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New Client Registration Form

In Consideration of being allowed to enter the play area and/or participate in any party and/or program at Perky's Play Café LLC, the undersigned, on his or her behalf, and on the behalf of the participant(s) identified below, acknowledges, appreciates and agrees to the following conditions:

Participation Agreement, Liability Waiver, and Hold Harmless Agreement

I, as the parent or legal guardian of the child (or children) whose name(s) are set forth below (each referred to as a "Participant" and collectively referred to as "Participants"), and in consideration of the Participants being permitted to participate in activities (as defined below) conducted by Perky's Play Café LLC, located at 1009 Adams Ave #B La Grande OR 97850, agree as follows:

Activities

"Activities" include, but are not limited to, all indoor playground use, arcade games, pool table, air hockey, foosball table, shuffleboard, video gaming room with virtual reality and Nintendo Switch, Xbox, parties, events, and general use of the upstairs and downstairs facilities.

Supervision and Age Policy

I understand and agree that Perky's Play Café LLC employees do not provide childcare or supervision. It is my sole responsibility to supervise any minor Participants I bring into the facility. While 100% supervision is encouraged, parents or guardians are required to remain on-site at all times and may not leave the premises.

  • Children must be at least 10 years old to access the upstairs area without an accompanying adult.
  • Adults (18+) are not permitted upstairs without a child.
  • Children (under 18) may not be on-site without an accompanying adult at any time.

I understand and acknowledge that Perky's Play Café LLC is not a daycare and does not assume responsibility for minor Participants’ actions or safety.

Rules and Equipment Care

I agree to ensure that Participants under my care follow all posted safety rules and guidelines, including:

  • Treating all equipment with respect and care. Misuse or rough handling of equipment is strictly prohibited.
  • Using handrails and exercising caution when navigating stairs. Running or unsafe behavior on stairs is not permitted.
  • Refraining from actions that may cause harm to others or disrupt the experience of other guests.

I assume full financial responsibility for any damage to the facility or its equipment caused by me or any Participant under my care due to negligence, misuse, or failure to follow posted rules. Perky's Play Café LLC reserves the right to bill me for repair or replacement costs. Guests who violate safety rules, misuse equipment, or cause disturbances may be asked to leave without refund and may be permanently banned.

Assumption of Risk

I acknowledge that participation in Activities involves inherent risks of injury or property damage, including but not limited to:

  • Minor injuries (scratches, bruises, sprains).
  • Major injuries (eye injuries, joint or back injuries, concussions).
  • Catastrophic injuries (permanent disability, paralysis, or death).

I understand that Perky's Play Café LLC cannot eliminate all risks or guarantee safety, and I voluntarily assume all risks associated with participation.

Release, Discharge, and Agreement Not to Sue

To the fullest extent permitted by law, I, on behalf of myself and any minor Participants under my care, release, discharge, and agree not to sue Perky's Play Café LLC, its owners, managers, employees, or agents for any illness, injury, death, or property damage arising, directly or indirectly, from participation in Activities.

This waiver applies even if such claims arise from ordinary negligence but does not release liability for gross negligence or intentional misconduct.

Indemnification and Hold Harmless

I agree to indemnify and hold harmless Perky's Play Café LLC from any claims, demands, liabilities, damages, or attorney's fees arising from:

  1. Injuries to myself or minor Participants under my care.
  2. Injuries caused by my minor Participant to another guest.
  3. Any failure on my part to adhere to facility rules.


Security Cameras

I acknowledge that the upstairs area is monitored by 24/7 surveillance cameras, with footage displayed in two locations downstairs. I consent to this surveillance and waive any expectation of privacy in monitored areas.

Lost or Stolen Belongings 

I understand that Perky's Play Café LLC is not responsible for lost, stolen, or forgotten items. While small storage spaces are available upstairs, I assume full responsibility for my belongings and those of the Participants under my care.

Photo Release

I grant Perky's Play Café LLC permission to use photographs, video, or sound bites of myself or any minor Participant under my care for promotional purposes without compensation.

Governing Law and Venue

This agreement shall be governed by and interpreted under the laws of the State of Oregon. Any legal action must be filed exclusively in a court located in Union County, Oregon.

Parent or Legal Guardian Certification and Consent

I certify that I am the parent or legal guardian of the minor Participants whose name(s) appear below and have the authority to waive legal rights on their behalf. I have read and understand this agreement, including the risks of participation, and agree to its terms voluntarily.

Today's date: April 2, 2025

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
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*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First 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.


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*
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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