Waiver

Precious Ones Indoor Playground's Waiver, Release, Hold Harmless, and Indemnification Agreement
As Consideration for being allowed to enter our facility, the play area and/or Participate in any party and/or program
at Precious Ones Indoor Playground, the undersigned, on his or her behalf, and on the behalf of the Participant(s) identified below,
acknowledges, appreciates, understands, and agrees to the following:
1.) I represent that I am the parent or legal guardian of the Participant(s) named below or I have obtained
permission from the parent/legal guardian of the Participant(s) named below to execute this agreement on their
behalf. {Print names and information below}
______________________________________________________________________________________________
Participant Name Date of Birth Participant Name Date of Birth
______________________________________________________________________________________________________
Participant Name Date of Birth Participant Name Date of Birth
______________________________________________________________________________________________________
Participant Name Date of Birth Participant Name Date of Birth
2.) I acknowledge and understand that there are risks associated with participation in Precious Ones Indoor Playground activities, use
of the facility and the use of the play indoor play area and equipment including but not limited to: contusions,
fractures, scrapes, cuts, bumps, paralysis, or death.
3.) I, for myself and the Participant(s) named, willingly assume any and all risks associated with participation and
accept that there are also risks that may arise due to OTHER PARTICIPANTS which I also willingly assume and
accept.
4.) I agree that the Participant(s) named, and I shall comply with all stated and customary terms, posted safety
signs, rules posted in the facility and on the company's website, and verbal instructions as conditions for participation
in the use of the facility, the indoor play area, any party and/or program at Precious Ones Indoor Playground.
5.) I, for myself, the Participant(s) named, our heirs, assigns, representatives, and next of kin agree to hold harmless
and indemnify the independent owner of this Precious Ones Indoor Playground facility, corporation, their
predecessors, parent, subsidiaries and affiliates, officers, and employees from any and all injuries, liabilities or
damages from participation.
6.) I additionally agree to indemnify the independent owner of this Precious Ones Indoor Playground facility, corporation, their predecessors, parent, subsidiaries and affiliates, officers, and employees for any defense cost
or expense arising from any and all claims, injuries, liabilities or damages arising from participation.
7.) I am of physical ability to participate and am legally competent to understand and complete this agreement. I
hereby execute this agreement without coercion.
8.) The invalidity or unenforceability of any provision of this Agreement shall not affect the validity or enforceability
of any other provision of this Agreement, which shall remain in full force and effect.
9.) Any controversy, dispute, or claim arising out of or related to this Agreement, which the parties are unable to
resolve by mutual agreement, shall be settled exclusively by submission by either party of the controversy, claim or
dispute to binding arbitration in Los Angeles, California before a single arbitrator in accordance with the rules of
the American Arbitration Association then in effect.
Parent / Guardian Name (please print):______________________________________________________________________
Parent / Guardian Signature : ____________________________________________________________ Date : ____________
Address : ___________________________________City : ____________________ State : __________ Zip : _____________
Emergency Contact number : ( ) ____ - ______ or ( ) ____ - ______