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THE PLAY YARD LLC WAIVER OF LIABILITY / ASSUMPTION OF RISK


I, for myself, my child/children or ward/wards sign this Waiver and Assumption of Risk in consideration of the opportunity to use the facility, or to participate in any parties or activities at/by The Play Yard LLC.

I, for myself, my child/children or ward/wards acknowledge and understand that there are dangers and risks associated with the activities at/by The Play Yard LLC and agree to assume all risk of personal injury, including the potential for paralysis and death.

I, for myself, my child/children or ward/wards agree to follow the safety instructions provided and acknowledge that failure to do so may result in expulsion from The Play Yard LLC.

I, for myself, my child/children or ward/wards, and on behalf of my or their heirs, assigns, personal representatives and next of kin, The Play Yard LLC, its owners, members, officers, employees, equipment manufacturers and sponsoring agencies from all liability for any such personal injury, disability, death or loss or damage to person or property to the fullest extent of the law.

I, for myself, my child/children or ward/wards understand that my execution of this waiver on the initial visit will authorize The Play Yard LLC to enter this waiver into its database and use it as a continuous, multi use waiver for my child’s/children’s ongoing participation in the activities or use it as a waiver executed for my other child/children. I hereby expressly authorize The Play Yard LLC to use this Waiver as a multi use waiver until such time as I revoke it in writing.

Today’s Date: September 19, 2024

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Age:
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Age:
Third Participant's Name

First Name*

Middle Name

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

Age:
Fourth Participant's Name

First Name*

Middle Name

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

Age:
Fifth Participant's Name

First Name*

Middle Name

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

Age:
Sixth Participant's Name

First Name*

Middle Name

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

Age:
Seventh Participant's Name

First Name*

Middle Name

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

Age:
Eighth Participant's Name

First Name*

Middle Name

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

Age:
Ninth Participant's Name

First Name*

Middle Name

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

Age:
Tenth Participant's Name

First Name*

Middle Name

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

Age:
Parent or Guardian's Email Address

Email
I give permission for photos, videos, and quotes of participants to be used for marketing purposes.
A signed copy of this waiver will be sent to the email address you provide.
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Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Age:
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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