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MAKER SQUARE PLAY PLACE

Maker Square Play Place LLC d/b/a Little Bloom House and d/b/a Maker Square Play Place

Waiver, Release of Liability, and Assumption of Risk Agreement

Please read this entire document carefully before signing. This is a legally binding agreement.

This Waiver, Release of Liability, and Assumption of Risk Agreement (this “Agreement”) is entered into by and between Maker Square Play Place LLC, doing business as Little Bloom House and as Maker Square Play Place, and under any other trade name it may use now or in the future, together with its owners, operators, landlords, employees, volunteers, agents, affiliated entities, successors, and assigns (collectively, the “Facility”), and the undersigned participant, or the parent or legal guardian signing on behalf of a minor participant (each, a “Participant,” and together with any accompanying guests, “you”). The Facility is located at 2011 North Roan Street, Suite E3C, Johnson City, Tennessee 37601. By signing below and by entering or using the Facility, you agree to all of the terms set forth below.

1. Assumption of Risk

You understand that use of the Facility — including its play houses, interactive and maker activities, equipment, tools, craft materials, and common areas — involves inherent and other risks, dangers, and hazards. These risks include, but are not limited to: slips, trips, and falls; collisions with other participants, equipment, or fixed objects; cuts, scrapes, bruises, sprains, strains, and broken bones; injuries from tools, craft supplies, or small parts; exposure to germs and communicable illnesses; and the negligent or intentional acts of other participants or third parties. You acknowledge that these risks may result in property damage, minor or serious personal injury, permanent disability, or death. You knowingly and freely assume all such risks, both known and unknown, and assume full responsibility for your participation and for any minor for whom you are signing. You agree that you (and any minor Participant) are physically fit and able to participate, and that you will inspect the facilities and equipment and immediately notify Facility staff of any condition you believe to be unsafe.

2. Release and Waiver of Liability

In consideration of being permitted to enter and use the Facility, you — on behalf of yourself, any minor Participant, and your and their heirs, assigns, personal representatives, and next of kin — hereby release, waive, discharge, and covenant not to sue the Facility from and against any and all liability, claims, demands, actions, and causes of action arising out of or related to any loss, damage, injury, or death that may be sustained by you or any minor Participant, or to any property belonging to you, whether caused by the ordinary negligence of the Facility or otherwise, to the fullest extent permitted by the law of the State of Tennessee. You understand that this release does not, and is not intended to, waive any liability for gross negligence, recklessness, or willful or wanton misconduct, or any liability that may not be released or disclaimed as a matter of Tennessee law.

3. Indemnification

You agree to indemnify, defend, and hold harmless the Facility from and against any and all claims, liabilities, losses, damages, costs, and expenses (including reasonable attorneys’ fees) arising out of or resulting from your conduct or the conduct of any minor Participant or guest for whom you are responsible, or from any breach of this Agreement.

4, Rules and Conduct

You agree to follow all posted rules, signage, and staff instructions while at the Facility. You agree to supervise any minor Participant in your care at all times, unless the Facility offers and you have separately arranged for supervised drop-off care. The Facility reserves the right to refuse entry to, or remove, any person who does not comply with its rules or who poses a risk to the safety or enjoyment of others.

5. Security Cameras and Video Monitoring

You acknowledge and agree that the Facility uses video security cameras throughout its premises, including in play areas, activity spaces, entrances, and common areas, for the purposes of safety, security, loss prevention, and the protection of guests and staff. By entering the Facility, you consent to being recorded by these cameras, and you consent to such recording of any minor Participant in your care. Cameras are not placed in restrooms, changing areas, or other areas where a reasonable expectation of privacy exists. Recordings are the property of the Facility and may be used for safety and security purposes, to investigate incidents or claims, and as otherwise permitted or required by law. The Facility does not guarantee that cameras cover all areas or that any incident will be recorded, and the presence of cameras does not replace parental or guardian supervision.

6. Medical Authorization

In the event of an injury or medical emergency, you authorize the Facility to secure such first aid or emergency medical treatment as may be reasonably necessary, and you agree to be responsible for any costs of such treatment. You should ensure the Facility has current emergency contact information on file.

7. Governing Law and Severability

This Agreement is governed by and construed in accordance with the laws of the State of Tennessee, without regard to its conflict-of-laws principles. Any dispute arising under this Agreement shall be brought exclusively in the state or federal courts located in Washington County, Tennessee. If any portion of this Agreement is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect, and the invalid provision shall be enforced to the greatest extent permitted by law.

8. Continuing Agreement; Change of Trade Name

This Agreement applies to your first visit and to every future visit to and use of the Facility by you and any minor Participant named below, and it remains in effect until you revoke it by written notice delivered to the Facility. You acknowledge that the Facility currently operates under the name Little Bloom House and intends to change its name, signage, and branding to Maker Square Play Place. This Agreement remains in full force and effect regardless of any change in the trade name, signage, branding, or ownership of the Facility, and it benefits and may be enforced by Maker Square Play Place LLC under any trade name it uses, and by its successors and assigns. You will not be required to sign a new agreement because of such a change, although the Facility may ask you to sign an updated agreement at any time.

9. Acknowledgment

I have read this entire Agreement. I understand that by signing it I am giving up substantial legal rights, including the right to sue the Facility. I am signing it freely and voluntarily, and I intend my signature to be a complete and unconditional release of liability to the greatest extent permitted by Tennessee law

First Participant's Name
First Name*
Last Name*
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
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Emergency Contact's Relation to Participant
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Photography and Media (Optional)
From time to time the Facility may take photographs or video for promotional or marketing purposes. Your consent to such promotional use is optional and separate from the security-camera consent above. Please indicate your choice:*
I Consent
I do NOT consent to the use of promotional photographs or video that may include me or my child
Parent or Guardian's Email Address
Email*
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
SMS Opt-In
Would you like to receive weekly texts from Maker Square Play Place featuring upcoming special events and updates?*
If yes, what is the 10 digit number you would like us to send texts to?
If you select Yes, you agree that Maker Square Play Place may send recurring automated informational texts (for example, visit or party reminders and weather/closure alerts) and marketing texts (for example, upcoming events) to the mobile number provided on this form, including texts sent by autodialer. Consent is not required to complete this waiver, to visit, or to purchase. Message and data rates may apply. Message frequency varies. Reply STOP to unsubscribe or HELP for help. Privacy Policy: https://www.makersquareplayplace.com/privacy *
Yes - I agree to receive these texts
No - I do NOT want texts
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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