Loading...

In consideration of participating in the benefits, activities, events and even entry onto the premises, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence STEMVILLE, LLC and its owners, directors, officers employees, agents, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as “Releasees”), on behalf of myself and my children, parents, heirs, assigns, personal representatives and estate, and also agree as follows: 

1. I acknowledge that STEMVILLE, LLC may potentially involve activities involve known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death, and property damage. Risks include, but are not limited to, musculoskeletal injuries, broken bones, and/or overuse injuries, injuries caused by equipment that breaks or otherwise fails; materials that could potentially cause skin irritation and rash, death as a result of small piece choking hazard, hot coffee, or medical conditions resulting from physical activity; and damaged clothing or other property. It is also understood that at Stemville there are many toys, products, and materials that could potentially be choking hazards. I understand such risks simply cannot be eliminated, and even with the best of supervision, and despite the use of safety equipment, without jeopardizing the essential qualities of the activity. As such I agree to waive, release, defend and indemnify any claims brought against Stemville for my children or those that I am charged with the responsibility of bring to and from Stemville.

2. I expressly accept and assume all of the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event, activities or conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation.

3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands, or causes of action which are in any way connected with my participation in this activity, or my use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct outside the scope of the employment of STEMVILLE, LLC. It is at the discretion of STEMVILLE as to whether conduct shall be deemed as Intentional. If any claim, demand or case is filed and only claims an intentional act, STEMVILLE at it’s sole discretion may elect to declare the actions of its employees negligence. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

4. I represent that I have adequate personal insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume – and bear the costs of – all risks that may be created, directly or indirectly, by any such condition. If I do not have medical insurance and someone is hurt at the fault of STEMVILLE not only do I release all claims, I will not claim as damages any amount of medical bills or related expenses.

5. In the event that I file a lawsuit against Stemville, its owners, mangers, employees, servants or agents, I agree that the defense and indemnification will be paid by me or my insurer.

6. In the event that I file a lawsuit against Stemville I agree to do so solely in the state where Releasees’ facility is located, and I further agree that the substantive law of that state shall apply.

7. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

8. It is further agreed and understood that this release, waiver/ document is valid for subsequent visits to the STEMVILLE facility even if a document similar or substantially similar was not signed on the date an individual, child, parent, guardian, baby sitter, care provider or otherwise a person in charge of supervision.

9. It is further understood that in the event of a incident, injury, dispute, problem or like issue (hereinafter “incident”), I agree that I will make a formal report with Stemville management and fill out the required Incident Report Form prior to leaving the premises. In the event completing the form prior to leaving Stemville premises on the date of the incident, I agree to provide Stemville management with a completed incident report within 24 hours from the time of the incident.

10. It is also hereby acknowledge and agreed that from time to time photographic images or videos of you, your guests, group, attendees, your minor child, or those minor children who accompanied you or are within your care may be photographed or video taped for purposes of business promotional material to be used in print or digital social medial or on the Stemville website or other forms of business publications. I hereby release and consent and do represent that I have obtained authority to consent to such video or photographic images to be used by Stemville which may potentially include use of a minor Child’s first name to be published. I understand that all such images of photographs or videos are the property of Stemville, LLC and I further agree that I nor anyone on behalf of the anyone defined above will receive any compensation or royalties from the use of the images. I further authorize Stemville, LLC to copy, edit, enhance, crop, or otherwise alter any Photo for use in their publications. I also waive any rights for approval or inspection of any Photos. I agree to forever release and discharge liability or any claim I may have against Stemville, LLC and agree to defend and indemnify Stemville, LLC of all claims its affiliates, successors and assigns, officers, employees, representatives, partners, agents and anyone claiming through them, in their individual and/or corporate capacities from any and all claims, liabilities, obligations, promises, agreements, disputes, demands, damages, causes of action of any nature or kind, known or unknown, which I, and anyone claiming on behalf of me, may have or claim to have against Releasee in connection with this Release. 

By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence. 

I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms. 

Today's date: December 26, 2024

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 16 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*

PARENT OR GUARDIAN ADDITIONAL AGREEMENT (Must be completed for participants under the age of 18)

In consideration of minor(s) being permitted to participate in this activity, I further agree to indemnify and hold harmless Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor. 



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*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 16 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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!