The Nook

The Nook

Minor Waiver & Release of Liability
Parent/Caregiver Information
Parent/Caregiver Full Name:*

First NameLast Name
Parent/Caregiver Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Caregiver Email:*
example@example.com
Relationship to the Child:*
Emergency Contact
YesNo
Emergency Contact Name:
Emergency Contact Phone Number:
Emergency Contact Relationship to the Child:
Child Information

Please list all children participating individually.
Please list each child individually.*
Waiver & Acknowledgments
In consideration of the minor(s) listed below (hereinafter "The Minor(s)") being permitted to use the play area and/or the equipment, participate in any and all events and/or program(s) hosted either by The Nook LLC, and all of their agents, employees, principals, servants, successors, heirs, executors, administrators and all other persons firms, corporations, associations or partnerships with whom any of the former have been, are now or may hereafter be affiliated with ( hereinafter collectively "The Nook") or by a third party vender on behalf of The Nook at the premises located at 141 Bridge Road suite 100A, Salisbury Ma 01952 (hereinafter “Premises”), the undersigned, on or behalf of The Minor(s) listed herein and any personal representatives, agents, guardians, heirs and next of kin (herein collectively referred to as "The undersigned") identified below, hereby acknowledges, understands, agrees, accepts and is fully aware of any and all risks and hazards associated with participating in any of the activities, events, and/or programs being performed and/held on the Premises and further agrees as follows:

I agree for myself and/or on behalf of the Minor(s) that we shall comply with any and all stated and customary terms, posted safety signs, rules, verbal and written instructions, verbal and written warnings, advice, and any and all conditions whether written and/or verbal, for play and participation in any activities, events, and/or programs at Premises and on behalf of The Nook. Further on behalf of myself and the Minor(s), my heirs, executors, administrators, successors and assigns, release, acquit and forever agree to hold The Nook harmless from any and all claims, actions, causes of action, demands, rights, damages, costs, loss of service, expenses and compensation whatsoever which the undersigned now has or which may hereafter accrue on account of or in any way growing out of any and all known and unknown, foreseen and unforeseen bodily and personal injuries and property damage and the consequence thereof resulting or to result from participation in any and all play and participation in any activities, events, and/or programs at Premises and on behalf of The Nook .

I understand that myself and the Minor(s) will be asked to leave immediately if it is determined that either myself and/or the Minor(s) have caused physical bodily harm to another child, visitor, guest, invitee, Employee and/or Staff member of The Nook while on the Premises. I further shall indemnify and hold harmless The Nook, for any physical bodily harm caused to another child, visitor, guest, invitee, or The Nook, while on the Premises, by either myself and/or the Minor(s). No refund shall be issued if it is determined that either myself and/or The Minor(s) have caused physical bodily harm to another child, visitor, guest, invitee, and/or The Nook while on the Premises for any remaining visits and/or time already purchased by myself and/or for the benefit of The Minor(s).

I understand and agree that in the event any employee, agent, staff member of The Nook, is under the belief that either myself and/or The Minor(s) are sick, ill, and/or unwell, I and the Minor(s) may be denied entrance to the Premises and/or asked to leave Premises immediately. Failure to leave the premises when asked to do so shall result in permanent banning from the Premises and/or any future events of The Nook as well as forfeiture of all prepaid playtime, and/or time purchased by myself and/or for the benefit of the Minor(s).

I understand that both myself and The Minor(s) will be asked to leave immediately if it is determined that either myself and/or the Minor Children have caused damage and/or vandalized the Premises, equipment, facilities, property, and/or any other article(s) property owned, leased, rented and/or licensed by The Nook, and/or all of their agents, employees, principals, servants, and/or administrators. FURTHER I AGREE TO Pay for any and all damages to the Premises caused by myself and/or The Minor(s). I further shall indemnify and hold harmless The Nook, for any physical bodily harm caused to another child, visitor, guest, invitee, Employee and/or Staff member of The Nook, as result of the damage and/or vandalism of the Premises, equipment, facilities, property, and/or any other article(s) property owned, leased, rented and/or licensed by The Nook, while on the Premises, by either myself and/or The Minor(s).

I hereby authorize and release The Nook staff to arrange for transport or arrange transport to a medical or dental facility, and/or call for medical help should The Nook deem this to be necessary in which I hereby agree to be personally responsible to pay for these services/arrangements.

To use the play area and/or the equipment, participate in any and all events and/or program(s) hosted either by The Nook and/or by a third-party vendor on behalf of The Nook, each participant must sign this waiver form. Any Minor must have this form signed by their respective parent, legal guardian, caregiver, or a designated third party by the Minor’s parent and/or legal guardian. If a waiver is not signed by all participant(s), Minor(s), and/or parent(s)/caregiver(s), then no person(s), minor(s) and/or individual(s) within the party shall be permitted to use the play area and/or the equipment, participate in any and all events and/or program(s) hosted either by The Nook and/or by a third-party vendor on behalf of The Nook.

If any term of this Agreement is to any extent illegal, otherwise invalid, or incapable of being enforced, such term shall be excluded to the extent of such invalidity or unenforceability; all other terms hereof shall remain in full force and effect; and, to the extent permitted and possible, the invalid or unenforceable term shall be deemed replaced by a term that is valid and enforceable and that comes closest to expressing the intention of such invalid or unenforceable term. If application of this Severability provision should materially and adversely affect the economic substance of the transactions contemplated hereby, the Party adversely impacted shall be entitled to compensation for such adverse impact, provided the reason for the invalidity or unenforceability of a term is not due to serious misconduct by the Party seeking such compensation.
I have read and agree to the waiver and release of liability. Initial Here:*
I understand the risks associated with indoor play activities. Initial Here:*
I agree to make sure my child follows all facility rules and guidelines. Initial Here:*
I accept full responsibility for supervising my child (ren). Initial Here: *
I confirm that I am the child’s parent or authorized caregiver and have permission to sign this form. Initial Here: *
Activity-Specific Risks:

I acknowledge that climbing and swinging activities inherently carry a higher level of risk than other types of play. The climbing structures at this facility reach heights of up to seven (7) feet, and swings are used over safety mats. While every precaution is taken to provide a safe environment, I understand that participation in these activities involves the possibility of injury, including falls, bumps, or other accidents that may occur despite safety measures.
I acknowledge and accept the risks associated with climbing structures and elevated play areas. Initial Here: *
Cleaning & Sanitation Fee Policy

A non-negotiable cleaning fee of $50 will be charged to the client in the event that any materials, equipment, or furniture are soiled by bodily fluids, including but not limited to vomit, urine, or feces. This fee will be applied at the time of the incident.The client acknowledges and agrees that they may be responsible for any additional cleaning or sanitation costs incurred beyond the standard fee if the extent of the soiling requires further professional cleaning or results in damage.
I acknowledge and accept the Cleaning and Sanitation Fee Policy. Initial Here:*
Photography Consent

Personal information will never be used or shared. The majority of photos and videos are shared via temporary story features and are not retained long-term.
YesNo
Signature*
Printed Name:*
Date*

MonthDayYear
Date
Should be Empty:

The Nook

Parent/Caregiver Information

Emergency Contact

Child Information

Waiver & Acknowledgments

Activity-Specific Risks:

Cleaning & Sanitation Fee Policy

Photography Consent