- COVID-19 PARTICIPANT RISK ASSESSMENT
I, as named parent or legal guardian of named minor (hereinafter “Minor”), hereby
1. I acknowledge that the Minor is not currently experiencing any or all of the symptoms listed below.
(a) Fever with temperature over 98.6 degree (Please note the Minor’s Temperature may be taken with a non-touch Forehead Thermometer before entry)
(b) Cold or flu symptoms including runny nose
(c) Cough or shortness of breath
2. I acknowledge that the Minor does not align with any of the following risk factors associated with COVID-19 infection including:
- (a) History of overseas travel or close contact with a person(s) who has travelled to country of high risk in the past 14 days.
- (b) Contact with a confirmed case in the past 14 days.
3. I understand that if at any time the Minor displays any of the symptoms listed above, they will be isolated from the program and a parent or carer must pick them up within the hour. No exceptions will be made.
4. I understand that should the Minor display any of these symptoms or risk factors, the Minor will not be able to return to the program for 14 days after displaying symptoms and that Lil Bunny LLC Cancellation policy will apply.
5. I understand that I will be asked to acknowledge and sign a daily sheet adhering to the conditions of entry for the minor of which I am guardian.
- COVID-19 PARTICIPANT RISK ASSESSMENT FORM & LIABILITY WAIVER
I, on my own behalf and on behalf of the Minor agree to release, indemnify and discharge Lil Bunny Indoor Playground , its agents, owners, shareholders, directors, partners, employees and volunteers, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:
1. I understand and acknowledge that the program(s) the Minor is about to voluntarily engage in as a participant anytime they enter the Lil Bunny Idoor Playground facility bear(s) certain known risks and unanticipated risks which could result in illness to Minor, or to third parties.
2. I release Lil Bunny Indoor playground and all associated Parties from any and all claims, demands, or causes of action, which are in any way connected with the Minor’s participation in this activity or use of Lil Bunny LLC equipment or facilities.
3. I indemnify and save and hold harmless Lil Bunny LLC and all associated Parties against any loss, liability, damage or cost that may incur arising out of or in any way connected with the Minor’s participation with Lil Bunny LLC.
4. By signing this Agreement, I acknowledge that I have had sufficient opportunity to read this entire Agreement, I understand it completely, I understand that it affects my legal rights, and I agree to be bound by its terms.
In consideration for gaining access to Lil Bunny LLC and participating in any party, play, activity, and/ or program at Lil Bunny Indoor Playground, the undersigned, on their own behalf, and on the behalf of the participant(s) identified on this form, hereby acknowledge, appreciate, and agree to the following conditions:
1. I attest that I am the parent or legal guardian of the participant(s) undersigned, or that I have obtained permission from the parent or legal guardian of the participant(s) undersigned to execute this agreement on their behalf and agree to attend to and monitor the activities of all participant(s) undersigned such that all activities are ageappropriate and abilityappropriate.
2. I agree that the participant(s) undersigned and I shall willingly comply with all stated and customary terms, posted safety signs, rules, and safety instructions and directions given by Lil Bunny and its staff and personnel as conditions for use of play equipment and participation in any party, event, activity, and/or program.
3. I, for myself and the participant(s) undersigned, acknowledge and understand that all equipment at Lil Bunny including slides, stairs, climbing structures, obstacles, interactive
panels, soft play structures with moving parts, games, inflatables, trampolines, and other toys can be hazardous and dangerous. Activities require various degrees of skill and experience. I understand that these activities can result in serious injury, death, illness, and loss of any kind. I understand that such risk cannot be eliminated without jeopardizing the essential qualities of the Activity. I promise to accept and assume all of the risk and responsibilities for loss of any kind, injury, death, and illness to myself and the participant(s) undersigned on the Lil Bunny premises, including those that may arise out of negligence of other participants. I also hereby agree to indemnify, hold harmless and defend Lil Bunny , their employees and agents from any and all claims resulting from injuries, including death, damages and loss sustained by anyone, which arise out of or are in any way associated with my conduct or the conduct of those individuals participating under my supervision and/or the activities of the facility. I acknowledge that myself and the participant(s) undersigned may require medical assistance, which I acknowledge will be at my own expense or the expense of my personal insurers. I represent and affirm that I have adequate an appropriate insurance to provide coverage for such medical expenses.
4. I am aware that there are age of certain activities for the safety of different age groups of children at Lil Bunny.
5. In consideration of Lil Bunny, allowing my participation and the participation of the undersigned, I, for myself and the participant(s) undersigned and/or legal ward, heirs, administrators, personal representatives, or assigns hereby voluntarily release, waive, and forever discharge and covenant not to sue Lil Bunny, LLC d/b/a Lil Bunny Indoor playground and its owners, agents, employees, officers, and all other persons or entities acting on its behalf.
6. I understand the effect of this waiver and acceptance of risk on my legal rights. By signing this release of liability agreement and participating at Lil Bunny , it is my intention to assume all risk of injury and I for myself and the participant(s) undersigned. I hereby fully and forever release and discharge indemnify and hold harmless Lil Bunny LLC , d/b/a Lil Bunny , its owners, employees, agents, the property owner and/or all other persons or entities acting on its behalf from any and all liabilities, claims, demands, damages, rights of action, suits or causes of action present or future, whether they be known or unknown, anticipated or unanticipated, resulting from or arising in any way out of my use or intended use of said premises, facilities or equipment to the fullest extent permitted by law. I fully and forever release and discharge the released parties and their employees and agents from any and all negligent acts and omissions in the same, and intend to be legally bound by this release to the fullest extent permitted by law.
7. I will review and observe the operational rules and understand that it is my responsibility to ask questions about the operational rules and regulations if necessary. I understand that it is my responsibility to ensure that myself and the participant(s) undersigned understand the rules. Although Lil Bunny staff observe and monitor children/adults playing, it is my responsibility to supervise my children and my own activities. Lil Bunny is not an insurer or guarantor of children's safety and does not assume the parental responsibility to supervise and direct children's activities. I will bring any observation of the rules being broken to the attention of a Lil Bunny staff member. I certify that myself and the participant(s) undersigned are in good health and that myself and the participant(s) undersigned have no physical limitations, which would preclude safe participation at Lil Bunny.
8. I agree to follow the rules as explained: Outside food is not allowed and all guests are required to wear socks at all times. Wearing socks is necessary to maintain health and safety standards. I understand that shoes are NOT allowed inside Lil Bunny. Lil Bunny understands that certain medical conditions can prevent me and/or participants from taking off shoes in the facility. With exceptions of medical conditions that may
require shoes, please speak to a Lil Bunny staff member at guest services in order to obtain a medical wristband. I understand that failure to adhere to these rules may result in being denied entry of myself and the participant(s) undersigned.
9. Photos and use of recording devices may be used on premises and images and videos of children may be used for marketing and security purposes. I further authorize Lil Bunny to use my or my child(ren)’s name, face, likeness, voice and appearances in connection with exhibitions, publicity, online or print advertising, and promotional materials.
10. I understand and agree that NO REFUND will be given to myself and the participant(s) undersigned if we have stayed 20 minutes or more regardless of the situation.
11. I acknowledge that the involvement of myself and the participant(s) undersigned in activities at Lil Bunny is voluntary and no one is forcing me to participate in spite of the risks. I hereby certify that I am over 18 years of age. I have carefully read the foregoing covenant not to sue, assumption of risk, and acknowledge that I understand and agree to all of the above terms and conditions. Prior to signing this agreement, I have had an opportunity to ask any and all questions. I am aware that by signing this agreement, I assume all risks and waive and release all substantial rights that I may have possess. I understand that this waiver is subject to change.
12. As Lil Bunny is a child/parent environment, the designated supervising adult(s) are responsible for the child(ren) in their care. While our staff will work hard to ensure everyone has fun, safe, and appropriate play, if a child is unable to follow the facility rules, the
following steps will be taken to ensure other guests are able to enjoy their playtime:
1st Warning: The rule will be reviewed with the child again to ensure complete understanding of Lil Bunny safety rules. 2nd Warning: The parent will be notified of the child's behavior and a last warning given. 3rd Warning: The child will be asked to discontinue play for at least 10 minutes (including the possibility of leaving Lil Bunny with no possibility of a refund).Bullying and unsafe play will not be tolerated.
13. If the participant is of minority age, the undersigned parent or guardian hereby gives permission for Lil Bunny to authorize emergency medical treatment as may be deemed necessary for the minor(s) named below while participating in Lil Bunny activities. The undersigned hereby releases, discharges, covenant not to sue, and
agrees to indemnify and save and hold harmless Lil Bunny from all liability, claims, demands, losses or damages on the minors account caused or alleged to have been caused in whole or in part by the negligent medical treatment, failure to provide medical treatment, or negligent rescue operations, and further agrees to indemnify and hold harmless Lil Bunny from any litigation expenses, attorneys fees, loss liability, damages, or costs incurred by Lil Bunny as a result of any such claim.
I HAVE READ THE ABOVE MEDICAL PERMISSION AUTHORIZATION AND BY SIGNING IT AGREE THAT IT IS MY INTENTION TO EXEPMT AND RELIEVE LIL BUNNY FROM ALL LIABILITY ARISING AS THE RESULT OF THIS MEDICAL AUTHORIZATION. PLEASE REVIEW ALL LIL BUNNY SAFETY RULES WITH YOUR CHILDREN AND ENSURE THAT THEY ARE NOT CHEWING ON ANYTHING AT ALL TIMES WHILE ON THE SOFT FLOOR TO AVOID CHOKING OR VOMITING. IF A STAFF MEMBER FEELS A CHILD IS UNHEALTHY TO CONTINUE PLAY, LIL BUNNY STAFF MAY STOP THEIR PLAY AND OFFER A FREE ADMISSION TO RETURN ANOTHER DAY.
NOTE: ALL EQUIPMENT IS EXCLUSIVELY DESIGNED FOR CHILDREN ONLY. YOU, AS A PARENT OR GUARDIAN, ARE NOT ALLOWED TO TRY ANY EQUIPMENT OTHER THAN THE LARGE PLAYGROUND STRUCTURE.
YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM AND LIL BUNNY HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM