TEA PLAY PLACE, LLC WAIVER AND RELEASE OF LIABILITY FORM PLEASE READ CAREFULLY BEFORE SIGNING 

I make this Agreement so that the above-named child(ren) can be admitted to, enjoy, and participate in activities offered by Tea Play Place, LLC. I understand that if I do not sign this Agreement, the above-named child(ren) will not be admitted to Tea Play Place.


Waiver of Liability, Release, Assumption of Risk & Indemnity: I understand that by signing this Waiver and Release of Liability Form, I release and hold harmless Tea Play Place, LLC, and its owners, directors, officers, employees, agents, volunteers, and all other persons or entities acting for or on behalf of Tea Play Place, LLC (“RELEASED PARTIES”) from any and all claims, demands, suits, costs, and charges in connection with or arising out of the above-named child(ren)’s use and enjoyment of the Tea Play Place, LLC facilities, including but not limited to injuries, damage, or death, whether caused by negligence or any other cause. By signing below, I am warranting to the RELEASED PARTIES that the above-named child(ren) is/are in sufficiently good health so as to participate in the activities offered by Tea Play Place, LLC. I understand that I must remain on the Tea Play Place premises at all times during the above-named child(ren)’s use and enjoyment of the facilities. I further agree to fully indemnify and defend the RELEASED PARTIES from and against any claims, lawsuits or other disputes which relate to or arise from the above-named child(ren)’s admittance, enjoyment, and use of the Tea Play Place. In no event will the RELEASED PARTIES be responsible, liable, or strictly liable for the intentional or negligent acts of the above-named child(ren) or any of the children using or enjoying the facilities provided by Tea Play Place, LLC, and I agree to defend and indemnify the RELEASED PARTIES from any claims, suits, or demands which may arise therefrom.


For the right to participate in any of the services or activities at Tea Play Place, LLC’s premises (the “PREMISES”), provided by the RELEASED PARTIES, I, on behalf of myself, and my spouse, legal partner, and children (over whom I certify I have legal authority as set forth herein) (“My Group”), hereby: acknowledge, agree or represent (as the case may be): (a) that immediately upon entering or participating I will inspect and carefully consider the PREMISES; (b) that entry into the PREMISES for observation or use of any facilities or equipment or participation in activities or services offered by Tea Play Place, LLC constitutes an acknowledgement that the PREMISES and all facilities and equipment thereon have been inspected and carefully considered by me and that My Group and I find and accept same as being safe and reasonably suited for the purpose of such observation, use or participation by My Group and me.

Authority. I am signing as the Parent or Guardian of a minor, and I represent that I have full authority to do so, realizing this Agreement is binding upon the minor as well as myself.


By signing this document, whether in written or electronic format, I understand that I may be found by a court of law to have forever waived, for me and My Group, the right to maintain any action in court or to be decided by a jury against Tea Play Place, LLC on the basis of any claim from which I have released the RELEASED PARTIES and that I have assumed all risk of damage, loss, personal injury, or death to myself and/or My Group and agreed to indemnify and hold harmless Tea Play Place, LLC and the RELEASED PARTIES from and against any and all losses, liabilities, claims, obligations, costs, damages and/or expenses whatsoever paid, incurred and/or suffered by Tea Play Place, LLC and the RELEASED PARTIES as a result of the participation in activities or services offered by Tea Play Place, LLC or the RELEASED PARTIES in or about the PREMISES by myself or My Group, and/or claims asserted by myself or My Group against Tea Play Place, LLC or the RELEASED PARTIES related to such participation in activities or services offered. I have had a reasonable and sufficient opportunity to read and understand this entire document and consult with legal counsel or have voluntarily waived my right to do so. I knowingly and voluntarily agree to be bound by all terms and conditions set forth herein. I further certify that I am the parent or legal guardian of the child(ren) listed on this Agreement or that I have been granted power of attorney and/or legal authority to sign this Agreement on behalf of the parent or legal guardian of the child(ren) listed in the Agreement.


You MUST have reached the age of majority in your state of residence to sign your own waiver


You MUST be the Parent or Legal Guardian or have legal authority to sign for a minor (under age of majority)


We reserve the right to review your license and/or other forms of ID to verify identity and age.

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Child Name and DOB *
Child Name and DOB
Child Name and DOB
Child Name and DOB
Child Name and DOB

PARENT OR GUARDIAN’S Name and DOB

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Address, City, State, Zip Code

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Phone Number:

Would you like us to send you text on deals and time changes? (Data rates may apply).

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Email:

Would you like us to send you emails on deals and events? 

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Relationship to Children

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Emergency Contact

Name and Phone Number

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CAUTION! READ BEFORE SIGNING!

THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS AND WILL BAR YOUR RIGHT TO SUE.

Signature of Parent/Guardian

Date

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CAUTION! READ BEFORE SIGNING!

THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS AND WILL BAR YOUR RIGHT TO SUE.

Signature of Parent/Guardian

Date

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Tea Play Place, LLC, and its owners, directors, officers, employees, agents, volunteers, and all other persons or entities acting for or on behalf of Tea Play Place, LLC (“RELEASED PARTIES”) would like to take photographs and/or videos of the children who enjoy the Tea Play Place facilities and use those photos or videos on Tea Play Place, LLC’s website, social media, and/or other promotional materials. Tea Play Place would like your permission to use photographs and videos of the above-named children for such purposes.


Permission to Use Photographs and Videos


I hereby give permission to Tea Play Place, LLC to use any photographs or videos of the above-named child(ren) which were captured by the RELEASED PARTIES for Tea Play Place’s website, social media and/or promotional materials. I hereby consent, on behalf of my minor child, to Tea Play Place, LLC’s use of my child(ren)’s image and likeness on its website, social media, and/or promotional materials. I hereby release and discharge the RELEASED PARTIES from any and all claims arising out of Tea Play Place, LLC’s previously described use of photographs/videos that I or the above-named children may have in this regard. By marking yes, you give Tea Play Place. 

No Permission to Use Photographs and Videos


 I do not give permission to Tea Play Place, LLC to use any photographs or videos of the above-named child(ren) which were captured by the RELEASED PARTIES for Tea Play Place’s website, social media and/or promotional materials. By marking no you do not authorize photos or videos. 



Authority. I am signing as the Parent or Guardian of a minor, and I represent that I have full authority to do so, realizing this Agreement is binding upon the minor as well as myself.


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CAUTION! READ BEFORE SIGNING!

THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS AND WILL BAR YOUR RIGHT TO SUE.

Signature of Parent/Guardian

Date

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