Multi-Use Waiver
I received this waiver and release because I chose to visit, participate or bring one or more minor children
to participate (“Child/Children”) in the activities (“Activity” or “Activities”) at JMPW, LLC d/b/a The Playpen
(“The Playpen”). I acknowledge that as a condition of my/my Child/Children’s participation I am required
to read, understand and sign this waiver and release, and abide by the terms and conditions of
participation contained in this waiver and release, and all other rules of participation set by The Playpen.
Therefore, I hereby acknowledge and agree as follows:
1. General Policies and Procedures:
(a) For the well-being of the other children, please do not bring a sick Child to the Playpen. If noticed by
staff, they have the authority to ask you to reschedule.
(b) Disruptive or inappropriate behavior will not be tolerated. In these circumstances, parents/guardians
will be notified immediately. After 3 incidents, a Child will not be allowed to return.
(c) Parents/Guardians will be responsible for any damages caused by their Child during their Child’s visit.
(d) Medications will not be administered by The Playpen staff.
(e) Medical Treatment Authorization: In the event my Child becomes injured or ill while at The Playpen, I
authorize The Playpen to secure first aid and/or the services of any legally qualified physician or hospital
for my Child and I agree to assume any financial obligations incurred therewith.
(f) The Playpen is not responsible for any lost, damaged or stolen items. Please keep track of your
belongings.
2. If I choose the Stay & Play option:
(a) I understand that it is my responsibility to supervise my Child/Children at all times while at The
Playpen. I acknowledge that I will watch my Child/Children closely at all times and never leave
him/her/them unattended.
(b) I acknowledge and agree that The Playpen shall not be liable for any loss or damage to person or
property as a result of my failure or the failure of anyone at The Playpen to supervise or otherwise attend
to my Child/Children or any other children.
3. If I choose the Stop, Drop & Roll option:
(a) I understand that if my Child is inconsolable for more than 15 minutes, I will be notified and asked to
return to The Playpen to assist staff.
(b) I understand that my Child/Children will be released ONLY to the person who dropped him/her/them
off unless The Playpen has been provided written consent to allow a named third-party to pick up the
Child/Children.
(c) I understand that my Child/Children cannot be left at The Playpen for longer than the agreed time slot
purchased. A late pick up fee of $15 will be processed automatically if picked up later than 15 mins from
scheduled pick up time.
4. Authorization for Multi-Use: I understand that if I authorize The Playpen to use this waiver and release
as a multi-use waiver and release, that I will not be required to sign a separate waiver and release every
time I visit The Playpen. However, I also understand that from time to time The Playpen may update or
otherwise modify their waiver and release, and if that happens I accept that I will be required to sign the
new waiver and release for me and my Child/Children to continue participating in Activities at The
Playpen.
5. Acknowledgement and Assumption of Risks: I hereby voluntarily choose to have my Child/Children
participate in Activities at The Playpen despite any risks to me or my Child/Children. I fully assume
responsibility for all risks of physical harm or property damage in any form to me or my Child/Children
that may occur as a result of my visit to The Playpen, however caused, to the fullest extent allowed by the
law. I understand The Playpen is not a licensed childcare facility. I acknowledge and agree that I may be
dismissed by any of the Playpen’s staff or authorized representatives if I do not abide by the rules and
policies instituted by The Playpen.
6. Indemnification and Hold Harmless: I hereby agree as follows: for myself and my minor child, and my
estate, heirs, administrators, executors and assigns, hereby release, discharge and hold harmless JMPW,
LLC d/b/a The Playpen, including its respective members, officers, employees, representatives, agents,
contractors, and volunteers, for, from and against any and all liability and responsibility whatsoever, for
any and all damages, claims, or causes of action, that my minor child or I may have for any loss, personal
injury, or death, arising out of any injury or accident sustained by my child which was not a result of The
Playpen’s negligence, including but not limited to, any injury or accident resulting from a food allergy,
health issue, disability, or other matter unique to my child unless such food allergy, health issue,
disability, or other matter was disclosed to The Playpen in this form. I certify that I am the parent or legal
guardian of the Child/Children whose name(s) appears above, and I have authority to waive rights on their
behalf.