Pop Up Playground - Liability Waiver
Hello There!

Thank you for filling out this waiver - our insurance requires that you do.

We tried our best to make this as simple, short and private as possible but if you have any questions or suggestions on how we can better prioritize & protect your information, please do not hesitate to let us know.

Once you hit submit, you will be invited to fill out a short, optional, anonymous, pre-experience survey that will help us understand our impact and inform the reset space, which we plan to launch this fall. We appreciate your participation in this survey and appreciate if you prefer not to!

In summary, we're appreciating and look forward to seeing you soon!

Reset
hello@thisisreset.org

Sign in to Google to save your progress. Learn more
Email *
Date of your PUP Experience *
MM
/
DD
/
YYYY
Time of your PUP Experience *
Time
:
I understand and agree that in participating in any activity that involves movement, dance and/or any type of physically active activity, there is a possibility of physical injury or death. I voluntarily agree, therefore, to assume all risks and responsibility for any such injury or accident which might occur to me during any of the Camp Reset activities and experiences. I also exempt, release and indemnify Camp Reset, it’s owners, staff, agents, volunteers, assistants, contractors and/or board members from any and all liability claims, demands, or causes of action whatsoever from any damage, loss, injury, or death to me or property which may arise out of or in connection with participating in any activities and experiences conducted by Camp Reset. I further hereby voluntarily agree to waive my rights and that of my heirs and assigns to hold Camp Reset, its owners, staff, agents, volunteers, assistants, contractors and/or board members liable for such damage, loss, injury or death. I understand that I should be aware of my physical limitations and agree to not exceed them.By signing below and participating in the activity, (1) I acknowledge that COVID-19 is highly contagious and is known to result in injury, illness, disability or even death; (2) I voluntarily assume the risk that you may be exposed to, or infected by, COVID-19 during (or in route to or from) the activity, from the acts, errors, omissions or negligence of yourself or others; and (3) I accept sole responsibility for any personal injury, illness, disability or death (all “claims”), including related damages, losses, claims, liabilities or expenses (all “damages”) of any kind that you may sustain in connection with your participation in the activities, either at the premises or in route to or from the premises.  
In signing this form, I acknowledge the information about the elements of risk noted and agree to be bound by the above statement. I am 18 years of age or older and I have read and fully understand the contents hereof and I am signing this form voluntarily. *
Required
Please Type Your Name Below To Sign This Form *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Moving EDGEucation. Report Abuse