Release of Liability Waiver

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All information provided in this document is used for insurance purposes only. No information is shared to any entity in any form. In exchange for participation in the activity of indoor play organized by The Big Backyard, LLC, I agree for myself and (if applicable) for the members of my family, to the following conditions:

Email *

#1 *

I represent that I am the parent or legal guardian of the participant named below, or I have obtained permission from the parent/guardian of the participant named below to execute this agreement on their behalf. I further represent that the participants are healthy and physically able to participate in any and all undertaken activities.

#2 *

I agree that the participant(s) named below and I shall comply with all stated and customary terms, posted safety signs, rules, and verbal instructions as conditions for play and participation in any party and/or program at The Big Backyard, LLC. I agree to pay for all damages to the facilities of The Big Backyard, LLC caused by my or my family's negligent, reckless, or willful actions. In addition, if I observe any hazard during our participation, I will bring it to the attention of the nearest The Big Backyard, LLC employee or official immediately.

Required

#3 *

I recognize that there are certain inherent risks associated with use of the play area, parties, and programs and I assume full responsibility for personal injury to myself and (if applicable) my family members. I, for myself and the participant(s) named below, and our respective heirs, assigns, administrators, personal representatives, and next of kin, waive, release and discharge The Big Backyard, LLC, its affiliates, officers, members, agents, employees, other participants, and sponsoring agencies for injury, loss or damage arising out of or related to our participation in any and all of The Big Backyard, LLC programs, activities, parties, and/or the use of the the facilities of The Big Backyard, LLC. This waiver and release shall apply to all risks, known and unknown, even if resulting from negligent actions of other guests or employees of The Big Backyard, LLC.

Required

E-mail *

Parent's First Name *

Parent Last Name *

Address *

City *

State *

Zip Code *

Emergency Phone *

Child 1 Name *

Child 1 Birthday

YYYY

Child 2 Name

Child 2 Birthday

YYYY

Child 3 Name

Child 3 Birthday

YYYY

Child 4 Name

Child 4 Birthday

YYYY

By initialing below and submitting this form you agree to all conditions set in this document above. *

A copy of your responses will be emailed to the address you provided.

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