I would like to be added the Playhouse email newsletter.
Adult First Name
Adult Last Name
If your primary residence is North Carolina, what county do you live in?
If your primary residence is outside North Carolina, what State do you live in?
Number of children in your party today
Ages of children with you today (check all that apply)
under 12 months
13 to 23 months
2 years old
3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
Over 8 years old
Number of adults in your party today (including you)
Have you visited The Children's Playhouse before?
1 time before
How did you hear about The Children's Playhouse?
word of mouth
Are you a member's guest?
Yes, I am adult here with member children
Yes, I am here with a member family and my own children
Please read the release form and signal your agreement to these terms by typing your name below. A large print copy is available at the desk.
As parent or caregiver for the children with me today, I do hereby release The Children’s Playhouse and its staff from any and all liability for injury, illness, or any other condition of my child(ren) that may occur while at The Children’s Playhouse, during participation in any activities or programs of The Children’s Playhouse, or as a direct or indirect result of participation in any activities or programs of The Children’s Playhouse, and waive my right to pursue legal action against The Children’s Playhouse or its staff or volunteers in connection with any such, injury, illness or condition. I understand that my child(ren) must be accompanied by an adult at all times while at The Children’s Playhouse and that the primary goal and responsibility of The Children’s Playhouse staff is to facilitate participation in creative learning activities and not to serve as caretakers to my child(ren). I further understand that The Children’s Playhouse provides resources and activities designed for children birth through eight years of age and that there may be activities that are not age appropriate or developmentally appropriate for my child(ren)’s participation. In addition, some activities may not be appropriate for my child(ren) because of a physical, medical, or other condition of my child. As a parent, I am responsible for monitoring the activities of my child(ren) while at The Children’s Playhouse and choosing activities that are appropriate for my child(ren). However, I understand that The Children’s Playhouse also reserves the right to limit my child(ren)’s participation in an activity based on safety issues or other program-related concerns.
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