Waiver Form - Play n Motion

Parent Name

First NameLast Name

Child's Name

First NameLast Name

Email Address

example@example.com

Phone Number

Format: (000) 000-0000.

By signing this waiver form, I acknowledge and confirm the following:

I hereby wholly release, acquit, forever discharge and hold harmless without limitation or qualification Play n Motion and its owners, officers, directors, employees, contractors, volunteers, agents, and affiliates from any and all liability, claims, causes of action, costs, expenses, or demands for damages and/or any other compensation whatsoever because of any loss, bodily injury, or property damage in any way directly or indirectly related to, arising out of, or connected with my child’s participation, whether caused or contributed to by the acts or negligence of Play n Motion or any of its owners, officers, directors, employees, contractors, volunteers, agents, and affiliates, or otherwise. I hereby acknowledge, agree, and understand that I assume all responsibility for any and all loss, bodily injury, or property damage in any way directly or indirectly related to, arising out of, or connected with my child’s participation.

Date Signed

Date

Client's Signature