Complete a waiver for myself
Complete a waiver for myself and children
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MyLilTown Waiver

Please read the waiver below and fill out the required fields found in the following form sections. All liability language from the waiver will apply to all persons listed below.

MY LIL TOWN WAIVER AND RELEASE FORM

This Assumption of Risk, Waiver, and Release of Liability covers all activities at the Playground.

1. Risk Factors‐ I understand and acknowledge that the use of the facilities at The Playground involves risks including, but not limited to the following: bodily injury including but not limited to permanent disability, paralysis, and death. These risks may result from a variety of circumstances including the misuse of equipment or facilities.

2. Assumption of Risk‐ I am choosing to use the facilities at The Playground at my own risk. I understand and acknowledge that the activities which I am or/and (any minor children for which I am the Parent, legal guardian, or otherwise responsible, any heirs personal representative) about to voluntarily engage in as a participant and/or volunteer bears certain know risks and unanticipated risk could result in injury, death, illness or disease, physical or mental, or damage to myself, or to spectators or third-parties. I assume full responsibility for all risks that may arise from using the facilities at The Playground or from participating in activities at The Playground.

3. Acknowledgement of Policies and Procedures‐ I acknowledge that I have read, know, and agree to all of the policies and procedures relating to the use of the facilities at The Playground. I agree to comply with all rules, regulations, and policies at The Playground. I understand The Playground reserves the right to revoke or terminate my use of the facilities at The Playground for any violation of rules, regulations, or policies.

4. Release, Indemnify, and Defend‐ I hereby release, waive, discharge, and hold harmless The Playground and all employees past or present from any claims, suits, liabilities, judgments, costs and expenses for any property damage, loss or theft, personal injury or illness, death, or other loss arising from the use of The Playground.

5. Waiver‐ I hereby waive any protections afforded by any statute or law in any jurisdiction whose purpose and/or effect is to provide that a general release shall not extend to claims, material or otherwise which the person giving the release does not know or suspect to exist at the time of executing the release. I am releasing unknown future claims.

6. Payment for damages‐ I agree to pay for any and all damages to any property or equipment as a result of my or my family’s willful actions, neglect, or recklessness and agree to be held liable for all such costs associated with such damages.

7. Representatives‐ I enter into this agreement for myself as well as for my heirs, assigns, and legal representatives.

8. Insurance‐ I understand that I am solely responsible for any medical, health, or personal injury costs relating to my use of The Playground and its facilities. I understand that I am strongly encouraged to have a medical physical exam and purchase health insurance prior to my use the facilities at The Playground.

9. Arbitration- All parties to this agreement agree to mediate, in good faith, any dispute prior to initiating arbitration or litigation based on the laws of the state of California. The prevailing party in the event of arbitration or litigation shall be entitled to costs and reasonable attorney fees.

I am the parent or legal guardian of the children that will enter the playground, I have read and fully understand this Assumption of Risk, Waiver, and Release from Liability and understand that it relates to surrendering and releasing valuable legal rights. I do so freely and voluntarily on behalf of myself and any minor child/children for which I am the parent, legal guardian, or otherwise responsible for. I agree to be bound by all the terms of the Assumption of Risk, Waiver, and Release from Liability. I give my consent for participation at The Playground.

Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The state of medical knowledge is evolving, but the virus is believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects, and even possibly in the air. People reportedly can be infected and show no symptoms and therefore spread the disease. The exact methods of spread and contraction are unknown, and there is no known guarantee treatment, cure, or FDA approved vaccine for COVID-19. Evidence has shown that COVID-19 can cause serious and potentially life threatening illness and even death.

My LiL Town cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while utilizing My LiL Town’s services or premises. It is not possible to completely prevent against the presence of the disease. Therefore, if you choose to utilize My LiL Town’s services and/or enter onto My LiL Town’s premises you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19.

 ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my children in order to utilize My LiL Town’s services and enter My LiL Town’s premises. These services are of such value to me [and/or to my children,] that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize My LiL Town’s services and premises in person.

 WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against My LiL Town and its owners, officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing My LiL Town’s services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.

CHOICE OF LAW: I understand and agree that the law of the State of California will apply to this contract.

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE:

I am the parent or legal guardian of the minor. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release.


By signing this waiver, I agree that all information is complete and accurate.