Primary Sensory Play Center

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LIABILITY WAIVER FOR PRIMARY SENSORY PLAY, LLC

1. Introduction

This liability waiver is being signed by the participant in recognition of the fact that Primary Sensory Play provides equipment, activities and services for which there is a potential risk of injury and or bodily harm.

2. Release of Liability

By signing this liability waiver, the participant releases and discharges Primary Sensory Play and all staff, agents, officials, and volunteers of Primary Sensory Play, and any property owner associated with Primary Sensory Play from any and all liability, claims, demands, actions, and/or causes of action, including claims for personal injury, property damage, loss of services, and any other claim of any kind or character, which may arise out of, in connection with, or in any way relating to any and all use of any and all facilities, services, equipment, or programs provided by Primary Sensory Play.

3. Assumption of Risks

The participant acknowledges that participation in activities provided by Primary Sensory Play involves inherent risks, which may be significant and causes the participant to freely and voluntarily assume the risk of injury to his or her person, including but not limited to the risks of permanent paralysis or death. The participant acknowledges that there is an inherent, unavoidable risk of personal injury as a result of participation in activities provided by Primary Sensory Play, despite the highest standard of care and every reasonable measure taken to minimize such risks.

4. Limitation of Liability

In the event that a claim is made against Primary Sensory Play, all claims, damages, or liabilities shall be limited to direct or indirect damages and in no event shall Primary Sensory Play be liable for any indirect, indirect, special, special, incidental, consequential, or punitive damages arising out of, in connection with, or in any way relating to any claim of any kind or character, including but not limited to personal injury, loss of services, property damage, loss of wages, and any other loss or damage, however caused, whether or not such damages were contemplated, known, or foreseeable.

5. Conduct of Participants

The participant will be responsible for his or her own safety, and that of any minor child in his or her care. The participant shall comply with all rules, instructions, and direction of Primary Sensory Play staff. The participant will pay any damages resulting from his

Consent*

I hereby declare that I am at least 18 years of age and have the full legal capacity to sign this agreement.

Date of Consent*

Date

Date of Play Visit *

Sensory Workshop / Play Session Time*

5pm-7 pm

Please Select One *

Glow PartySensory Workshop with Play Session

$25.00 Quantity

Cash payment for session Select this box only if you are on site at the center and are paying cash.

$ Free

Primary Sensory Pal -10in Teddy Bear (subject to availability, styles my differ)

$23.00 Quantity

Celebrate add onBallon Arrangement, Birthday Button and Sensory Goodie Bag (age appropriate, styles may differ)

$25.00 Quantity

Reserve the Play Space ( 12 MAX ) Product Image

Reserve the Play Space ( 12 MAX )4 hours of private acess to our play space, comes with coloring sheets, crayons, play dough, balloons, table with cloth (for food) , generic cake plates and cups.

$485.00 Quantity

Total

$0.00

Name of Child

First NameLast Name

Name of Child

First NameLast Name

Name of Child

First NameLast Name

Name of Parent/Guardian

First NameLast Name

Signature of Parent/Guardian

Date

Payment Methods

Choose from one of the PayPal options to make your payment.