loss or theft of any personal property which me and/or child/ward may incur. I am aware, understand and acknowledge that participation in BUDDY'S INDOOR PLAYHOUSE ACTITIVIES & SERVICES is a potentially hazardous activity and involves inherent risks of danger or injury, including but not limited to, sprains, strains, fractures, concussions, contusions, lacerations, abnormal blood pressure, heart disorders, fainting, shortness of breath, chest pain, strokes, heart attack, or even death that can occur (hereinafter collectively referred to as “RISKS“). I am voluntarily participating in BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES with the knowledge of the danger involved with the RISKS and with the knowledge that staff assistance and/or medical facilities may not be available in the event of illness or injury. I HEREBY AGREE TO ACCEPT ANY AND ALL RISK OF INJURY, ILLNESS, OR DEATH INHERENT IN BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES AND VERIFY THIS STATEMENT BY PLACING MY SIGANTURE BELOW. RELEASE OF LIABILITY: I understand that I, and/or my child/ward, will be engaging in BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES using the BUDDY'S INDOOR PLAYHOUSE facilities and it is my voluntary and informed decision to release any future lawsuits or claims that I and/or they have or may have against the RELEASEES. RELEASOR EXPRESSLY RELEASES AND FOREVER DISCHARGES AND HOLDS HARMLESS RELEASEES FROM ANY AND ALL PAST, PRESENT AND FUTURE LIABILITY, CLAIMS, DEMANDS OR CAUSES OF ACTION WHATSOEVER ARISING OUT OF THEIR ACTS AND/OR OMISSIONS, INCLUDING BUT NOT LIMITED TO, DEMANDS, OBLIGATIONS, ACTIONS, CAUSES OF ACTION, RIGHTS, DAMAGES, COSTS, NEGLIGENCE CLAIMS, GROSS NEGLIGENCE CLAIMS, ASSAULT CLAIMS, DECEPTIVE TRADE PRACTICE CLAIMS, CONTRACT CLAIMS, INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS CLAIMS, PERSONAL INJURY CLAIMS, PREMISES LIABILITY CLAIMS, PRINCIPAL-AGENT LIABILITY CLAIMS, MENTAL ANGUISH CLAIMS, PAIN AND SUFFERING CLAIMS, PHYSICAL IMPAIRMENT CLAIMS, DISFIGUREMENT CLAIMS, LOST WAGES CLAIMS, LOSS OF EARNING CAPACITY CLAIMS, WARRANTY CLAIMS, PUNITIVE DAMAGES CLAIMS, EXEMPLARY DAMAGES CLAIMS, AND ANY OTHER FORM OF COMPENSATORY CLAIMS OF ANY NATURE WHATSOEVER, WHETHER BASED ON A TORT, CONTRACT, OR OTHER THEORY OF RECOVERY, WHETHER SAME BE KNOWN AND REALIZED OR UNKNOWN AND NOT REALIZED, THAT I, MY ASSIGNEES, HEIRS, DISTRIBUTES, GUARDIANS OR LEGAL REPRESENTATIVES NOW HAVE, HAVE HAD, OR EVER WILL HAVE; FOR INJURY, ILLNESS, DEATH, OR DAMAGE RESULTING FROM MY PARTICIPATION IN BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES AND THE RISKS INVOLVED WITH SAME. THIS RELEASE IS INTENDED BY BOTH PARTIES TO BE AS BROAD IN ITS EFFECT AS ALLOWED BY LAW. This release is valid and effective whether the damage, loss, or death is a result of any act or omission on the part of accidents, which may occur as a result of the: (a) use or misuse of the facility in any way by anyone; (b) use of any equipment that malfunctions or breaks; (c) improper maintenance of the facility, grounds or any equipment; (d) instruction or supervision; or (e) slipping, tripping and/or falling while in the facility or on the surrounding premises. As consideration for being permitted by BUDDY'S INDOOR PLAYHOUSE to participate in BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES, I hereby agree that I, my assignees, heirs, distributes, guardians, and legal representatives will not make a claim against, or sue BUDDY'S INDOOR PLAYHOUSE or its past, present or future parent, subsidiaries, affiliates, other related entities, successors, owners, members, managers, officers, agents, employees, servants, assigns, investors, legal representatives, and all individuals, and entities involved in the operations of BUDDY'S INDOOR PLAYHOUSE for injury, illness, death or damage resulting from my participation in BUDDY'S INDOOR PLAYHOUSE ACTIVITIES & SERVICES and the RISKS involved therein. I further grant BUDDY'S INDOOR PLAYHOUSE the right to photograph, videotape, and/or record me and/or my child/ward and to use my or my child’s/ward’s name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising, and promotional materials without reservation or limitation. I HAVE CAREFULLY READ THIS WAIVER, RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT IN ITS ENTIRETY AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A WAIVER, RELEASE OF LIABILITY, ASSUMPTION OF RISK AGREEMENT AND A LEGAL CONTRACT BETWEEN ME AND BUDDY'S INDOOR PLAYHOUSE AND THAT IT AFFECTS MY LEGAL RIGHTS. I AM SIGNING THIS DOCUMENT OF MY OWN FREE WILL.

First Participant's Name

First Name*

Middle 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*

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*
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*

Middle 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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!