Release of Liability Waiver
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 address *
#1 *
Required
#2 *
Required
#3 *
Required
Parent First Name *
Your answer
Parent Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Emergency Phone
Your answer
Child 1 Name *
Your answer
Child 1 Birthday
MM
/
DD
/
YYYY
Child 2 Name
Your answer
Child 2 Birthday
MM
/
DD
/
YYYY
Child 3 Name
Your answer
Child 3 Birthday
MM
/
DD
/
YYYY
Child 4 Name
Your answer
Child 4 Birthday
MM
/
DD
/
YYYY
By initialing below and submitting this form you agree to all conditions set in this document above. *
Your answer
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