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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 Playground, 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 Playground 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 Playground and freely assume all risks, both known and unknown, even if arising or resulting from negligence of Little Dimples Playground 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 Playground and its employees, owners and representatives (collectively ‘Little Dimples Playground’) 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 Playground, 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 Playground or otherwise and hereby agree to indemnify and hold harmless Little Dimples Playground 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.
  • *I hereby release and agree to hold Little Dimples Playground 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 Playground. I understand that this release discharges Little Dimples Playground 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


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*
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.


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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