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

Open Play 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.

Welcome to PLAYCAFE!

A space designed for young children to play and explore, but only under the supervision of each child’s parent or caregiver.

In consideration of being allowed to enter the play area and/or participate in any party and/or event at Play Cafe, LLC, the undersigned, on his or her behalf, and on the behalf of the participant(s) identified below, acknowledges, appreciates and agrees to the following conditions:

I represent that I am the parent or legal guardian of the participant(s) named below, or I have obtained permission from the parent/legal guardian of the participant(s) named above to execute this agreement on their behalf. I agree that the participant(s) named above and I shall comply with all stated and customary terms, posted safety signs, rules, and verbal instructions as conditions for participation in any party and/or program at Play Cafe, LLC.

In addition, if I observe any hazard during our participation, I will bring it to the attention of the nearest Play Cafe, LLC employee or official immediately.

I understand that I am responsible for my child’s safety and behavior at all times and at each visit. I understand that my child will remain in my clear view at all times during my visit. I am aware that there are inherent risks associated with participation in Play Cafe, LLC programs, parties and I, on behalf of myself and the participant(s) named above, knowingly and freely assume all such risks, both known and unknown, including those that may arise out of the negligence of other participants;

and, I, for myself and the participant(s) named above, and our respective heirs, assigns, administrators, personal representatives, and next of kin, hereby release and hold harmless, Play Cafe, LLC, and Play Cafe, LLC management, their affiliates, officers, members, agents, employees, other participants, and sponsoring agencies from and against any and all claims, injuries, liabilities or damages arising out of or related to our participation in any and all Play Cafe, LLC programs, activities, parties, and the use of the play area.

I, for myself, and the participant(s) named above, will read and abide by all posted rules including, but not limited to: wearing socks inside of the play area, ensuring only children within the age limit (under 2) enter the baby area, refraining from running, and refraining from throwing or misusing toys in anyway. I also understand that there is absolutely no food allowed inside of the play area at any time.

I understand that in order to play, my child must be well and free of any communicable/contagious illnesses.

I understand that I am responsible for monitoring the participant(s) named below during the entirety of our visit.

NOTE: We reserve the right to deny service to any child or adult who may appear ill, and require a doctor’s note for any ill child to return. We also reserve the right to ask any guest who does not adhere to this signed agreement to leave without refund.


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