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

Imagination City Hillsdale Mall

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.

 In consideration of Imagination City LLC., at 448 Hillsdale Mall, San Mateo CA. 94403, granting any and all children (each a “Child” and together the “Children”) who enter Imagination City indoor playground facility (the “Facility”) under the direct or indirect supervision of the undersigned, to use the Facility, I, hereby on behalf of myself, my Child/Children, my Children’s heirs, executors, administrators, or anyone who might claim on their behalf warrant and agree as follows: 

1. I represent and warrant that I am the parent or legal guardian of the below named Child/Children. I will be responsible for the supervision of the Child/Children. 

2. By entering Imagination City, I acknowledge and I am fully aware of the inherent risks present in an indoor play environment. That the equipment and the nature of its use can be dangerous and may result in serious injury to myself and/or my Child/Children. These risks include, without limitation, damage to personal property, personal injury or death. 

3. I hereby knowingly and voluntarily assume and accept all risks, including all presently unknown or unforeseeable risks, and assume all responsibility of risks to myself, my Child/Children, my personal property and the personal property of my Child/Children upon signing this Waiver. 

4. I warrant and represent that I have read the Imagination City Indoor Playground Rules (the “Rules”), which form part of this Waiver. I agree to, and shall ensure my Child/Children use the Playground only in accordance with the Rules. I acknowledge that failure to abide by the Rules or to use the equipment in a safe and appropriate manner may, at the sole discretion of Imagination City, result in my or my Child’s/Children’s removal from the Facility. 

5. I understand and agree that Imagination City, its shareholders, officers, directors, employees, management, contractors, agents or other representatives (the “Representatives”) shall not be liable for any injury, damage or loss that I or my Child/Children may suffer as a result of using the Facility. I understand and agree that Imagination City and its Representatives are not responsible for the supervision of my Child/Children and shall not be held liable for any reason whatsoever for failing to supervise my Child/Children, including child disappearance. 

6. I hereby release, waive and forever discharge Imagination City and its Representatives from any and all liability, claims, demands, losses, or damages, however caused, whether related to property damage, theft, and/or personal injury (including death), and whether based on tort, intentional act, strict liability, negligence, and/or negligent rescue, that I or my Child/Children may suffer as a result of my Child/Children using the Facility, including as a result of the negligence of Imagination City or its Representatives. I will indemnify, save and hold harmless each of Imagination City and its Representatives from any and all claims, expenses, legal fees, losses, liabilities, damages, or costs which relate to, or arises from, this Waiver, to the fullest extent permitted by law. 

7. If my Child/Children is a minor, I the undersigned, parent or guardian, hereby gives permission for Imagination City to authorize emergency medical treatment as may be deemed necessary for the Child/Children named below while participating in activities at the Facility. The undersigned hereby releases, discharges, covenant to bring an action and agrees to indemnify and save harmless Imagination City from all liability, claims, demands, losses or damages on the Child’s/Children’s account caused or alleged to have been caused in whole or in part by the negligent medical treatment, failure to provide medical treatment, and further agree to indemnify, save and hold harmless Imagination City and its Representatives from any liability whatsoever as a result of any such claim. 

8. I represent and warrant that my Child/Children is/are in good physical condition and physically able to play in the Facility and that my Child/Children is/are old enough to participate. 

9. I agree and acknowledge that my execution of this Waiver on the initial visit, or for one of my Children, will and does authorize Imagination City to enter this Waiver into its database and use it as a continuous, multi-use waiver for my Childs/Childrens ongoing entry to play in the Facility or use it as a Waiver executed for my other Child/Children. I hereby expressly authorize Imagination City to use this Waiver as a multi-use wavier until such time as I revoke it in writing. 

10. I agree and acknowledge that Imagination City shall use reasonable efforts to ensure that the Facility is a nut free facility, however due to numerous factors outside its control, Imagination City makes not guarantee, warranty or representation that the Facility is a nut free facility. I accept any and all risk that this may cause for my Child/Children. 


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