Little Angels Playground Waiver Form
Review the safety terms and sign to confirm you understand the risks for indoor play.
Participant's Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Participant 2 Full Name
First Name
Last Name
Participant 2 Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Participant 3 Full Name
First Name
Last Name
Participant 3 Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Full Name
*
First Name
Last Name
Email Address
example@example.com
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please read and acknowledge the following waiver terms:
I understand that participation in activities at the indoor playground involves inherent risks. By signing below, I agree to release the playground and its staff from any liability for injury or accident. I confirm that I am the legal parent or guardian of the participant (if a minor) and have read and agree to the terms of this waiver.
Signature
*
Date Signed
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Photo/Video Permission
Photo/Video Permission
*
Yes, I allow Little Angels to use photos/videos of my child for marketing.
No, I do not give permission.
Marketing Permission
Marketing Permission
I agree to receive promotional emails.
I agree to receive promotional text messages.
Additional Participants
Submit Waiver
Submit Waiver
Should be Empty: