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CUSTOMER INFORMATION

*This form is an example and does not constitute legal advice. You should consult with a legal professional to create a waiver that meets your specific needs.

Birthday Participant
Month
Day
Year
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CONSENT AND RELEASE OF LIABILTY AGREEMENT

This Consent and Release of Liability (“Agreement”) is made between Creative Kids Clubhouse (“CKC”), a New Hampshire limited liability company located at 10 View St, Concord NH 03301, and listed as (“Participant”), a minor under 18 years old whose parent/guardian is signing and entering into this agreement on their behalf.

 

Recitals

 

CKC provides services/events for young children.  Participants, by way of their parent or guardian, must agree to the consents and Release of Liability contained in this Agreement before they will be permitted to participate in CKC services and events.   

 

The undersigned (on behalf of my minor) and the minor Participant consent and agree as follows:

 

1.    To abide by all CKC policies, procedures, rules, posted signs and written or oral instructions.

2.    To control my body and words and behave in a safe manner in consideration of my own well-being and that of other CKC participants and CKC employees.

3.    I understand that CKC may end my participation with CKC services and events should CKC find I failed to follow CKC policies, procedures, rules, signs and instructions or that I am a disturbance to the performance of CKC’s services and events, or danger or safety to myself or others. 

4.    I shall immediately report to CKC anything I observe or that is shared with me that: 1) impacts the safety of participants or employees; or 2) is inappropriate behavior

5.    I understand that CKC provides services and events at various locations, both indoors and outdoors, and that this Agreement applies in whatever location CKC provides its services and events.

6.    I am fully aware and appreciate the risks associated with participating in CKC services and events, including the risk of catastrophic injury, paralysis and even death as well as other damages and losses associated with participation in CKC services and events. 

7.    I understand the nature of CKC services and events and attest that I possess the necessary experience and capabilities and that I am in good health and proper physical condition to participate in CKC services and events.

8.    I authorize the CKC to seek medical treatment by calling 911 and to contact my emergency contact identified below on my behalf in case of injury, accident, or illness.

 

RELEASE OF LIABILITY

In consideration of my being allowed to participate in CKC services, We hereby waive, release, and discharge any claims for damages, death, personal injury, NEGLIGENCE, or property damage which we may have against CKC arising from our participation in CKC services and events. This Release of Liability is intended to discharge CKC, its officers, directors, agents, representatives, volunteers and employees from and against any liability, whether for inherent risks or other alleged causes arising out of or connected in any way with our participation in CKC services and events, including emergency rescue efforts. I agree to release, defend, indemnify and hold harmless CKC, its officers, directors, agents, representatives, volunteers and employees for any claims or lawsuits against them by us or by anyone claiming to act on our behalf. We further understand that this Agreement is binding upon my heirs and personal representatives. The above Release of Liability applies in whatever location CKC provides its services and events.


General Terms

Severability.  If any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, then such holding shall not invalidate or render unenforceable any other provision hereof.


Waiver of Breach.  The waiver by either party of a breach or violation of any provision of this Agreement shall not operate as, or be interpreted to be, a waiver of any subsequent breach.

 

Governing Law.  This Agreement shall be governed by, and construed and enforced in accordance with, the laws of the State of New Hampshire, without giving effect to any choice of law or conflict of law rules or provisions that would apply the laws of any other jurisdiction.

 

Termination.  This Consent and Waiver of Liability Agreement is valid for one year from the date of its execution and will be expected to be renewed annually should I continue CKC services.

  

THIS AGREEMENT CONTAINS A RELEASE OF LIABILITY. I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS ON BEHALF OF MYSELF AND MY MINOR CHILD BY SIGNING THIS AGREEMENT AND THAT I HAVE SIGNED THIS AGREEMENT FREELY AND WITHOUT INDUCEMENT OR ASSURANCE OF ANY NATURE. I INTEND THIS AGREEMENT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. I HAVE READ THIS AGREEMENT CAREFULLY. I UNDERSTAND AND ASSUME THE RISKS INVOLVED. BY SIGNING, I CERTIFY THAT I AM 18 YEARS OR OLDER, OR I AM SIGNING ON BEHALF OF MY MINOR CHILD. BY SIGNING, I GIVE UP MY RIGHT AND THE RIGHT OF MY HEIRS AND PERSONAL REPRESENTATIVES TO BRING ANY CLAIM OR LAWSUIT AGAINST CKC OR ITS OFFICERS, DIRECTORS, AGENTS, REPRESENTATIVES VOLUNTEERS OR EMPLOYEES.

 

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