Release of Liability Waiver Form
For Activities, Classes, and Other Programs Sponsored by Planet Play
Sign in to Google to save your progress. Learn more
Email *
Participation
I understand that upon entering I am being permitted to utilize the facilities, services and programs of Planet Play, for any
purpose, including, but not limited to observation or use of facilities or equipment, or participation in any program. I hereby acknowledge, agree and represent that I have inspected and carefully considered such premises and facilities safe and reasonably suited for myself and my children to participate. During time spent inside Planet Play, it is my primary responsibility to accompany my child and make sure they are safe and acting in a way to keep other children, parents, and guardians safe. My child is in good health and able to participate safely.
Participation
I understand that upon entering I am being permitted to utilize the facilities, services and programs of Planet Play, for any
purpose, including, but not limited to observation or use of facilities or equipment, or participation in any program. I hereby acknowledge, agree and represent that I have inspected and carefully considered such premises and facilities safe and reasonably suited for myself and my children to participate. During time spent inside Planet Play, it is my primary responsibility to accompany my child and make sure they are safe and acting in a way to keep other children, parents, and guardians safe. My child is in good health and able to participate safely.
Waiver and Release
I hereby voluntarily, fully and forever waive, release and discharge Planet Play, its owners, officers, directors, agents, employees, volunteers, and all other persons or entities acting in any capacity on its behalf (hereinafter referred to collectively as “PP”) from any and all losses, liabilities, claims, expenses, demands, actions, damages, injuries, causes of action, and rights of action which are related to, arise out of, or are in any way connected with my child’s participation in activities at, with, or sponsored or administered by PP. The foregoing waiver of liability includes, without limitation, damages or injury resulting from the negligence of PP (whether such claims are based upon breach of contract, breach of warranty, or any other legal theory) or from any other cause or causes.
Assumption of Risk
I understand that my child may suffer physical harm as a result of the acts or omissions of me, PP, or other participants due to his or her participation in activities at, with, or sponsored or administered by PP. My child elects to participate in spite of the risks.
Covenant Not To Sue
I agree not to institute any suit or action at law or otherwise against PP, or to initiate or assist in the prosecution of any claim for damages or cause of action which my child or I may have by reason of injury to my child, myself, or property related to, arising out of, or in any way connected with my child’s participation in activities at, with, or sponsored or administered by PP.
Indemnity
I agree to indemnify, defend, and hold harmless PP from any and all losses, liabilities, claims, expenses, actions or proceedings of any kind which may be initiated by myself, including n behalf of my child, or any other person or entity related to, arising out of, or in any way connected with my child’s participation in activities at, with, or sponsored or administered by PP. This includes reimbursement for all legal costs and attorneys’ fees incurred by PP, myself, and other indemnified parties, or any of them, for the defense of any such actions.
Medical Expenses
I will pay for my child’s and my own emergency medical expenses and all subsequent medical expenses in the event of any incident, accident, illness or incapacity, regardless of whether I have otherwise authorized such expenses.
Photography Release
I give consent for myself or my child to be photographed, videotapes or filmed while participating in Planet Play’s activities and for the resulting images to be used by Planet Play for promotional purposes.
By signing this Waiver, I make all of the preceding statements for and on behalf of myself, my spouse, my children, my parents, and any of our or their heirs, assigns, personal representatives, and estates. I understand that I will receive marketing materials regarding the facility and special events.
If you would like a copy of your waiver, please select "Send me a copy of my responses" below before submitting, or ask our front desk for a paper copy.
Date          (select today's date MM/DD/YYYY) *
MM
/
DD
/
YYYY
Parent/Guardian's Name *
Please type the first and last name of the party host. If attending open play, put "none"
Child/Children's Names          (separate with commas. Example: Joe, Jane, Jax) *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy