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Indoor Playspace Registration Form

*Raising Wonder Foundation requires each new playspace visitor to be included on the following registration form. This registration is valid for one year from the completed date.

Parent/ Legal Guardian First Name

Parent/ Legal Guardian Last Name

Phone

Additional Parent / Legal Guardian / Adult Full Name

Child Name, Age

Additional Child Name, Age

How did you hear about us?

Liability Waiver

I, the undersigned parent/guardian/caregiver, understand that participation in activities at this indoor playspace involves inherent risks, including but not limited to slips, falls, collisions, choking hazards, and other injuries that may occur during play. I acknowledge that I am voluntarily allowing my child(ren) to participate and assume full responsibility for any risks of injury, illness, or harm that may occur. On behalf of myself and my child(ren), I hereby release, waive, and hold harmless the nonprofit organization, its directors, officers, employees, volunteers, and affiliates from any and all claims, liabilities, damages, or expenses arising from participation in activities within the facility, except in cases of gross negligence or willful misconduct.

I understand and agree that this facility is not a drop-off childcare center. I agree that I am solely responsible for the supervision, behavior, and safety of my child(ren) at all times during our visit. I will remain on-site and actively supervise my child(ren) throughout the duration of our stay.

I agree that my child(ren) and I are in good health and free from contagious illness when visiting. I understand the importance of monitoring for small objects and potential choking hazards. I will ensure that no toys or items are brought from home unless medically deemed as necessary for my child(ren) and are age-appropriate and safe.

I agree to promptly inform staff or volunteers of any injuries, accidents, unsafe conditions, or conflicts that occur during our visit, whether involving my child(ren) or others.

I understand that the organization reserves the right to deny entry or terminate a visit without refund if any individual’s behavior is unsafe, disruptive, or in violation of these policies.

I understand that the organization is not responsible for lost, stolen, or damaged personal items.

I understand that this indoor playspace is operated by a nonprofit organization. My participation and any associated fees or donations support the organization’s mission and community programming.

I acknowledge that I have read and understood this waiver and voluntarily agree to its terms.

Emergency Contact Information

Please provide at least one emergency contact other than the parent/guardian listed above. (Full Name, Phone, Family Relationship)

You are welcome to share any additional information about your child(ren)’s allergies, needs, preferences, or accommodations that would help us create a safe, supportive, and inclusive experience for your family.

In the event of an emergency, I authorize staff/volunteers to contact emergency services if needed. I understand that I am responsible for any medical expenses incurred.

Media Release Consent

From time to time, Raising Wonder Foundation staff/volunteers may photograph or record participants during programs and events for educational, promotional, fundraising, social media, website, or other nonprofit-related purposes. Names will not be publicly shared without additional consent.

Please select one:

YES, I grant permission for my child(ren)'s photograph, video image, and/or likeness to be used by Raising Wonder Foundation without compensation.

NO, I do not grant permission for my child(ren)’s photograph, video image, and/or likeness to be used.

By signing below, I acknowledge that I have received, read, and agree to follow the terms outlined in the above liability waiver, emergency contact information, and media release consent sections established by Raising Wonder Foundation.

Signature

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