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Assumption of Risk and Liability Waiver

As consideration for being allowed to enter the play area/or participate in any party and /or program at Little Dimples LLC, the undersigned, on his or her behalf, and on the behalf of the Participant(s) identified below, acknowledges, appreciates, understands, and agrees to the following:

  • I understand that inherent risk of injury or illness, though minimal, does exist.
  • I and the children have no illness or injury that may affect the safe enjoyment of Little Dimples LLC by us or other guests.
  • I, for myself and the children, knowingly and freely assume full responsibility for me and the children’s participation at Little Dimples LLC and freely assume all risks, both known and unknown, even if arising or resulting from negligence of Little Dimples LLC staff or others.
  • I and the children willingly agree to comply with the stated terms and conditions for participation and to obey the directions of and requests of Little Dimples staff.
  • I, for myself, the children and on behalf of me and their heirs, assigns, personal representatives and next Of kin, hereby waive, release and discharge Little Dimples LLC and its employees, owners and representatives (collectively ‘Little Dimples LLC’) with respect to any and all losses, damages, injuries, expenses and claims, including without limitation suffered or incurred as a result of the children using Little Dimples LLC, due to any cause whatsoever, for personal injury, death or loss or damage to person or property, even if arising from the negligence of Little Dimples LLC or otherwise and hereby agree to indemnify and hold harmless Little Dimples LLC from and against any liability, losses, claims and damages resulting from the children using Little Dimples Playground.
  • I have read this release and waiver of liability agreement, fully understand its terms, understand that I have given up substantial rights for myself and the children by signing it, and sign it freely and voluntarily, without inducement.

Covid-19 Liability

  • I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
  • I further acknowledge that Little Dimples LLC has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.
  • I further acknowledge that Little Dimples LLC can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, staff, and other customers and their families.
  • I voluntarily seek services provided by Little Dimpless LLC and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment.
  • I attest that:

* I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.

* I have not traveled internationally within the last 14 days.

* I have not traveled to a highly impacted area within the United States of America in the last 14 days.

* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.

* I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.

* I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

  • I hereby release and agree to hold Little Dimples LLC harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the salon, or that may otherwise arise in any way in connection with any services received from Little Dimpless LLC. I understand that this release discharges Little Dimples LLC from any liability or claim that I, my heirs, or any personal representatives may have against the establishment with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connec

    As consideration for being allowed to enter the play area/or participate in any party and /or program at Little Dimples LLC, the undersigned, on his or her behalf, and on the behalf of the Participant(s) identified below, acknowledges, appreciates, understands, and agrees to the following:

    I understand that inherent risk of injury or illness, though minimal, does exist.
    I and the children have no illness or injury that may affect the safe enjoyment of Little Dimples LLC by us or other guests.
    I, for myself and the children, knowingly and freely assume full responsibility for me and the children’s participation at Little Dimples LLC and freely assume all risks, both known and unknown, even if arising or resulting from negligence of Little Dimples LLC staff or others.
    I and the children willingly agree to comply with the stated terms and conditions for participation and to obey the directions of and requests of Little Dimples staff.
    I, for myself, the children and on behalf of me and their heirs, assigns, personal representatives and next Of kin, hereby waive, release and discharge Little Dimples LLC and its employees, owners and representatives (collectively ‘Little Dimples LLC’) with respect to any and all losses, damages, injuries, expenses and claims, including without limitation suffered or incurred as a result of the children using Little Dimples LLC, due to any cause whatsoever, for personal injury, death or loss or damage to person or property, even if arising from the negligence of Little Dimples LLC or otherwise and hereby agree to indemnify and hold harmless Little Dimples LLC from and against any liability, losses, claims and damages resulting from the children using Little Dimples Playground.
    I have read this release and waiver of liability agreement, fully understand its terms, understand that I have given up substantial rights for myself and the children by signing it, and sign it freely and voluntarily, without inducement.

    Covid-19 Liability

    I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
    I further acknowledge that Little Dimples LLC has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.
    I further acknowledge that Little Dimples LLC cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, staff, and other customers and their families.
    I voluntarily seek services provided by Little Dimples LLC and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment.
    I attest that:

    * I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.

    * I have not traveled internationally within the last 14 days.

    * I have not traveled to a highly impacted area within the United States of America in the last 14 days.

    * I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.

    * I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non-contagious by state or local public health authorities.

    * I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

    I hereby release and agree to hold Little Dimples LLC harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the salon, or that may otherwise arise in any way in connection with any services received from Little Dimples LLC. I understand that this release discharges Little Dimples LLC from any liability or claim that I, my heirs, or any personal representatives may have against the establishment with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Little Dimples LLC. This liability waiver and release extends to the establishment together with owner and employees.tion to, any services received from Little Dimples LLC. This liability waiver and release extends to the establishment together with owner and employees.

Date: November 4, 2025

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
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*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
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.


By signing below the parent or court-appointed legal guardian agrees that they are also 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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
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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