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Winnie’s Playroom Participant Waiver & Release of Liability

Required for all guests before entry, party participation, or membership use.

Welcome to Winnie’s Playroom! We’re so excited to have you here. To help keep our space safe, clean, and fun for everyone, every parent or legal guardian must complete this waiver before their child plays—whether you’re here for open play, a birthday party, special event, or as a member.

1. Assumption of Risk

I understand that Winnie’s Playroom is a play space where children may climb, jump, run, and engage in physical activity. I acknowledge that there are inherent risks associated with play, and I assume full responsibility for any injuries or accidents that may occur while my child is participating in activities, whether supervised or unsupervised.


2. Supervision

I understand that parent or guardian supervision is required at all times. Winnie’s Playroom is not a drop-off facility, and I am responsible for supervising the child(ren) in my care.


3. Designed for Ages 0–6

I understand that the play areas are designed exclusively for children ages 0–6. Children older than 6 are not permitted to play in the play areas, but they are welcome to relax in our café space while accompanying younger siblings or guests.


4. House Rules

To ensure a safe and respectful environment, all guests must follow our playroom rules:

  • No shoes in the play area — socks only for both children and adults
  • No food or drinks are allowed in the play area
  • Please treat all toys and equipment with care and help us keep the space tidy

Failure to follow these rules may result in being asked to leave the facility.


5. Health & Safety

I confirm that the child(ren) in my care are healthy and free from any contagious illness. I agree not to bring sick children into the play space and understand that Winnie’s Playroom may ask us to leave if illness is suspected, in order to protect others.


While Winnie’s Playroom takes reasonable steps to maintain a clean and sanitary environment, I acknowledge that the facility cannot guarantee protection against the spread of illnesses, and I will not hold Winnie’s Playroom responsible for any illness or exposure that may occur during or after a visit.


6. Birthday Parties & Memberships

This waiver applies to all visits to Winnie’s Playroom, including open play, birthday parties, special events, and member access. I agree to the same safety, supervision, and behavior expectations for each visit.


7. Release of Liability

In consideration of being allowed to enter and use the facilities at Winnie’s Playroom, I hereby waive, release, and discharge Winnie’s Playroom, its owners, staff, and affiliates from any and all liability, claims, or causes of action for personal injury, property damage, or wrongful death resulting from participation, whether caused by ordinary negligence or otherwise.


8. Agreement

I am the parent or legal guardian of the child(ren) listed, or have been authorized by the parent/legal guardian to sign this waiver and release on their behalf. I have read and understood this waiver. I agree to follow all posted rules and staff instructions. This waiver applies to all current and future visits unless revoked in writing.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle 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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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