Assumption of Risk, Waiver, and Release from Liability


I, the undersigned, am an adult entrusted to care for the child(ren) named below. I have carefully reviewed the contents of this waiver and release and knowingly and intelligently enter into this agreement, recognizing and appreciating that I am giving up mine and my child’s right to sue. I am legally authorized to sign on the child’s/children’s behalf. I desire to allow my child(ren) and/or the child(ren) entrusted to my care to use the facilities at Kids at Play. This Assumption of Risk, Waiver, and Release of Liability covers all activities, equipment, supplies, and supervision at Kids at Play. I understand that any individual that is not bound by this agreement has no right to use the enter the facilities or participate in any activities at Kids at Play.

I have read and understand the above paragraph.

1. Risk Factors‐ I understand and acknowledge that the use of the facilities at Kids at Play involves risks including, but not limited to the following: any type of bodily injury including but not limited to permanent disability, paralysis, and death. These risks may result from a variety of circumstances including the misuse of equipment or facilities and supervision as well as other children and adults and any other patrons of Kids at Play.

I have read and understand the above paragraph.

2. Assumption of Risk‐ I am choosing to use the facilities at Kids at Play at my own risk as well as my child’s. Kids at Play makes no warranties or representations as to the safety of use of facilities and/or participation in any activities at Kids at Play. I acknowledge that it is my sole responsibility to supervise my child(ren) while using the facilities at Kids at Play and that Kids at Play does not offer supervision of children. I assume full responsibility for all risks all activities, including equipment, supplies, and supervision that may arise from using the facilities at Kids at Play or from participating in activities at Kids at Play and relieve Kids at Play from any such responsibility. I understand that I am solely responsible for any medical, health, or personal injury costs relating to my use of Kids at Play and its facilities.

 I have read and understand the above paragraph.

3. Acknowledgement of Policies and Procedures‐ I acknowledge that I have read, know, and agree to all of the policies and procedures relating to the use of the facilities at Kids at Play. I agree to comply with all rules, regulations, and policies at Kids at Play. I understand Kids at Play reserves the right to revoke or terminate my use of the facilities at Kids at Play for any violation of rules, regulations, or policies.

  I have read and understand the above paragraph.

4. Release, Indemnify, and Defend‐ I hereby release, waive, discharge, and hold harmless and agree to indemnify Kids at Play and all employee, officers, owners, agents, servants, workmen and independent contractors past or present from any damage including but not limited to, claims, suits, liabilities, judgments, costs and expenses for any property damage, loss or theft, personal injury or illness, death, disease, medical expenses and any other losses whatsoever arising from the use of Kids at Play.

 I have read and understand the above paragraph.

5. Prerequisite skills‐ I acknowledge that I, and any children entrusted to my care, using Kids at Play have the skills, qualifications, physical ability to properly and safely use the facilities at Kids at Play, and Kids at Play has not performed any type of screening to make that determination and is solely and wholly relying on my representations of those qualifications. 

 I have read and understand the above paragraph.

6. Waiver‐ I hereby waive any protections afforded by any statute or law in any jurisdiction whose purpose and/or effect is to provide that this waiver is invalid, limited or inapplicable and therefore I am releasing unknown future claims. Notwithstanding the above, if any claim is allowed for any reason I agree that my sole remedy is to enter into mutually binding arbitration in Pennsylvania where each party shall agree to select an arbitrator of their choosing and they will in turn agree on a neutral in accordance with standard arbitration procedures.

 I have read and understand the above paragraph.

7. Representatives‐ I enter into this agreement for myself and child(ren) and agree to bind my heirs, assigns, and legal representatives.

 I have read and understand the above paragraph.

8. If emergency First Aid is rendered, I understand that I am waiving any and all claims resulting from the First Aid and all the terms and provisions of this agreement remain in full force and effect under those circumstances.

 I have read and understand the above paragraph.

Consent and Release on Behalf of Minor by Parent/Legal Guardian

After reading the following paragraph, name any minor who is accompanying you to Kids at Play on the line provided. I am the parent or adult entrusted to care for the minor(s) named below. I have read and understand this Assumption of Risk, Waiver and Release form Liability and understand that it relates to surrendering valuable legal rights of the minor(s) and myself. I agree to be bound by all the terms of the Assumption of Risk, Waiver, and Release from Liability. I give my consent for participation at Kids at Play.

Names of minors accompanying you to Kids at Play:

Your phone number:

Policies and Procedures

  1. All children must be accompanied by an adult.
  2. You must supervise your child at all times while at Kids at Play.
  3. Equipment may only be used in its intended normal use.
  4. Please be courteous of other patrons and do not bring sick children to Kids at Play.
  5. Kids at Play is a germ-free environment. All patrons must use the hand sanitizer provided before playing on any equipment. Please re-apply as needed.
  6. Please help us all stay healthy and promptly clean up any bodily discharge. Notify a staff member if you need assistance.
  7. No food or drink whatsoever allowed in the play area.
  8. No shoes allowed on play equipment or in ball pits.
  9. Socks must be worn at all times.
  10. Kids at Play is not responsible for loss, damage or theft of personal effects. This includes, but is not limited to, items placed in the cubbies or items lost/damaged while playing.
  11. You must listen to and abide by Kids at Play employee’s instructions.
  12. At its own discretion, Kids at Play can refuse to allow use of its facilities and equipment to anyone it so chooses.
  13. When other patrons are waiting to use the zip line, use is limited to two times back and forth.  
  14. When other patrons are waiting to use a swing or other equipment, please limit your use to no longer than three minutes.
  15. The virtual playground is limited to four players at one time.
  16. When other patrons are waiting to use the virtual playground, play is limited to one complete game.
  17. Kids at Play therapists who are actively working with a child are not subject to time restrictions on equipment. During therapy sessions certain pieces of equipment may not be available for Open Play.
  18. Kids at Play birthday party participants may be given exclusive use of certain equipment. Please do not attempt to use the equipment while it is designated for a birthday party.
  19. Violation of Policies and Procedures may result in having to leave Kids at Play and no refund will be given.

I have read and understand this Assumption of Risk, Waiver and Release form Liability and understand that it relates to surrendering my valuable legal rights. I agree to be bound by all the terms of the Assumption of Risk, Waiver, and Release from Liability.

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Kids at Play - Indoor Playground PA https://kidsatplaypa.com
Signature Certificate
Document name: Assumption of Risk, Waiver, and Release from Liability
Unique Document ID: 8d6805ffeb9a50dc49015aeb1ab71f4872eb7efe
Timestamp Audit
May 15, 2017 11:59 am ESTAssumption of Risk, Waiver, and Release from Liability Uploaded by Julia Katz - office@kidsatplaypa.com IP 72.174.11.70