Playdate’s Kids Cafe Waiver Form

In Consideration of being allowed to enter the play area, and/or participate in any party,

program/ activity or to consume food and /or drink at the cafe, (hereinafter referred to as

Activity) at PlayDates Kids Cafe in Grand Rapids, MI, the undersigned, on his or her behalf and

on the behalf of the minor(s) listed below, enters into this release and waiver, as follows:

The undersigned knowingly and voluntarily fully assumes all risks, known and unknown,

associated with the attendance at and/or participation in any and all activities,

programs, parties, or food and/or drink consumption or any other event at Playdates

Kids Cafe facility, and waives all claims for damage to personal property or injury to

persons arising from such participation and expressly releases and waives any and all

claims for damages. The undersigned does hereby surrender and waive any rights to sue

or exercise any legal right to seek damage against Playdates Kids Cafe or any affiliates

thereof, its owners, officers, members, agents, employees, volunteers, directors,

trustees, affiliates, supervisors, or entities providing facilities or assisting in the conduct

of the Activity. This release and waiver encompasses the potential for death, severe

injury, and property loss resulting from negligence, carelessness, or gross negligence on

the part of the individuals or entities being released and other participants.

The undersigned certifies that he or she is physically able and may participate in the

activities available at the Playdates Kids Cafe facility, and has not been advised to the

contrary by a qualified medical professional. The undersigned further certifies that

he/she is aware of and is solely responsible for their consumption of any food or drink

while at the Playdates Kids Cafe facility.

The undersigned on his or her behalf and on behalf of any executor, heirs, successors

and assignees, hereby releases, discharges, and holds harmless any authorized entity

doing business as Playdates Kids Cafe, including its owners, officers, members, agents,

employees, directors, trustees, affiliates, other persons or entities acting on their behalf

of Playdates Kids Cafe from any and all claims, damages, or liability arising from death,

disability, personal injury, property damage, theft or any kind of accident.

The undersigned agrees to pay for all damages to Playdates Kids Cafe facility caused by

them or their family’s negligent, reckless, or willful actions.

The undersigned agrees to abide with rules and conditions of participation and/or

attendance, posted at or explained by an employee at Playdates Kids Cafe facility. If the

undersigned experiences any significant hazard or injury during such participation, the

undersigned will promptly inform an employee of the company facility which they are

currently attending.

The undersigned acknowledges that this release and waiver of liability form will be used

and relied upon by Playdates Kids Cafe, and that it will govern the undersigned’s actions

and rights.

In addition to any rules posted on premises, rules that must be followed include: Shoes

are not allowed on the play floor and socks must be worn at all times. Adults must

supervise their children at all times. Outside food is not allowed at Playdates Kids Cafe.

Playdates Kids Cafe is not a peanut product free establishment, I understand that

Playdates Kids Cafe is not liable for any allergic reaction. Food and drink are not allowed

on the play floor - and must be enjoyed at a cafe table. Children and adults must show

respect to other customers, the employees, and the equipment at all times.

Each participant must have a form signed, either by them, or if under the age of 18

years, then signed by a legal guardian/parent/designated representative. If a person has

not signed then he/she will not be able to participate in Playdates Kids Cafe activities,

events, classes, or use the facilities (play area). If a membership is purchased, the waiver

will cover the length of the membership.

I represent that I am the parent or legal guardian of the child(ren) named below, or I

have obtained permission from the parent/legal guardian of such child(ren) to execute

this agreement on their behalf. I agree that the child(ren) named below and I shall

comply with all stated and customary terms, posted safety signs, rules, and verbal

instructions as conditions for participation in any program and/or class. I am aware that

there are inherent risks associated with participation in Playdates Kids Cafe programs,

classes, and/or use of the playroom. I either have full knowledge and understanding of

the nature and extent of such risks or I expressly recognize that there may be some risks

unknown to me and sign this document knowing that it shall be effective with respect to

such risk. I, on behalf of myself and the child(ren) names below, knowingly and freely

assume all such risks, including, but not limited to, personal injury, illness, death, and

property damage, and those risks that may arise out of the negligence of other

child(ren) and/or those arising out of or relating to participation in any and all of the

Playdates Kids Cafe, classes, or use of the playroom.

By stepping into this establishment, you are indicating your acceptance of the terms and

conditions outlined above. Furthermore, you are affirming that neither you nor your child are

experiencing any of the following symptoms: nausea, vomiting, fever, sore throat, runny eyes,

coughing, diarrhea, or any other contagious illness. If you or your child are feeling unwell, we

kindly request that you refrain from entering; in such cases, we will be happy to provide you

with a return visit pass.

I have read this document before signing, and I fully understand the content, meaning and

impact of this consent, waiver, indemnity and release.