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Imaginasium LLC DBA Imaginasium

A completed waiver is required for all children under the age of 18 who enter the facility.

ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY

INDEMNITY AGREEMENT AND MEDICAL CONSENT ("WAIVER")

In exchange for being able to participate in any and all activities at Imaginasium LLC, childrens indoor playground the undersigned acknowledges and agrees to the following.


1. Risk Factors‐ I understand and acknowledge that the use of the facilities at Imaginasium LLC involves risks including, but not limited to the following: 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.

2. Assumption of Risk‐ I am choosing to use the facilities at Imaginasium LLC at my own risk. I understand and acknowledge that the activities which I am or/and (any minor children for which I am the Parent, legal guardian, or otherwise responsible, any heirs personal representative) about to voluntarily engage in as a participant and/or volunteer bears certain know risks and unanticipated risk could result in injury, death, illness or disease, physical or mental, or damage to myself, or to spectators or third-parties. I assume full responsibility for all risks that may arise from using the facilities at Imaginasium LLC or from participating in activities at Imaginasium LLC.

3. Agreement to follow all rules- I agree to comply with all rules, regulations, and policies at The Playground. I understand The Playground reserves the right to revoke or terminate my use of the facilities at The Playground for any violation of rules, regulations, or policies.

4.Release, Indemnify, and Defend‐ I hereby release, waive, discharge, and hold harmless Imaginasium LLC and all employees past or present from any claims, suits, liabilities, judgments, costs and expenses for any property damage, loss or theft, personal injury or illness, death, or other loss arising from the use of Imaginasium LLC.

5.Waiver‐ I hereby waive any protections afforded by any statute or law in any jurisdiction whose purpose and/or effect is to provide that a general release shall not extend to claims, material or otherwise which the person giving the release does not know or suspect to exist at the time of executing the release. I am releasing unknown future claims.

6.Payment for damages‐ 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 be held liable for all such costs associated with such damages.

7.Representatives‐ I enter into this agreement for myself as well as for my heirs, assigns, and legal representatives.

8.Insurance‐ I understand that I am solely responsible for any medical, health, or personal injury costs relating to my use of Imaginasium LLC and its facilities. I understand that I am strongly encouraged to have a medical physical exam and purchase health insurance prior to my use of the facilities at Imaginasium LLC.

I have read and fully understand this Assumption of Risk, Waiver, and Release from Liability and understand that it relates to surrendering and releasing valuable legal rights. I do so freely and voluntarily on behalf of myself and any minor child/children for which I am the parent, legal guardian, or otherwise responsible for, named below:

Date: May 17, 2024

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
I am the parent or legal guardian of the above named minor. I have read and understand this Assumption of Risk, Waiver and Release from Liability form and understand that it relates to surrendering valuable legal rights of the minor 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 Imaginasium LLC.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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