Waiver View Page

We require Parent or Guardian signature on our waiver for each child, at each visit, upon arrival. Children may ONLY play in play area with a parent/guardian signed waiver and if wearing non-slip socks.

 

TINY TOWN PLAY CAFE LLC
LIABILITY WAIVER AND RELEASE FORM

As parent or legal guardian of the child whose name is set forth below (referred to herein as the "Participant") and in consideration of the Participant being permitted to participate in the activities conducted by Tiny Town Play Café LLC (referred to herein as "Tiny Town Tulsa Play Cafe"), the Participant and I agree as follows:

1. I am fully aware of the risks and hazards connected with the activities which may take place in this building. Such risks and hazards include but are not limited to: - Falls on or from the equipment - Tripping - Collisions with the equipment or with other participants I am aware that such activities include the risk of bodily injury to the Participant. Injuries that could result will vary but may include (a) minor injuries such as scratches, bruises and sprains; (b) major injuries such as eye injury, joint or back injuries or concussions; and (c) catastrophic injuries, including paralysis and even death. I understand that Tiny Town Tulsa Play Cafe does not require me to participate in this activity.

2. I voluntarily assume full responsibility for any risks of loss, property damage or personal injury that may be sustained by me, or any loss or damage to property owned by me, as a result of being engaged in such activities.

3. I understand that adult supervision of each child by that child's parent or authorized caregiver is required at all times. Tiny Town Tulsa Play Cafe shall not be liable for any injury resulting from an absence of adult supervision, including but not limited to, any child leaving the property of Tiny Town Tulsa Play Cafe without a parent or guardian.

4. I understand that my agreement and completion of this Waiver on the first visit will authorize Tiny Town Tulsa Play Cafe to use it as a continuous waiver for my child's/children's ongoing participation in the Activities or use it as a Waiver executed for my other child/children. I hereby expressly authorize Tiny Town Tulsa Play Cafe to use this Waiver as a multi-use waiver until I have expressed to change this in writing.

5. I acknowledge that I have read, know and agree to all of the policies and procedures relating to the use of the facilities at Tiny Town Tulsa Play Cafe. I agree to comply with all rules, regulations and policies. I understand Tiny Town Tulsa Play Cafe reserves the right to revoke or terminate my use of the facilities for any violation or rules, regulations or policies.

6. I agree to pay for any and all damages to any property or equipment as a result of my or my family's willful actions, neglect or recklessness and agree to held liable for all such costs associated with such damages.

7. I hereby release, waive, discharge and hold harmless Tiny Town Tulsa Play Cafe and all employees past or present from any claims, suits, liabilities, judgements, costs and expenses for any property damage, loss or theft, personal injury or illness, death or other loss arising from the use of Tiny Town Tulsa Play Cafe.

Parent Or Legal Guardian Certification And Consent

I hereby certify that I am the parent or legal guardian of the Participant whose name(s) appears below, and I have the authority to waive rights on behalf of the minor Participant.

I have read and understand all of the provisions of this document and the risks of the Activities. I understand that the Activities could cause injury or even death. I acknowledge that I have read and understand the terms of this document and I am freely and voluntarily signing this document.

I HAVE READ THE ABOVE WAIVER AND BY SIGNING IT I AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE TINY TOWN TULSA PLAY CAFE FROM ALL LIABILITY FROM UTILIZING THE FACILITIES.

 By checking this box, I allow Tiny Town Tulsa Play Café to send me emails and/or text messages with special offers, coupons, promos and/or discounts. I understand my info will not be sold in any way and will only be used by Tiny Town Tulsa Play Café staff.

Childs full name____________________________

Childs Birthdate____________________________

Parent/Guardian Signature___________________

Parent/Guardian Printed Name_______________________

Email________________________

Date_________________________