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CUSTOMER LIABILITY WAIVER

This Waiver and Release Agreement ("The Company - The Little Lotus of Lynbrook") is entered into by and between The Little Lotus of Lynbrook, its owners, employees, agents, and representatives (collectively "The Little Lotus of Lynbrook"), and the undersigned participant or the legal parent/guardian of the participant (collectively "Participant").

1) Assumption of Risk: Participant acknowledges that using the indoor space/facilities carries inherent risks of injury, illness, or damage to/loss of personal property. Participant voluntarily assumes all risks, known and unknown, associated with the use of the Company's facilities, even if arising from the negligence or fault of the Company.

2) Release of Liability: Participant, on behalf of himself/herself and his/her heirs, assigns, personal representatives, and next of kin, hereby releases, waives, and discharges the Company from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by Participant related to the use of the Company's facilities.

3) Policies and Regulations: Participant agrees to comply with all policies and regulations of the Company, as may be amended from time to time. Participant acknowledges that they have been given access to and have read, or have had the opportunity to read, the Company's policies. This includes, but is not limited to, a no-shoe policy within the space.

4) Birthday Parties:  Birthday parties or similar gatherings are strictly prohibited during open play hours. Reservations for private events must be made in advance and during designated times. Any attempt to host a birthday party or similar gathering during open play hours may result in immediate removal from the premises without a refund.

5) Photo Release:  Participant grants the Company, its representatives, and employees the right to take photographs of Participant and Participant's property in connection with the Company's operations. Participant authorizes the Company to use and publish these photographs in print and/or electronically, including on social media platforms. Participant agrees that the Company may use such photographs of Participant without Participant's name for any lawful purpose, including for example, such purposes as publicity, illustration, advertising, and web content.

6) Health and Safety Concerns:

General Wellness Requirement: For the health and safety of all patrons and staff, children who are visibly ill or displaying symptoms of any illness, not limited to COVID-19, are not permitted to play in the indoor playground area. This includes but is not limited to symptoms such as fever, cough, runny nose, skin rash, stomach issues, or any other signs of contagious illness. If a child is suspected of being unwell, the Company reserves the right to ask the child and their accompanying guardian to leave the premises immediately.

Food Allergies

I agree to inform The Company of any specific dietary restrictions or food allergies that my child or children may have. I understand that while reasonable efforts will be made to accommodate these restrictions, The Company cannot guarantee a completely allergen-free environment. I acknowledge that [The Little Lotus of Lynbrook] and its affiliates are not responsible for any allergic reactions that may occur. I take full responsibility for providing any necessary medications, such as epinephrine auto-injectors, and instructions for their use in case of an allergic reaction. I also acknowledge that [The Little Lotus of Lynbrook] is not responsible for emergency medical treatment in the event of a severe allergic reaction. By signing this waiver, I release The Little Lotus of Lynbrook and its affiliates from any liability in the event of an allergic reaction.

7. Smoking and Drinking:

I understand that The Little Lotus of Lynbrook has zero tolerance for smoking and drinking.

8. Medication:

I understand that The Little Lotus of Lynbrook administers absolutely NO medication.

9) Miscellaneous:

a.  This Agreement contains the entire agreement between the parties and supersedes all prior negotiations, understandings, and agreements between the parties.

b. If any provision of this Agreement is found to be invalid, the remaining provisions shall remain in full force and effect.

c.  This Agreement shall be governed by the laws of [New York/United States of America].

I, the undersigned, have read and understood this Waiver and Release Agreement, and I voluntarily sign it, intending to be legally bound.

Date: December 4, 2024

Food Allergy

Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member. Please list any allergies here: TBD

TERMS AND CONDITIONS

1. You must arrive 5 minutes prior to your scheduled play time or class time.

2. Socks must be worn at all times.

3. We are a peanut-free facility.

4. We are not responsible for any lost, damaged, or missing items.

5. For yoga sessions or other fitness classes, participants acknowledge and agree that The Little Lotus of Lynbrook is not liable for any injuries sustained during classes or while on the premises. It is the responsibility of the participant to consult a medical professional before starting any new exercise regimen. 

6. For play sessions and other children's classes, adults are fully responsible for the safety of their children at all times. Children may NOT be left unsupervised. The Little Lotus of Lynbrook is NOT responsible for any accidents or injuries.

7.  No refunds for missed classes. No refunds will be provided for cancellations made within 24 hours of the scheduled class or session.

8. Please be advised that pictures may be taken during activities for business marketing and promotional purposes.

9. Please respect other users of the space and staff members.

10. Please help maintain the cleanliness of the play area by cleaning up after yourself. No outside food or drinks allowed. 

11. Use play equipment and toys appropriately to avoid accidents. 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
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 Information

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
Third Participant's Name

First Name*

Middle Name

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

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
Fourth Participant's Name

First Name*

Middle Name

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

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
Fifth Participant's Name

First Name*

Middle Name

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

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
Sixth Participant's Name

First Name*

Middle Name

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

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
Seventh Participant's Name

First Name*

Middle Name

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

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
Eighth Participant's Name

First Name*

Middle Name

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

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
Ninth Participant's Name

First Name*

Middle Name

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

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
Tenth Participant's Name

First Name*

Middle Name

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

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Participant's 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:*
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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Food Allergy
Although we are not accountable/responsible for food allergies, it is important to be aware of any allergies that you or your child may have. Always be sure to inform a staff member.


Please list any allergies here:
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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