Registration (Child's Information Please)

For Participation in Activities and Use of Facility

NOTICE: THIS IS A LEGALLY BINDING DOCUMENT. BY SIGNING THIS AGREEMENT, YOU ARE WAIVING CERTAIN LEGAL RIGHTS. PLEASE READ CAREFULLY.

This Waiver and Release of Liability (“Agreement”) is entered into by and between (“Participant” or “Parent/Guardian”) and The Third Place DBA The Third Place for Kids, a nonprofit organization operating in the State of Colorado (“TTP”). This Agreement is effective as of {sign_date} and shall apply to all visits to or participation in activities at the TTP facility by any minor child named herein.

1. ASSUMPTION OF RISK

I certify that I am the parent or legal guardian of the minor child {name}. I acknowledge that I may also be present in the facility, either as a supervising adult or passive participant. I understand that even if I do not actively use equipment, I may still be exposed to potential risks inherent to the environment. Accordingly, I knowingly and voluntarily assume full responsibility for any injury, illness, or other harm I may sustain while on the premises.

I understand and acknowledge that participation in activities at TTP involves inherent risks that may result in physical or emotional injury, paralysis, illness, permanent disability, death, or property damage. These risks include, but are not limited to: falls; equipment failure; collisions with fixed objects, equipment, or other participants; unpredictable behavior of children; exposure to allergens or communicable diseases; and physical exertion or overstimulation.

I understand that the facility includes but is not limited to: indoor play equipment such as swings, climbing walls, suspended or loose apparatus, gross motor challenges, balance structures, and bouncing surfaces. I also understand that TTP does not provide medical or therapeutic services and is not a clinical facility. No individualized therapeutic oversight is provided.

I voluntarily assume full responsibility for any and all risks, known and unknown, foreseeable or unforeseeable, associated with my child’s participation at TTP, even if arising from the negligence of TTP or others. I understand that TTP staff are not responsible for supervising my child unless expressly stated in writing, and that I am solely responsible for monitoring and supporting my child’s participation.

2. RELEASE AND WAIVER OF LIABILITY

In consideration of my child’s participation in TTP activities, I, on behalf of myself, my child, and our respective heirs, assigns, personal representatives, and next of kin, hereby fully and forever waive, release, discharge, and hold harmless TTP, its officers, directors, agents, employees, contractors, volunteers, and affiliates from and against any and all claims, demands, causes of action, liabilities, damages, injuries, costs, or expenses (including attorney’s fees) that may arise out of or relate to participation in activities at TTP or the use of its facilities or equipment, whether caused by the negligence of TTP or otherwise.

This waiver includes, without limitation, claims for personal injury, emotional distress, illness (including communicable disease), disability, death, or damage to property. I further agree not to bring any legal action against TTP arising from such claims.

3. MEDICAL CARE AND EMERGENCIES

I authorize TTP and its staff to obtain emergency medical care for my child if I cannot be reached in a timely manner. I understand and agree that I will be responsible for any and all medical bills or related expenses incurred as a result of any illness or injury sustained at TTP, and that TTP does not carry health insurance for participants. I affirm that my child is physically and emotionally fit to participate in the activities offered by TTP.

4. INSURANCE

I acknowledge that I have adequate health, accident, and liability insurance to cover any bodily injury or property damage that may be sustained by my child or caused by my child to others. If I do not have such insurance, I agree to bear all financial responsibility personally.

5. INCLUSION & VOLUNTARY SELF-IDENTIFICATION

TTP is designed as an inclusive, welcoming space for all families, including those with neurodivergent, disabled, and/or medically complex children. I understand that TTP may ask for voluntary information about how a child self-identifies (such as neurotypical, neurodivergent, or disabled) solely for the purpose of improving accessibility and programming. No medical information, diagnosis, or protected health information is required or collected. I understand that TTP is not subject to HIPAA and will never request confidential medical records.

6. SURVEILLANCE AND SAFETY MONITORING

I acknowledge that for the safety and security of all visitors, TTP may use surveillance cameras in common areas of the facility. These cameras are used solely for security purposes and are never installed in private areas such as restrooms.

7. MEDIA RELEASE (Optional and Provided Separately)

A separate form will be provided to consent to photo, video, or audio capture of participants for marketing or promotional use. I understand that signing this waiver does not grant photo release rights unless separately granted.

8. NO DROP-OFF POLICY

TTP is not a licensed childcare provider. Children may not be left unattended at any time. I understand that I, or a responsible adult designated by me, must remain present in the facility during my child’s visit unless otherwise stated in writing by TTP.

9. ILLNESS AND COMMUNICABLE DISEASE POLICY

I agree not to bring my child to TTP if they are actively ill, running a fever, or experiencing symptoms of contagious conditions (including but not limited to COVID-19, RSV, or flu-like symptoms). I understand that while TTP follows reasonable cleaning and safety protocols, it cannot guarantee a virus-free environment. I release TTP from any claims related to the contraction of any illness, virus, or infection while on site.

10. SEVERABILITY AND VENUE

I agree that this Agreement shall be governed by the laws of the State of Colorado. If any provision is found to be unenforceable or invalid, the remainder of the Agreement shall remain in full force and effect. Any legal action arising from this Agreement shall be brought in a court of competent jurisdiction in Douglas County, Colorado.

11. ENTIRE AGREEMENT

This Agreement represents the entire understanding between TTP and the undersigned regarding liability and participation. It supersedes any previous agreements or representations, whether oral or written.

ACKNOWLEDGEMENT & SIGNATURE

I certify that I am the parent or legal guardian of the minor child {first_name}. I have read this Agreement in full, understand its contents, and agree to be bound by its terms. I acknowledge that I am voluntarily giving up certain legal rights on behalf of myself and my child.

Photo & Video Release Form

By entering The Third Place for Kids, I acknowledge and agree to the following on behalf of myself () and my child ({name}):

We regularly capture photos and videos of our space in use to celebrate our community and promote our mission through marketing materials, social media, website content, and press. Occasionally, trusted partners or influencers may also film or take photos while in the space, under our supervision and standards of privacy.

I understand that photos or videos of myself and/or my child(ren) may be used by The Third Place for Kids in accordance with their standard media policy. By participating in activities, you grant us permission to:

• Use photos or videos that may include you or your child(ren) for promotional, marketing, fundraising, and educational purposes, in perpetuity and without compensation.

• Share selected images or footage with approved third parties (such as press, partners, or influencers) strictly for purposes aligned with our mission.

We are committed to using respectful and appropriate images that reflect our values. No names will be shared without additional explicit consent.

I would like to opt out of photo and video use. I understand that I must inform a staff member upon arrival at each visit so a visual indicator (such as a wristband or sticker) can be provided. I acknowledge that The Third Place for Kids will make reasonable efforts to exclude me and/or my child(ren) from photography and videography but is not liable for incidental inclusion if this procedure is not followed.