I, as the parent or legal guardian of the child(ren) named herein whom I have added to my electronic record as part of this process (“Minor Participant”), or the agent of the parent or guardian, hereby freely and voluntarily give my consent and approval for the Minor Participant to participate in all classes, programs, events and activities (individually a “Program” or collectively the “Programs”) offered by Kids’ Nite Out Across America® (“KNOAA”), regardless of facility or location. If I am not the parent or legal guardian of the Minor Participant, I acknowledge that I have the right and authority to execute this Consents, Waiver, Release, Covenant Not to Sue and Indemnity Agreement (the “Agreement”) on behalf of the parent or legal guardian and with the consent of the parent or legal guardian that they will be bound to this Agreement. All reference to “I” or “me” in this Agreement refers to not only the person who signs this Agreement, but also the parent or legal guardian of the Minor Participant when not signed by them.
I hereby represent and certify that except as noted above, the Minor Participant is in good health and has no physical limitations which would preclude safe participation by the Minor Participant in any and all Programs offered by KNOAA. I acknowledge that while KNOAA makes reasonable efforts to permit children with disabilities to participate in KNOAA Programs, some disabilities may prevent children from participating in some or all of the Programs. I assume all risk associated with the Minor Participant participating in any of the Programs, including infection or illness to the Minor Participant, me or other members of my family or friends as a result of any Program instructor, supervisor, other Program participant or anyone else present at a Program not being in good health. I understand and agree that neither KNOAA nor the KNOAA owner/operator has any responsibility to assure that any Program instructor, supervisor, other Program participant or anyone else present at a Program is free of any disease or illness, whether caused by a pandemic, epidemic or otherwise. In case of injury or illness, I give my consent to emergency transportation and the administration of any first aid, medical and/or dental treatment for the Minor Participant. I accept responsibility for the payment of any such emergency transportation and treatment expenses and any related or subsequent medical bills. I acknowledge that neither KNOAA nor the KNOAA owner/operator has purchased and will not provide any medical, health, or accident insurance to cover such expenses and that any such insurance is my/our responsibility.
I understand and agree that KNOAA is a drop-in program and not a childcare provider. I further acknowledge that the KNOAA program being offered is operated by an independent owner/operator of KNOAA. I understand there are inherent risks associated with sports activities, swimming and other water related activities, and the use of inflatable jumping apparatuses, rock walls and other climbing equipment, some or all of which may be included within the KNOAA Programs made available to the Minor Participant. Such risks include, but are not limited to physical injury, drowning and even death. I, individually and on behalf of the Minor Participant, assume all risks and hazards incidental to such participation, including, but not limited to, physical injury, drowning and death; and I hereby waive, release, absolve, indemnify and agree to hold harmless, and covenant and agree not to sue KNOAA, the KNOAA owner/operator, the owner of the Program facility, the activity and/or Program instructors, supervisors, other Program participants, and the owners, officers, directors, employees, volunteers, agents or any other representatives of KNOAA or the KNOAA owner/operator, from and against any and all causes of action, claims, demands, losses, expenses or liability of any nature whatsoever, in law or in equity, arising from the Minor Participant’s participation in any KNOAA Program, even if caused by such person’s negligence.
I, individually and collectively and on behalf of the Minor Participant, accept responsibility for the payment of any damages caused by Minor Participant to personal and/or real property. I hereby grant authorization to KNOAA and/or the KNOAA owner/operator to charge my credit card and/or to process an ACH charge for any such damages.
I, individually and collectively and on behalf of the Minor Participant, give permission for photographs, video and other images to be taken of the Minor Participant participating in any KNOAA Program to be used by KNOAA, without charge and without payment to me or Minor Participant or any other person or entity, for advertising and promotional purposes as may be determined by KNOAA in its sole discretion. I hereby consent for me and Minor Participant(s) to receive direct mail, telephone calls, emails, autodialed and/or pre-recorded telemarketing calls and/or text messages from or on behalf of KNOAA and/or approved affiliates, vendors or partners of KNOAA at the telephone number(s) and email address(es) I provided as part of this process.
To acknowledge that you agree to be bound by the terms and conditions of this Agreement, click "I AGREE":
Date: September 26, 2023
Please fill out only one waiver per child. If you have already completed a waiver, please do not submit another one unless your contact information has changed.