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Participation Agreement

DEFINITIONS

Participant(s) means any person on whose behalf You are signing this form.

You or Your means the person whose signature appears on the bottom of this form.

Play Street Museum means any Play Street Museum, Play Street Museum Upper West Side, Payne Family Enterprise LLC, or any of its owners, directors, employees, representatives, volunteers, affiliates, successors, or assigns.

ASSUMPTION OF RISK

You understand that there is a natural risk of injury, whether caused by Participant (which means any person on whose behalf You are signing this form) or someone else, in the use of or presence at Our (which means the independent owner, Payne Family Enterprise LLC) of the Play Street Museum Upper West Side location, the use of our equipment and services, and participation in any Play Street Museum-related activities. These activities include, but are not limited to, the use of any Play Street Museum toys, equipment, exhibits, or materials, and/or Play Street Museum events, private parties, community, school, or non-profit programs We host.

You understand that the risk of injury includes, but is not limited to any accidental or "slip and fall" injuries and injuries or medical disorders (such as heart attacks, strokes, heart stress, head injuries, sprains, cuts, bruises, broken bones and torn muscles or ligaments) resulting from Your use of or presence at our Play Street Museum location, Participant's use of equipment or services at our Play Street Museum location, or Your or the Participant’s participation in any Play Street Museum activities. You understand and voluntarily accept this risk on behalf of the Participant(s).

COVID-19

Due to the 2019-2020 outbreak of the novel Coronavirus (COVID-19), Play Street Museum Upper West Side is taking extra precautions with enhanced sanitation/disinfection procedures per the Centers for Disease Control guidance. Symptoms of COVID-19 include fever, fatigue, dry cough, and difficulty breathing. By signing this Agreement, You understand these symptoms and affirm that:

  • You and all household members do not currently have, nor have experienced, the symptoms listed above WITHIN THE PAST 14 DAYS.
  • You and all household members have not been diagnosed with COVID-19 WITHIN THE PAST 30 DAYS.
  • You and all household members have not knowingly been exposed to anyone diagnosed with COVID-19 WITHIN THE PAST 30 DAYS.

We are not liable for any exposure to the COVID-19 virus caused by Your or the Participant(s) presence at our Play Street Museum location.

You specifically acknowledge that, if you are not a parent or legal guardian of the Participant, you have discussed the terms of this Agreement with the Participant’s parent or legal guardian and have been given the authority by the Participant’s parent or legal guardian to sign this Agreement on the Participant’s behalf.

You understand that You must monitor the Participant(s) at all times as the potential exists for there to be a choking hazard or other safety concern.

You approve using any pictures that may be taken at our Play Street Museum location, in which the Participant is part of, to be used on any Play Street Museum website, social or print media, and marketing advertisements.

RELEASE OF LIABILITY

You specifically waive Your right and/or Participant’s right to bring or take any action against Us and our owners, directors, employees, representatives, volunteers, affiliates, successors, or assigns as a result of any injury, loss, theft, or damage to You and/or Participant, including and without limitation, personal bodily or internal injury, exposure or harm due to COVID-19, economic loss or any other type of damage, regardless of whether resulting from Our negligence or anyone else using or present at Our Play Street Museum location. 

You agree to defend, indemnify, and hold Payne Family Enterprise LLC and our owners, directors, employees, representatives, volunteers, affiliates, successors, or assigns harmless against any claims arising out of You or Participant's negligence or willful acts or omissions.

You agree to specifically assume all risk of loss, theft, or damage of personal property for the Participant while he or she is present at our Play Street Museum location or participating in any Play Street Museum-related activity.

I hereby certify that I have read and understand this entire Agreement and agree to and accept the terms and conditions of this agreement.

Date: May 8, 2024

First Guest's Name

First Name*

Last Name*
First Guest's Age Acknowledgment*
First Guest's Date of Birth*
I certify that I am 18 years of age or older
First Guest's Signature*
Second Guest's Name

First Name*

Last Name*
Second Guest's Date of Birth*
Third Guest's Name

First Name*

Last Name*
Third Guest's Date of Birth*
Fourth Guest's Name

First Name*

Last Name*
Fourth Guest's Date of Birth*
Fifth Guest's Name

First Name*

Last Name*
Fifth Guest's Date of Birth*
Sixth Guest's Name

First Name*

Last Name*
Sixth Guest's Date of Birth*
Seventh Guest's Name

First Name*

Last Name*
Seventh Guest's Date of Birth*
Eighth Guest's Name

First Name*

Last Name*
Eighth Guest's Date of Birth*
Ninth Guest's Name

First Name*

Last Name*
Ninth Guest's Date of Birth*
Tenth Guest's Name

First Name*

Last Name*
Tenth Guest's Date of Birth*
Parent or Guardian's Email Address

Email*

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

First Name*

Last Name*

Emergency Contact's Phone Number*
Please help us identify our next Play Street Museum location by sharing your zip code with us

Zip Code: *
Events and Update Notifications
Would you like to receive a weekly text from Play Street Museum featuring upcoming special events and important updates?*

If yes, what is the 10 digit number you would like us to send this text to? (FYI - you can unsubscribe at any time)
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*
Parent or Guardian's Age Acknowledgment*
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.


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