NOTE: Parker's Place does not accept paper waivers, please submit electronically.

Parker’s Place Indoor Playspace Waiver and Release Agreement

Parent/Guardian Information:

Full Name

Phone Number

Email Address

Please select how many children you are checking in:

First Child Name

First Date of Birth

First Allergies / Medical Conditions

Second Child Name

Second Date of Birth

Second Allergies / Medical Conditions

Third Child Name

Third Date of Birth

Third Allergies / Medical Conditions

Fourth Child Name

Fourth Date of Birth

Fourth Allergies / Medical Conditions

Fifth Child Name

Fifth Date of Birth

Fifth Allergies / Medical Conditions

Sixth Child Name

Sixth Date of Birth

Sixth Allergies / Medical Conditions

Acknowledgment and Agreement:

By signing this waiver, I, the undersigned parent or legal guardian, agree to the following:

General Release of Liability: I acknowledge that Parker’s Place Indoor Playspace (“Parker’s Place”) is a recreational facility designed for children and that activities within the playspace may involve inherent risks, including but not limited to minor injuries, falls, or other accidents. I hereby release, discharge, and hold harmless Parker’s Place, its owners, employees, agents, and affiliates from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, injury, or damage that may occur while my child is present on the premises, whether under supervision or otherwise.
Drop-Off Program Agreement:
1. I understand that Parker’s Place is offering a drop-off program, during which my child may be left in the care of Parker’s Place staff for up to 2.5 hours.
2. I certify that my child is at least 15 months old and arrives for drop-off with a non-soiled, clean diaper, as required for participation in the drop-off program.
3. I agree to provide accurate emergency contact information and remain reachable for the duration of my child’s time at Parker’s Place.
Medical Authorization:
1. In the event of an emergency, I authorize Parker’s Place staff to seek appropriate medical care for my child, including contacting emergency medical services or transporting my child to the nearest medical facility. I agree to assume all costs associated with such care.
2. I certify that my child does not have any condition that would prevent them from safely participating in the activities at Parker’s Place.
Behavior and Safety Policy:
1. I acknowledge that Parker’s Place staff will make every reasonable effort to ensure my child’s safety and well-being.
2. I understand that if my child’s behavior is deemed unsafe, inappropriate, or disruptive, I may be contacted and required to pick up my child before the conclusion of the 2.5-hour session.
Personal Belongings:
1. Parker’s Place is not responsible for any lost, stolen, or damaged personal items brought to the playspace.
Late Fees:
1. I understand that Parker’s Place provides a 10-minute grace period for late pick-ups. After the grace period, a $25 late fee will be assessed.
2. I agree to pay any late fees promptly upon pick-up.
Release Restrictions:
1. For the safety of the children, Parker’s Place reserves the right to deny releasing a child to a parent or guardian who appears to be impaired or under the influence of drugs or alcohol. In such cases, the emergency contact will be called to pick up the child.

Emergency Contact Information:

Emergency Contact Name

Emergency Contact Phone

Relationship to Child

Agreement and Signature:

I have read and fully understand the terms of this waiver and release agreement. By signing below, I acknowledge that I am voluntarily waiving certain legal rights and assuming full responsibility for my child’s participation in activities at Parker’s Place.

Click to Sign

Signature

Sat Oct 4, 2025

Electronic Signature Consent

By checking here, you acknowledge you have read and understand the above terms, and are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

NOTE: Parker's Place does not accept paper waivers, please submit electronically.

Parker’s Place Indoor Playspace Waiver and Release Agreement

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