Community Play Atelier LLC Waiver and Release Form

  • Community Play Atelier LLC

  • Waiver and Release Form for Parent or Guardian

  • This Waiver and Release Form (the "Agreement") is entered into by the undersigned parent or legal guardian ("I" or "me") on behalf of the minor child/children named below ("Participant"). In consideration for being permitted to participate in classes offered by Community Play Atelier LLC ("Community Play Atelier"), I agree to all the terms and conditions set forth in this agreement.

  • 1. Assumption of Risk. I hereby consent to my participation, and give consent for Participant's participation, in any Community Play Atelier class ("Class"). I understand that the Class will include, but is not limited to: process art projects with a variety of arts materials such as paint, clay, wire, glue, crayons, oil pastels, markers, scissors; sensory play with materials such as water, rice, sand, play dough, clay, pebbles, and yarn; and gross motor play both indoors and outdoors. I understand the nature of the Class and that there are certain dangers, hazards, and risks (foreseen and unforeseen) associated with participation in the Class, including, without limitation, risks related to the use of equipment, personal safety (including risks of minor or more serious personal injury), and risks of property damage. I further acknowledge that the above is not inclusive of all possible risks associated with the Class and that the above in no way limits the extent or reach of this Agreement. In recognition of the dangers, hazards, and risks (foreseen and unforeseen) associated with the Class, and Participant's and my experience and capabilities, Participant and I are physically and mentally qualified to participate in the Class, and Participant has no physical or mental condition(s) which

  • would cause him/her to be a danger to himself/herself or to others. Participant and I are willingly and voluntarily participating in the Class, and I agree that Participant and I shall assume all dangers, hazards, and risks (foreseen and unforeseen) inherent in, arising from, or related to their participation in the Class.

  • 2. Liability Release and Indemnity. I agree to waive and release, indemnify, hold harmless and forever discharge Community Play Atelier and its agents, employees, officers, directors, members, affiliates, successors and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature whether known or unknown, in law or equity, including any claims of personal injury, death or damage to personal property, that Participant(s) or their family members, caregivers, other guardians or I ever had or may have, arising from, or in any way related to, participation in any Class, either indoors or outdoors. This Agreement expressly releases Community Play Atelier from liability for its own negligence in connection with any Class.

  • 3. Lost Belongings. I understand that Community Play Atelier is not responsible for loss, damage, or theft of personal belongings while my child/children are attending the Class

  • 4. Emergency Medical Constent. I hereby expressly consent to the provision of first-aid and/or emergency medical treatment of my child/children and myself in the event of an injury in connection

  • with the Class. I hereby expressly release and forever discharge
    Community Play Atelier from any claim whatsoever which arises,
    or may hereafter arise, on account of any first-aid treatment or
    other medical services rendered in connection with an emergency
    at Community Play Atelier.

  • 5. Policy and Media Consent.

  • In registering for and participating in
    the Class, I understand that Participant, their family members,
    caregivers, guardians and I must adhere to and follow any rules
    and policies set forth by Community Play Atelier. At the discretion
    of the owner or staff, Community Play Atelier reserves the right to
    deny service to anyone. I understand that Community Play Atelier
    may take pictures and/or videos of my child/children participating
    in the Class. Community Play Atelier may use my child/children's
    photographs, images and/or likeness for any print, social media, or
    web advertising or other promotional purposes, unless I notify
    Community Play Atelier to the contrary.

  • 6. Parent and Caregiver Responsibilities.

  • In registering for and
    participating in the Class, I acknowledge the following: (a) the
    childcare services being offered by the program are not licensed by
    the Department of Early Education and Care or any other state
    agency; (b) Parents or caregivers must remain responsible for the
    basic care of their child/children (including, but not limited to
    diapering, toileting, and feeding) during caregivers participation
    classes and must perform these duties as needed. I agree that if my
    caregiver fails or I fail to comply with the above conditions,
    Community Play Atelier will be unable to provide childcare
  • services for my child/children.
  • 7. Term of Agreement. This Agreement will remain in full force and effect even after the termination of the Class conducted by, or for the benefit of, Community Play Atelier, whether by agreement, by operation of law, or otherwise.
  • 8. Governing Law. I agree that any dispute or claim arising from, or in connection with, this Agreement shall be decided by the laws of the Commonwealth of Connecticut
  • 9. Entire Agreement. This Agreement contains the entire agreement between the parties, and supersedes any prior written or oral agreements between them concerning the subject matter of this Agreement. The provisions of this Agreement may be waived, altered, amended or repealed, in whole or in part, only upon the written consent of all parties.
  • 10. Severability. The terms and provisions of this Agreement shall be severable, such that if a court of competent jurisdiction holds any term to be illegal, unenforceable, or in conflict with any law governing this Agreement, the validity of the remaining portions shall not be affected thereby, and each and every term and condition of this Agreement shall be valid and enforced to the fullest extent and in the broadest application permitted by law.
  • It is my express intent that this Agreement shall bind any other parent to Participant, their family, estate, heirs, administrators, personal representatives or assigns and myself. I acknowledge that I have read and understand this document and its provisions.

  • PARENT OR GUARDIAN INFORMATION

  • Format: (000) 000-0000.
  • Date:
     - -

  • PARTICIPANT INFORMATION

  • Community Play Atelier LLC

    COVID-19 Waiver and Release Addendum for Parent or Guardian

  • This COVID-19 Waiver and Release Addendum (the "COVID Agreement") is entered into by the undersigned parent or legal guardian ("I" or "me") on behalf of the minor child/children named below ("Participant"). In consideration for being permitted to participate in classes offered by Community Play Atelier LLC ("Community Play Atelier"), I agree to all the terms and conditions set forth in this COVID Agreement.
  • 1. Acknowledgement and Assumption of COVID Risks. I acknowledge and fully assume the risk of illness or death related to
  • COVID-19 arising from Participant or me participating in the Community Play Atelier classes. I understand the hazards of the novel coronavirus ("COVID-19") and am familiar with the Centers for Disease Control and Prevention ("CDC") guidelines regarding COVID-19, as well as the latest guidelines from the Commonwealth of Connecticut. I acknowledge and understand that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the CDC and Connecticut guidelines are regularly modified and updated, and I accept full responsibility for familiarizing myself with the most recent updates. Notwithstanding the risks associated with COVID-19, which I readily acknowledge, I hereby willingly consent to my participation, and give consent to Participant to participate in, classes conducted by, or for the benefit of, Community Play Atelier.

  • 2. Liability Release and Indemnity.

  • I hereby release, waive, discharge, and covenant not to sue, on behalf of any minor child/ children for whom I have the capacity to contract and myself, Community Play Atelier, its agents, employees, officers, directors, members, affiliates, successors and assigns (the "Releasees") from any liability related to COVID-19 which might occur as a result of my minor child/children or me participating in the classes. I shall indemnify, defend and hold harmless the Releasees from and against any and all claims, demands, suits, judgments, losses or expenses of any nature whatsoever (including, without limitation, attorneys' fees, costs and disbursements, whether of in-house or outside counsel and whether or not an action is brought, on appeal or otherwise), arising from or out of, or relating to, directly or
  • indirectly, the infection of COVID-19 or any other illness or injury. It is my express intent that this Agreement shall bind any assigns and representatives, and shall be deemed as a release, waiver, discharge, and covenant not to sue the above named Releasees.

  • 3. Governing Law. This Agreement and the provisions contained herein shall be construed, interpreted and controlled according to the laws of the Commonwealth of Connecticut.

  • 4. Jury Trial Waiver. I hereby knowingly and voluntarily waive any right to a jury trial of any dispute arising in connection with this Agreement.

  • I acknowledge that this COVID Agreement was expressly negotiated and is a material inducement for the permission granted by releasees to be on premises and participate in the classes. In signing this Agreement, I acknowledge and represent that I have read the foregoing Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written COVID Agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this COVID Agreement for full, adequate and complete consideration fully intending to be bound by same.
  • Date:
     - -
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