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PlayPatch Playhouse waiver
Please read this waiver and check the box at the bottom that you have read and agreed to the terms below

We do NOT sell your information. It's strictly for the liability waiver that is required to enter and play at PlayPatch Playhouse, LLC.
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Email *
Parent/legal guardian name (First & Last) *
Date of birth of parent/guardian *
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/
DD
/
YYYY
Zip code of parent/guardian *
Name of Minor (First & Last) *
Date of birth of minor *
MM
/
DD
/
YYYY
Name of Minor #2 (First & Last)
Date of birth of minor #2 
MM
/
DD
/
YYYY
Name of Minor #3 (First & Last)
Date of birth of minor #3 
MM
/
DD
/
YYYY
Parent/Guardian Phone number *
I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND
THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO
SUE.
I ACKNOWLEDGE THAT I UNDERSTAND AND ASSUME ALL RISKS
DESCRIBED ABOVE. I AM SIGNING THE AGREEMENT VOLUNTARILY, I AM AT
LEAST EIGHTEEN (18) YEARS OF AGE, AND I HAVE THE LEGAL AUTHORITY TO
SIGN ON BEHALF OF THE PARTICIPANT.
 *
Required
I understand the attending adult(s) MUST wear socks and the children MUST wear grip socks on the play surface at all times. *
Required
A copy of your responses will be emailed to the address you provided.
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