The Nurtured Nest – Family Registration, Liability Waiver & Consents
Complete once per family before your first visit. Takes about 5 minutes. The Nurtured Nest FL LLC · 23123 State Road 7, Suite 250, Boca Raton, FL 33428
Family Information
Parent/Legal Guardian Full Name
*
First Name
Last Name
Relationship to child(ren)
*
Please Select
Mother
Father
Legal Guardian
Other
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Child 1 Full Name
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First Name
Last Name
Child 1 Date of Birth
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Child 2 Full Name
First Name
Last Name
Child 2 Date of Birth
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Child 3 Full Name
First Name
Last Name
Child 3 Date of Birth
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Other adults authorized to bring and supervise the child(ren)
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Allergies, medical conditions, or medications we should know about
*
Sensory, communication, mobility, or other support needs that help your child feel successful, including any wandering/elopement concerns
Liability Waiver, Assumption of Risk & Release
Activities. Programs at The Nurtured Nest may include free and open play, sensory play (water, sand, dough, foam, slime, bubbles), arts and crafts with paint and other materials, music, dance and movement, yoga, climbing and gross-motor play, building with blocks and small parts such as LEGO, gardening with soil and plants, science activities, snacks, parties, special events, and interaction with other children and adults.
I have read and agree
*
Inherent Risks. I understand these activities involve inherent risks that cannot be fully eliminated, including but not limited to slips, trips and falls; collisions with people, equipment or walls; bumps, bruises, cuts, scrapes, sprains and broken bones; allergic or skin reactions to food, art, sensory or garden materials; choking on small parts or food; exposure to illnesses; and other injuries that can occur during ordinary childhood play.
I have read and agree
*
Supervision. Unless a program is advertised in writing as drop-off, a parent, guardian or authorized adult must stay on the premises and actively supervise the child at all times. The Nurtured Nest is not a childcare provider during classes, open play, parties or events. Staff and instructors guide activities but do not replace the supervising adult.
I have read and agree
*
Assumption of Risk and Release. On behalf of myself and the minor child(ren) named above, I voluntarily permit participation and knowingly assume the inherent risks of these activities. To the fullest extent permitted by Florida law, including section 744.301(3), Florida Statutes, I release, waive and agree not to sue The Nurtured Nest FL LLC and its owners, members, employees, and volunteers for any personal injury, including death, or property damage to the minor child(ren) resulting from the inherent risks of the activities. For my own participation as an adult, I release the same parties from claims arising from my participation to the fullest extent permitted by law.
I have read and agree
*
Rules and Equipment. We agree to follow staff instructions and posted rules and to use equipment only as intended. The Nurtured Nest may pause or end participation when there is a safety concern.
I have read and agree
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Emergency Medical Authorization. In an emergency, I authorize The Nurtured Nest staff to call 911 and to obtain emergency medical care for my child if I cannot be reached immediately. Staff will try to reach me or my emergency contact right away. I am responsible for any resulting medical costs.
I have read and agree
*
Duration and Severability. This waiver applies to every visit, class, program, party and event at The Nurtured Nest until I revoke it in writing. If any part is found unenforceable, the rest remains in effect. This waiver is governed by Florida law.
I have read and agree
*
Parent/Caregiver Policies
Our Parent/Caregiver Policies Agreement covers supervision, personal care, illness, allergies, accommodations, behavior and safety, late arrival, cancellations, memberships, parties, independent instructors, and emergencies. A grown-up stays with their child unless a program is drop-off. Please stay home with fever, vomiting, diarrhea or an unexplained rash. We cannot guarantee an allergen-free space. Our programs are enrichment, not therapy or medical treatment. Read the full agreement at thenurturednestfl.com/waivers.
I have read and agree to The Nurtured Nest Parent/Caregiver Policies Agreement.
*
Photo & Media Consent
We sometimes photograph or record classes and events, including group photos. Choose only the uses you're comfortable with. Saying no will never affect your child's participation. We never publish a child's full name, school or address, or tag their accounts, without separate permission. You can withdraw consent anytime by contacting us; withdrawal applies to future use. No compensation is provided.
Media permission
*
Yes, for the uses I check below
No media consent: do not use my child's image, voice or likeness for promotion
Approved uses
Website
Organic social media
Paid digital advertising
Email newsletters
Printed marketing materials
In-studio displays
Press and community media
Internal training materials
Signature
I certify that I am the parent or legal guardian of the child(ren) named above with legal authority to sign for them, that I have read this entire form, and that I sign it voluntarily. I agree to sign electronically, and my electronic signature has the same legal effect as a handwritten signature.
Printed Full Name
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First Name
Last Name
Signature
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Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Registration
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