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Piper’s Place New Client Waiver Child Information 

In Consideration of being allowed to enter the play area and/or participate in any party, event, sensory play, water play, outdoor garden play, and/or program and/or field trip at Piper’s Place Discovery Museum, 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: I represent that I am the parent or legal guardian of the participant(s) named above, or have obtained permission from the parent/legal guardian of the participant(s) named above to execute this agreement on their behalf. I agree that the participant(s) named above and I shall comply with all stated and customary terms, posted safety signs, rules, and verbal instructions as conditions for participation in any play and or party, event, sensory play, water play, outdoor garden play, and/or program and/or field trip party and/or program at Piper’s Place Discovery Museum. In addition, if I observe any hazard during our participation, I will bring it to the attention of the nearest Piper’s Place Discovery Museum employee or official immediately. I understand that I am responsible for my child's safety and behavior at all times each visit. I am aware that there are inherent risks associated with participation in Piper’s Place Discovery Museum play area and/or participate in any party, event, sensory play, water play, outdoor garden play/use, and/or program and/or field trip and or parties and I on behalf of myself and the participant(s) named, knowingly and freely assume all such risk both known and unknown, including those that may arise out of the negligence of other participants; I for myself and the participant(s) named above and our respective heirs, assigns, administrators, personal representatives, and next of kin, hereby release and hold harmless, Piper’s Place Discovery Museum, and Piper’s Place Discovery Museum management, their affiliates, officers, members, agents, employees, other participants, and sponsoring agencies from and against any and all claims, injuries, liabilities or damages arising out of or related to participation in any and all Piper’s Place Discovery Museum programs, activities, parties, sensory play, events, water play, outdoor garden play/use and the use of the play area.

Photo Release Form for Minors (if under 18) Project Play Professional Corporation has my permission to use my or my child's photograph publicly to promote the Project Play Discovery Museum. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use

Date: April 24, 2025

Personal Property

Piper’s Place Discovery Museum LLC, its agents and employees are not responsible for guests personal property. It is the sole responsibility of each person entering into the facility to be responsible for all possessions and belongings unless pre-arranged with Piper’s Place Discovery Museum LLC, and/or its staff. Under no circumstances shall, Piper’s Place Discovery Museum LLC, its agents or employees, take responsibility for any lost, stolen, missing or damaged personal property or otherwise.

Date: April 24, 2025

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
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*

Phone*
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 or Guardian's Date of Birth*
Parent or Guardian's Information
Photo Release*
Yes, I give photo consent for my child(ren)
No, I do not give photo consent for my child(ren)
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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