Kalisi Movie Night December 12 FRIDAY

December 12 FRIDAY

6-9 pm

Kids Movie night

includes dinner and play time

Child’s name*

First NameLast Name

Age*

Write something about yourself. Please list any allergies, medical conditions, and things such as if the child requires an EpiPen.*

Do you want to add enroll more students? ( Separate enrolment form must be filled out)*

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Parent/Guardian Name*

First NameLast Name

Phone Number*

Email*

example@example.com

Relationship*

Emergency contact*

First NameLast Name

Phone Number*

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Child Health Care Number

Please only sign if you're 18 years old and above otherwise, leave it blank and have your parent/guardian signed the next signature field.

Event I am registering for*

December 12 FRIDAY Movie Night 6-9 pm

I have submitted payment in full at registration to kalisi.kids@gmail.com*

KALISI KIDS MOVIE NIGHT DROP-OFF EVENT PARTICIPATION AGREEMENT, LIABILITY WAIVER, AND RELEASENOTICE: PLEASE READ THIS ENTIRE DOCUMENT CAREFULLY BEFORE SIGNING. BY SIGNING THIS WAIVER, YOU GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.In consideration of my child/ward being permitted to participate in the Movie Night Drop-Off Event at Kalisi Kids, located at 1610 Joan Ave, Crofton, BC V0R 1R0, Vancouver Island, British Columbia, Canada, including the use of equipment, toys, and facilities in the kids’ café, main café, and outdoor courtyard, I, the undersigned parent or legal guardian, acknowledge and agree to the following on behalf of myself, my child/ward, and our heirs, assigns, and personal representatives:1. Event Details and Activities: The Movie Night Drop-Off Event is scheduled for December 12 from 6:00 PM to 9:00 PM. Parents or guardians may drop off their child/ward for the three-hour duration, during which the child/ward will engage in supervised play time, watch the movie “The Grinch,” and enjoy dinner consisting of pizza bites and other finger foods. Activities may involve the use of playground equipment, toys, games, and other items that carry inherent risks. These risks include, but are not limited to: • Minor injuries such as cuts, scrapes, bruises, or sprains from play or movement. • Major injuries such as falls, eye injuries, choking, or allergic reactions. • Property damage, including damage to clothing or personal belongings. • Risks associated with food consumption, including potential allergic reactions or cross-contamination. • General risks from group activities in a child care setting, such as slips, trips, or interactions with other children.I acknowledge that these activities may occur in areas not fully controlled by Kalisi Kids and that, despite reasonable precautions, not all risks can be eliminated. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of Kalisi Kids, its employees, agents, or affiliates. This event is governed by the laws of British Columbia, Canada, and any disputes arising from this agreement shall be resolved in the courts of British Columbia.1. Food Allergies and Dinner: I understand that dinner items, including pizza bites and other finger foods, are prepared and/or sourced off-site. Kalisi Kids cannot guarantee an allergen-free environment, and cross-contamination may occur due to factors beyond their control, such as changes in manufacturer formulations. Parents or guardians are responsible for providing accurate and complete information about their child’s food allergies or dietary restrictions prior to participation. Children with severe food allergies must bring their own safe, ready-to-eat meals (refrigeration and heating are not available) and may not participate in food-related activities if deemed unsafe. I assume all risks related to food consumption and release Kalisi Kids from liability for allergic reactions or food-related incidents.2. Supervision and Drop-Off: Parents or guardians are not required to remain on-site during the Movie Night Drop-Off Event. Kalisi Kids staff will provide supervision for all participating children throughout the event. However, I understand that staff supervision is not a substitute for parental responsibility, and Kalisi Kids is not liable for any incidents arising from child behavior, interactions with other children, or unforeseen circumstances. I confirm that my child/ward is capable of following instructions and behaving appropriately in a group setting. Emergency contact information must be provided at drop-off, and I agree to be available by phone for the duration of the event in case of any issues requiring my immediate attention.3. Medical Authorization and Emergencies: I authorize Kalisi Kids staff to administer basic first aid and, in the event of an emergency, to seek medical treatment for my child/ward, including transportation to a medical facility if necessary. I agree to cover all costs associated with such treatment. I confirm that my child/ward has no medical conditions that would prevent safe participation in the event, or if such conditions exist, I have disclosed them fully in writing prior to drop-off. I release Kalisi Kids, its employees, agents, and affiliates from any liability related to medical decisions or treatment provided in good faith.4. Release of Liability: I hereby release, waive, discharge, and covenant not to sue Kalisi Kids, its owners, employees, agents, affiliates, volunteers, or any related entities (collectively, the “Releasees”) from any and all liability, claims, demands, actions, or causes of action whatsoever arising out of or related to any loss, damage, injury, or death that may be sustained by my child/ward or myself, or to any property belonging to us, while participating in the Movie Night Drop-Off Event, whether caused by the negligence of the Releasees or otherwise. This release includes, but is not limited to, claims arising under the laws of British Columbia, including the Occupiers Liability Act and any other applicable statutes or common law.5. Indemnification: I agree to indemnify, defend, and hold harmless the Releasees from any and all claims, demands, losses, liabilities, damages, costs, and expenses (including legal fees) arising out of or related to my child/ward’s participation in the event, including but not limited to any claims brought by third parties as a result of my child/ward’s actions or behavior. 7. Severability: If any provision of this agreement is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.8. Acknowledgment: I certify that I have read this entire document, understand its terms, and sign it voluntarily without any inducement. I am at least 18 years of age and fully competent to execute this agreement.*

Yes

I understand that payment is due at registration to kalisi.kids@gmail.com. Please note in memo name and event.

Yes

Parent/guardian Signature*

Date Signed*

Date

Kalisi Movie Night FRIDAY DECEMBER 12

Information

Parent/Guardian Information

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