Complete a waiver for myself
Complete a waiver for myself and children
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Adult Information

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( Age must be at least 18 years old )

Contact Information

Participants

Liability 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.

 

The undersigned is a customer, visitor, participant or guest of Imagine that! LLC (hereinafter "Imagine that"). Imagine that's main business is to provide a facility where children can play. It is possible for a customer, visitor, participant or guest to suffer injuries while using the facilities in the normal course of their visit to Imagine that. You are fully aware of the risks and hazards connected with the activities which may take place in this building. Such risks and hazards include but are not limited to:

  • Falls on or from the equipment
  • Tripping
  • Collisions with the equipment or with other participants

You are aware that such activities include the risk of injury and even death, and you hereby elect to voluntarily participate in said activities, knowing that the activities may be hazardous to your property, yourself and your minor children. You understand that Imagine that, does not require you or my minor child to participate in these activities. You voluntarily assume full responsibility for any risks of loss, property damage, or personal injury, including death, that may be sustained by you, or any loss or damage to property owned by you, as a result of being engaged in such activities, whether caused by the negligence of releasees or otherwise, to the fullest extent allowed by law. You understand that adult supervision of each child by that child's parent or authorized caregiver is required at all times. Imagine that shall not be liable for any injury resulting from an absence of adult supervision, including, but not limited to, any child leaving the premises of Imagine that without a parent or caregiver. By your signature below, you hereby waive and release Imagine that and its owners, landlord, licensees, employees and other agents from all claims arising from your presence or participation in Imagine that, including, but not limited to, personal injury, accidents, and other unintentional causes. Your entrance and use of the equipment, play apparatuses, or presence in Imagine that means you accept this responsibility. You further hereby agree to indemnify and hold harmless the owners, landlord, licensees, employees and other agents from any loss, liability, damage, or costs, including court costs and attorneys' fees that you may incur due to your participation in said activities, whether caused by negligence of releasee or otherwise, to the fullest extent allowed by law. Imagine that is not able to keep medical or emergency information on file. Therefore, if you have any medical conditions, special needs, or situations that might reasonably affect your participation (or that of your minor child), it is your responsibility to notify the management of Imagine that, who will have the sole discretion to deny admittance, based on this information. Imagine that has the sole discretion to determine whether its staff can reasonably accommodate an individual with medical or special needs. If you are a minor under the age of 18, your parent or legal guardian, or caregiver, must give consent by execution of this WAIVER, for you to participate. This WAIVER shall be prominently posted in Imagine that. It is the responsibility of the customer, visitor, participant, or guest to execute this WAIVER upon entering Imagine that and prior to participating in any activities therein. Failure to do so shall imply that you consent to the terms and conditions of the WAIVER. Imagine that shall endeavor to keep all prior executed waivers on file in order to eliminate the necessity of making multiple copies. It is agreed that an executed waiver on file at Imagine that remains applicable during all subsequent visits. Imagine that is not required to be licensed by the Commonwealth of Virginia as a childcare or daycare facility. We are child's playground that provides a place for children to play. We do not provide childcare. A parent or guardian must remain with their child while visiting Imagine that. Children are free to enter and leave the premises without permission or supervision from the staff of Imagine that. If you cannot be reached for any reason, you authorize Imagine that personnel to obtain emergency medical treatment, at your expense, for your child in the case of serious illness, emergency or injury. By signing below, you give your consent to the emergency facility, physician or hospital personnel to administer necessary treatment to your child. You also give consent to transportation by ambulance if required. You also hereby give consent for Imagine that personnel to administer immediate first aid if needed for minor injuries. You hereby certify that you are the parent or legal guardian of the Participant whose name appears below, and you have authority to waive rights on behalf of the minor Participant. You have read and you understand all of the provisions of this waiver/release and the risks associated with activities in Imagine that. You understand that the activities could cause injury and even death. You acknowledge that you have read and understand the terms of this document and you are freely and voluntarily signing this document.

 


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