Complete a waiver for myself
Complete a waiver for myself and children
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Liability Waiver

Please read the waiver below and fill out the required fields found in the following form sections. All liability language from the waiver will apply to all persons listed below.

                  KIDZ-N-PLAY Liability Waiver, Release and Assumption of Risk

I have voluntarily elected to allow the minor child(ren) identified below and all minor children under my supervision and referred to individually and collectively herein as (“Child” or “Children”), to use the KIDZ-N-PLAY Facilities and equipment located at 2322 Highway 45 N Suite 2, Columbus, Mississippi 39705, (the “KIDZ-N-PLAY Facility”). In consideration for being allowed to use said facilities and equipment, and any other services provided by KIDZ-N-PLAY or its employees or agents at said location, or any other location within the State of Mississippi, I – on behalf of myself, my Child, or any other person under my supervision or control - represent, acknowledge and agree as follows:

GENERAL RELEASE

I acknowledge and agree that this Agreement (the “Agreement”) covers and is intended to release and provide other benefits, contracting Covid-19 (Coronavirus) legal protections, and consideration to Kidz-N-Play LLC, and their respective and collective agents, owners, officers, managers, shareholders, affiliates, assigns, volunteers, participants, employees, and all other persons or entities acting in any capacity on their respective or collective behalf (collectively, the “Company”). I acknowledge and agree that the terms and conditions in this Agreement shall apply to adult and minor participants and/or observers alike.

DESCRIPTION OF ACTIVITIES, RISKS, AND POTENTIAL FOR INJURY

I acknowledge and agree that I am executing this Agreement as consideration for my Child, myself and any other person under my supervision and control to use the KIDZ-N-PLAY Facilities and participate in related activities. The use of the playground area and equipment at the KIDZ-N-PLAY Facility, and participating in other related activities, is inherently and obviously dangerous. These risks include serious physical or emotional injury, contracting Covid-19, including but not limited to scrapes, cuts, bruises, sprains, fractures, pinches, concussion, death, damage to myself, the Child, and/or third parties, and damage to personal property of any or all such persons. I understand that the risk of injury extends to all extremities and all other parts of the body. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity, which I further agree is for recreational purposes and completely voluntary. I acknowledge and agree that, while the activities that take place at the KIDZ-N-PLAY Facility are monitored generally by KIDZ-N-PLAY Facility employees, it is not feasible for such employees to monitor the activities and actions of all customers at all times or all customers simultaneously. Furthermore, KIDZ-N-PLAY Facility employees have difficult jobs to perform. They seek safety, but they are not infallible.

VOLUNTARY ASSUMPTION OF RISK

I acknowledge and agree that I and the Child are participating voluntarily at our own risk. I acknowledge and agree that the actions or activities of other customers or the actions or inactions of KIDZ-N-PLAY Facility employees could cause me or the Child injury (as described in this Agreement), and that the Company is not responsible for the actions, contracting Covid-19, or activities of other customers using the KIDZ-N-PLAY Facility or the negligence of its employees in supervising the KIDZN-PLAY Facility or its usage, including actions, activities, or omissions that result in such harm.

AGREEMENT TO PAY MY OWN MEDICAL EXPENSES

I acknowledge, accept, and assume the risk of any and all medical conditions, limitations, or disabilities (whether temporary or permanent) that I or the Child possess, whether known or unknown, which might contribute to or exacerbate any injury I or IP: 50.213.139.254 Email: scott@aluvii.com Version: 1.0.0.20190102 Page 1 of 5 the Child might sustain as a result of using the KIDZ-N-PLAY Facility or any of its equipment. I acknowledge and agree that if medical assistance (of any form, including emergency care, hospitalization, out-patient care, and/or physical therapy) is required or performed as a result of any injury I or the Child sustains while using the KIDZ-N-PLAY Facility, such assistance shall be at my own expense.

RELEASE OF LIABILITY

The Releasing Parties (as defined below) hereby forever, irrevocably and unconditionally release, waive, relinquish, discharge from liability and covenant not to sue the Company, and their successors, predecessors-in-interest, and insurers (collectively, the “Releasees”) from any and all claims, demands, rights, actions, suits, causes of action, obligations, debts, costs, losses, charges, expenses, attorneys’ fees, damages, judgments and liabilities, contracting Covid-19, of whatever kind or nature, in law, equity or otherwise, whether now known or unknown, suspected or unsuspected, and whether or not concealed or hidden, related to or arising, directly or indirectly, from my or the Child’s access to and/or use of the KIDZ-N-PLAY Facility, premises and/or its equipment, the Child’s and/or my entry into the KIDZ-N-PLAY Facility, the condition, maintenance, inspection, supervision, control or security of the KIDZ-N-PLAY Facility, the failure to warn of dangerous conditions in connection with the KIDZ-N-PLAY Facility, and/or the acts or omissions of the Company or any of the Releasees, including, without limitation, any claim alleging negligent act(s) or omission(s) of Releasees. This release extends to claims seeking relief for any and all forms of damage or injury, including property damage, personal injury, emotional injury, illness, bodily harm, paralysis or death. I understand that this release and waiver applies to all activities and games at the KIDZ-N-PLAY Facility. I understand that this release and waiver applies to and includes all activities that I or my Child engage in at the premises, whether inside or outside the KIDZ-N-PLAY Facility. In the event that any claim released herein is brought by, or asserted on behalf of, the Releasing Parties, I shall immediately defend, indemnify and hold harmless the Releasees, and any of them, from any loss or liability, including reasonable attorneys' fees, associated therewith or arising therefrom.

I understand and fully acknowledge and agree that all of the risks identified herein and any other risks associated with use of the KIDZ-N-PLAY facility and its equipment are sometimes beyond the control of the Releasees. I agree and acknowledge that should The Company or any other Releasee or anyone acting on their behalf, be required to incur attorneys' fees and/or costs to enforce this agreement, I agree to immediately defend, indemnify and hold The Company and any other Releasee or them harmless for and against all such attorneys’ fees and/or costs.

In the event of a medical emergency and when the parent or guardian of a Child is unavailable, the undersigned hereby further authorize(s) any of the staff, employees, agents and representatives of the Company to provide for, approve and authorize any health care at any hospital, emergency room, doctor's office or other institution, employ any physicians, dentists, nurses or other person whose services may be needed for such health care, review and if necessary disclose the contents of any medical records, execute any consent form required by medical, dental or other health authorities incident to the provision of medical, surgical, or dental care to the Child. Health care shall include, but not be limited to the administration of anesthesia, x-ray, examination, performance of operations, diagnostic and other procedures.

ARBITRATION OF DISPUTES; TIME LIMIT TO BRING CLAIM

I understand that by agreeing to arbitrate any dispute as set forth in this section, I am waiving my right, and the right(s) of the minor child(ren) above, to maintain a lawsuit against the Company and the other Releasees for any and all claims covered by this Agreement. By agreeing to arbitrate, I understand that I will NOT have the right to have my claim determined by a jury, and the minor child(ren) above will NOT have the right to have claim(s) determined by a jury. Reciprocally, the Company and the other Releasees waive their right to maintain a lawsuit against me and the minor child(ren) above for any and all claims covered by this Agreement, and they will not have the right to have their claim(s) determined by a jury. ANY DISPUTE, CLAIM OR CONTROVERSY ARISING OUT OF OR RELATING TO MY OR THE CHILD’S ACCESS TO AND/OR USE OF THE KIDZ-N-PLAY PREMISES AND/OR ITS EQUIPMENT, INCLUDING BUT NOT LIMITED TO CLAIMS FOR PERSONAL INJURY, BREACH OF CONTRACT, AND/OR THE DETERMINATION OF THE SCOPE OR APPLICABILITY OF THIS AGREEMENT TO ARBITRATE, SHALL BE BROUGHT WITHIN ONE YEAR OF ITS ACCRUAL (i.e., the date of the alleged injury) AND BE DETERMINED BY ARBITRATION IN THE COUNTY OF THE KIDZ-N-PLAY FACILITY, MISSISSIPPI, BEFORE ONE ARBITRATOR. THE ARBITRATION SHALL BE ADMINISTERED BY JAMS PURSUANT TO ITS RULE 16.1 EXPEDITED ARBITRATION RULES AND PROCEDURES, AS WELL AS APPLICABLE JAMS APPELLATE RULES AND PROCEDURES. JUDGMENT ON THE AWARD MAY BE ENTERED IN ANY COURT HAVING JURISDICTION. THIS CLAUSE SHALL NOT PRECLUDE PARTIES FROM SEEKING PROVISIONAL REMEDIES IN AID OF ARBITRATION FROM A COURT OF APPROPRIATE JURISDICTION. This Agreement shall be governed by, construed and interpreted in accordance with the laws of the State of Mississippi, without regard to choice of law principles. Notwithstanding the provision with respect to the applicable substantive law, any arbitration conducted pursuant to the terms of this Agreement shall be governed by the Federal Arbitration Act (9 U.S.C., Sec. 1-16). I understand and acknowledge that the JAMS Arbitration Rules to which I agree are available online for my review at jamsadr.com, and include JAMS Comprehensive Arbitration Rules & Procedures; Rule 16.1 Expedited Procedures; and, Policy On Consumer Minimum Standards Of Procedural Fairness, as well as applicable JAMS Appellate Rules.

PHOTO/VIDEO/SOCIAL MEDIA WAIVER

In connection with my and the Child’s use of the KIDZ-N-PLAY Facility, I consent to the recording of the Child’s and my physical likeness and/or voice through mechanical, photographic, technical, digital, electronic or other means (“Recordings”). I hereby consent to and authorize the Company and its agents, representatives, employees, successors and assigns to use, in perpetuity, such Recordings, as well as the Child’s name and my name, for any purpose, including advertising, promoting, exploiting and/or publicizing any KIDZ-N-PLAY Facility. I further agree that the foregoing includes the consent to use the Child’s and/or my physical likeness in any form. In addition, I waive any and all claims I may have in connection with the Recordings.

TERM OF AGREEMENT

I understand that this agreement extends forever into the future and will have full force and legal effect each and every time I or my child(ren)/ward(s) visit KIDZ-N-PLAY, whether at the current location or any other location or facility.

SAFETY IS YOUR RESPONSIBILITY: I AND EACH CHILD AGREE TO FOLLOW THE CODE OF PATRON RESPONSIBILITY:

a) You acknowledge that there are inherent risks in using the KIDZ-N-PLAY Facilities. Patrons of the KIDZ-N-PLAY Facilities accept the risks inherent in such participation of which the ordinary prudent person is or should be aware. Patrons have a duty to exercise good judgment and act in a responsible manner while using the KIDZ-N-PLAY Facilities and other equipment, and while engaging in such activities. Patrons have a duty to obey all oral or written warnings, or both, prior to or during participation, or both.

b) You and your Child have a duty to properly use all safety equipment provided.

c) You have a duty to not participate and not to allow a Child to participate in any activity or use equipment, if you or a Child have pre-existing medical conditions that could cause injury to you or a Child.

d) Except for in the case of the Parents/Kidz Night Out (additional terms and conditions may apply to Parents/Kidz Night Out) where Children are dropped off by Releasing Parties, all Children must be supervised by a parent, guardian or caretaker at all times.

e) This agreement must be signed before participating in any activity at the KIDZ-N-PLAY Facilities.

f) No adult is permitted entry into the KIDZ-N-PLAY Facilities without a Child and not Child is permitted entry without an adult.

g) Socks are requested at all times. No shoes are permitted in the playground area. Bare feet are not permitted in the playground area.

h) No outside food, except baby food, milk or formula is permitted within the KIDZ-N-PLAY Facilities.

i) All dress-up clothes must remain in the pretend area.

j) No toys are permitted in the climbing structure.

k) Please do not bring sick Children to the KIDZ-N-PLAY Facilities.

ACKNOWLEDGEMENT OF RULES AND WARNINGS

I agree to follow and obey all posted and stated warnings, rules, policies, and patron education signs. I further agree that, as applicable, prior to each Child utilizing the Company facilities or equipment, I will ensure each Child understands all safety rules, warnings, and patron education and shall assume all responsibility for their compliance therewith.

I have had sufficient opportunity to read this document. I have read and understood and agree to be bound by its terms. I understand that employees working at the KIDZ-N-PLAY Facility, including the manager, do not have the authority to waive any provision of this Agreement. This Agreement constitutes and contains the entire agreement between the Company and me relating to the Child’s and my use of the KIDZ-N-PLAY Facility. There are no other agreements – oral, written, or implied – or any other outside terms or conditions with respect to such matters. I agree that if any portion of this Agreement is found to be unenforceable, the remaining portions shall remain in full force.

By signing below, I represent and warrant that I am the parent, legal guardian, or power-of-attorney of the below listed Child(ren) and have the authority to execute this Agreement on his/her or their behalf and to act on his/her or their behalf. I have read each and every paragraph in this document and I and they agree to be bound by the terms stated therein, including the release of liability contained therein. I further agree to indemnify and hold harmless the Releasees from any and all claims which are brought by or on behalf of this or these minor Child or Children, or any of them, which are in any way connected with, arise out of, or result from their use of the KIDZ-N-PLAY Facility. I am 18 years of age or older. I am entering this agreement on behalf of myself, my spouse or domestic partner, the Child, and our respective and/or collective issue, parents, siblings, heirs, assigns, personal representatives, estate(s), and anyone else who can claim by or through such person or persons (collectively, the “Releasing Parties”).

IN SUMMARY, BY MY SIGNATURE BELOW, I ACKNOWLEDGE THAT IF I OR ANY OF MY CHILDREN ARE INJURED IN ANY WAY, THIS WAIVER PREVENTS AND PROHIBITS ANY RECOVERY OF MONEY FROM ANY KIDZ-N-PLAY RELATED ENTITY.

 


By signing this waiver, I agree that all information is complete and accurate.