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Birthday Party Waiver
Birthday Party Waiver
Birthday Party Waiver
Participants of the birthday party must complete the form below before participating!
Parent/Guardian Name
(Required)
First
Last
Participant's Name
(Required)
First
Last
Today's Date
(Required)
MM slash DD slash YYYY
MINOR’S RELEASE AND WAIVER OF LIABILITY AGREEMENT
(Required)
I, THE PARENT/GUARDIAN/CUSTODIAN, OF THE MINOR CHILD HEREBY ACKNOWLEDGE THAT I HAVE FULLY READ AND UNDERSTAND EACH OF THE ABOVE PROVISIONS AND THAT I UNDERSTAND I AM GIVING UP SIGNIFICANT LEGAL RIGHTS OF MINE AND MY CHILD’S, INCLUDING THE RIGHT TO SUE THE COMPANY. I ACKNOWLEDGE THAT PRIOR TO SIGNING THIS AGREEMENT I HAD THE OPPORTUNITY TO CONSULT WITH AN ATTORNEY TO REVIEW THIS AGREEMENT. I AM AT LEAST EIGHTEEN (18) YEARS OF AGE AND FULLY COMPETENT, AND I EXECUTE THIS AGREEMENT VOLUNTARILY AND FOR ADEQUATE CONSIDERATION INTENDING TO BE FULLY BOUND.
WHEREAS, PHOENIX ALL STARS, INC. (“Company”) is the owner and operator of an
activity, Tumbling, Cheerleading, Obstacle Courses (the “Activity”), and is willing to permit the
minor individual (the “Child”) on whose behalf the parent/guardian/custodian is signing this
Agreement to participate in the Activity, upon the terms and conditions of this Agreement. All of
the Activity shall take place on property controlled by the Company. The location of the
Activity shall be on property (the “Premises”) located at 1007 Hill Ave, Wyomissing, PA 19610.
The Company and Participants signing this Agreement may be collectively referred to as (the
“Parties”).
In consideration for being provided the ability to participate in the Activity and enter the
Premises, I, and my minor child, signing below hereby stipulate and agree:
1. Scope and Continued Application. This Minor’s Release and Waiver of Liability
Agreement applies to me, the parent or legal guardian signing on behalf of my Child, to my
Child as a minor, and to my Child when they reach the age of majority or become an adult
member of Company.
2. Use of Premises for Activity Only. I understand and agree that my Child may only use the
Premises for the Activity set forth in this Release and Waiver of Liability agreement. I
further agree that my Child is responsible for the proper use and care of the Premises and any
of Company’s property thereon, and that I will be liable for the replacement cost of any
Company property/equipment which is damaged, destroyed or lost by my Child.
3. Acknowledgement of Danger. I understand and acknowledge that the Activity my Child
wants to participate in is extremely strenuous. I recognize and understand these Services are
not without varying degrees of risk, which may include, but are not limited to the following:
(1) PHYSICAL INJURY AND/OR DEATH including minor injuries and major injuries such
as joint and knee/back/foot/shoulder injuries, broken bones, concussions, rhabdomyolysis,
musculoskeletal injuries, muscle strains, pull or tears, shin splint, heat exhaustion,
cardiovascular injuries, heart attack, stroke, and brain injuries, injuries from falling from
heights during jumping and climbing activities, impact injuries, and collision injuries; (2)
exposure to, and sickness from, infections viruses, bacteria and disease, including but not
limited to, COVID-19; and (3) property damage. I understand that the Premises may contain
toys or other items that other children have brought along with them, and I willingly accept
the risk related to these objects being around and/or in contact with my Child. I further
acknowledge that any injury my Child may sustain while participating in the Activity may be
compounded by improper use or failure of equipment, a known or unknown medical
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condition, negligent or delayed medical service, or negligent or delayed assistance by the
Company.
4. Acceptance of Responsibility. I willingly assume full responsibility for any and all risks
that I am exposing my Child to as a result of my Child’s participation in any Activity in the
Premises and training program and accept full responsibility for any injury or death that may
result from their participation.
5. Assumption of Risk. Understanding, acknowledging, and accepting all the risks and
hazards involved with the Services, I freely and voluntarily choose to all my Child to
participate, enter, and use the Premises, and I, FOR MYSELF AND ON BEHALF OF MY
CHILD, HEREBY VOLUNTARILY AND EXPRESSLY AGREE TO ACCEPT AND
ASSUME ALL RISK OF LOSS, DAMAGES, THEFT, INJURY OR DEATH THAT MAY
OCCUR TO MY CHILD OR THEIR PROPERTY AS A RESULT OF OR INCIDENT TO
MY CHILD’S PARTICIPATION IN THE SERVICES, INCLUDING THE RISK THEY
MAY BE INJURED BY THE ACTIONS, OMISSIONS, REPRESENTATIONS OR
NEGLIGENCE OF THE COMPANY, ITS OWNERS, AGENTS, OFFICERS,
PRINCIPALS, EMPLOYEES, INDEPENDENT CONTRACTORS, VOLUNTEERS, OR
ANY OTHER PERSON ASSOCIATED WITH COMPANY (“RELEASED PARTIES”),
OTHER PARTICIPANTS OR THIRD PARTIES WHILE PARTICIPATING IN THE
SERVICES OR FROM OR USING OR VISITING THE PREMISES. I understand and
agree that this Agreement will be binding on me, my spouse (or registered domestic partner),
my guardians, the executors or administrators of my estate, my heirs, my personal
representatives, my assigns, my successors in interest, my children, and any guardian ad
litem for said children (collectively, the “releasors”). I accept full and complete responsibility
for the safety of myself, any guests, observers or other individuals who I have invited to the
Premises, and property we have brought to the Premises, and I assume the risk of damage,
theft, loss or injury caused by others to me, my guests and our property. I also accept full and
complete responsibility for the consequences of my Child taking unreasonable risks while
participating in the Services or using the Premises, including, without limitation, attempting
activities that my Child not qualified to perform safely, causing any other
participants/spectators an unreasonable risk of harm, or failing to follow correct safety
procedures when using the Premises and participating in the Services.
6. Physical Contact Acknowledgement. I understand that the Activity my Child will be
participating in involves physical contact between my Child, other participants, and those
presenting Company. I give permission for my Child to be touched in a professional manner
by coaches and trainers representing the Company and recognize that they will have direct
contact with my Child when doing so. I acknowledge that it is my responsibility to notify
Company if I am uncomfortable with this physical contact with my Child and will work with
Company to determine how my Child may continue to participate in the Activity with no
contact.
7. Publicity Release. For good and valuable consideration, the receipt of which is hereby
acknowledged, I hereby irrevocably grant to Company, the irrevocable, perpetual and
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unrestricted (except as expressly set forth below) right and permission, to use and publish my
Child’s appearance (“publicity rights”) in any and all media now or hereafter known in
connection with the Company, the Services, including any goods or products, or any related
activities to any of the foregoing (all such medium in which the Publicity Rights are used
shall be referred to as the “pictures”), for any commercial purpose whatsoever, without
royalty, payment, or any other compensation whatsoever to me or my Child. For such use of
the Publicity Rights and the Pictures, I understand and agree that I and my Child will not be
entitled to any compensation or consideration beyond my Child’s participation in the
Services. I further agree that the Company may edit, alter, digitize, synchronize, reproduce or
otherwise change the Pictures for any such purpose. I acknowledge that I and my Child shall
have no, and hereby expressly disclaim, any ownership, authorship or moral rights in the
Pictures or any part thereof.
8. Video Surveillance. I recognize the need for video surveillance on and about Premises for
security and productivity purposes. I recognize and agree that it is a condition of my Child’s
participation at the Company that I freely execute and agree to this video surveillance,
including being personally recorded pursuant to said video surveillance. I agree that the
Released Parties may use any taping of my Child’s image, voice or appearance at any time
pursuant to said video surveillance at its discretion in the ordinary course of its operations.
9. Audio/Visual Publicity Waive. I agree to indemnify and hold harmless the Released
Parties, its agents, successors, and assigns, from any and all claims, demands, actions or
causes of action, liabilities, costs, dues, sanctions, fees, penalties, or expenses of any sort
arising from the making of such recordings of my Child and their lawful and appropriate use.
I further acknowledge that the Company exclusively owns all rights to these recordings
regardless of the form in which they are produced or used.
10. Copyrights. The rights granted to the Released Parties herein include, without limitation, all
rights of every nature whatsoever in connection with use of the Pictures, including without
limitation all copyrights (and any other intellectual property rights) therein and renewals and
extensions thereof. I acknowledge and agree that all copyrights and right of every other kind
relating or pertaining to the Pictures described above are the sole property of the Company
and I and my Child have no claim to the copyrights (or any other intellectual property rights)
in the Pictures.
11. Responsibility for Personal Property. I acknowledge and agree that my Child is fully and
solely responsible for any of my Child’s property and personal belongings that he/she brings
onto the Premises or that he/she uses during the Activity, and that the Company will not be
responsible for or provide any security for his/her property and personal belongings.
12. No Representations by Company. I acknowledge that Company makes no representation as
to the condition of the Premises or the safety of the Activity or any equipment either on the
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Premises or used in the Activity. I accept, and my Child shall use, the Premises, and its
equipment, in its “AS IS” condition. I acknowledge and agree that I am not relying upon any
representation or statement by the Company or the Company’s employees, agents, sponsors,
or representatives regarding this agreement or the Premises or Activity, except to the extent
such representations are expressly set forth in this agreement.
13. Service Animals: I understand that only dogs trained as service animals, within the
definition of the Americans with Disabilities Act, to perform tasks or work for a person with
a disability are permitted as service animals.
(a) Service animals must be well-behaved and under control at all times. If the service
animal is not under control, or behaving inappropriately, I understand that Company
may ask me to leave. Inappropriate behavior includes showing aggression, being
disruptive, or not being housebroken. I understand that if the presence of the service
animal poses a direct threat to the health or safety of others that cannot be mitigated, I
may be asked to remove the service animal from the premises. I shall be liable for any
damage or injury to any person or property caused by such animal as a result of my
negligence or failure to control or properly handle the service animal. I will indemnify,
defend, and hold harmless Company, and its owners, agents, officers, principals,
employees, independent contractors and volunteers for any damages, loss, expenses,
attorneys' fees, costs, judgments or liability which might accrue as the case may be,
because of the my negligence or failure to control or properly handle the service
animal.
14. Bouncy House and Trampoline. In consideration of my Child being allowed to use the
bouncy house, trampoline, and surrounding area for recreational and instructional purposes, I
release the Released Parties from all liability and for any loss or damage to property, physical
injury or death to my Child whether caused by Released Parties or otherwise that result,
directly or indirectly from the use by my Child of the bouncy house, trampoline, and
surrounding area owned by Company located on the Premises. I further agree to indemnify,
save and hold Released Parties harmless from any loss, liability, attorney fees, damage, or
costs that they (or any of them) may incur arising out of or related to the use of said bouncy
house and surrounding area by my Child whether caused by the negligence of the Released
Parties or otherwise.
(a) I further agree and warrant that if at any time I believe conditions to be unsafe
regarding the use of said bouncy house, trampoline, and surrounding area I will inform
Released Parties in writing and immediately discontinue use of said bouncy house and
trampoline.
(b) I fully understand that use of a bouncy house and trampoline involves risks and
dangers to my Child of serious bodily injury, including permanent disability, paralysis,
and death. I fully understand that these Risks and dangers may be caused by the actions
or inactions of my Child or the actions or inactions of others participating in bouncy
house and trampoline activities. I understand that use of the bouncy house, trampoline,
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and surrounding area will not be supervised by any of the Released Parties, and I fully
accept and assume all such risks and all responsibility for losses, costs, and damages
my Child incurs as a result of such bouncy house and trampoline activities.
15. Consent to Medical Treatment. I understand that the Services that take place on the
Premises may not be supervised and that the Company does not provide medical services. I
understand that certain prescribed medications may exacerbate these physiological changes
and create an even greater risk of physical damage or death to my Child. In connection with
any injury that my Child may sustain or illness or other medical conditions that my Child
may experience during their presence at the Company, I authorize and consent for my Child
to receive any emergency first aid, medication, medical and/or surgical treatment deemed
necessary by the attending personnel and/or the Released Parties. I acknowledge that the
Released Parties are under no obligation to provide such medical treatment or services, and
the Released Parties do not warrant or make any representation concerning the adequacy or
continuation of such medical services, nor can the Released Parties be deemed responsible or
held liable for any claims arising out of the provision of such medical services or the failure
to provide or to continue to provide such medical services. I further authorize the Released
Parties to execute on my behalf and my Child’s behalf any permission forms, consents or
other appropriate documents relating to medical attention and to act on my behalf if not able
or immediately available to do so and the same is urgent as determined in their sole
discretion. I ACKNOWLEDGE AND AGREE THAT EMERGENCY ASSISTANCE
AND/OR TREATMENT MAY BE RENDERED BY PERSONS WITH TRAINING OR
EXPERIENCE WHICH MAY NOT BE ADEQUATE FOR CERTAIN MEDICAL
SITUATIONS AND/OR THE INJURIES SUSTAINED BY MY CHILD, WHICH
INJURIES MAY BE COMPOUNDED BY NEGLIGENT FIRST AID OR EMERGENCY
RESPONSE OF THE RELEASED PARTIES OR OTHER INDIVIDUALS OR MEDICAL
OR EMERGENCY PERSONNEL AND WAIVE ANY CLAIM IN RESPECT THEREOF. I
expressly acknowledge that if the Company is located some distance from medical facilities,
that such distance may exacerbate any injury or condition sustained by my Child. I shall be
responsible for all costs associated with such medical care and related transportation.
16. Release from Liability and Waiver. In full consideration of the above mentioned risks and
hazards and in full consideration of the fact that I am willingly and voluntarily allowing my
Child to participate in the Services, I HEREBY WAIVE RELEASE AND FOREVER
DISCHARGE ON MY BEHALF AND MY CHILD’S BEHALF ANY AND ALL CLAIMS
OR CAUSES OF ACTION, NOW KNOWN OR HEREAFTER KNOWN IN ANY
JURISDICTION THROUGHOUT THE WORLD, AGAINST THE RELEASED PARTIES,
INCLUDING, WITHOUT LIMITATION, ANY BODILY INJURY OR DISABILITY,
ILLNESS OR DISEASE, ACCIDENT, DEATH, FINANCIAL LOSS, PROPERTY LOSS,
DAMAGE, DESTRUCTION, DELAY, INCONVENIENCE OR OTHER HARM OF
WHATEVER NATURE THAT MAY BE DIRECTLY OR INDIRECTLY RELATED TO,
ARISING FROM OR SUSTAINED FROM PARTICIPATION IN THE SERVICES
AND/OR USE OF THE PREMISES OR ACTIVITIES RELATED THERETO,
NEGLIGENT FIRST AID OR EMERGENCY RESPONSE OF THE RELEASED PARTIES
OR OTHER NEGLIGENT ACT OR OMISSION OR BREACH OF ANY EXPRESS OR
IMPLIED WARRANTY OF ANY RELEASED PARTIES OR OTHERWISE, provided that
6
nothing in this Section shall be deemed to release any Released Party from liability arising
from their own willful or intentional injury to me or my property.
17. Indemnification: I SHALL INDEMNIFY, DEFEND, AND HOLD HARMLESS THE
RELEASED PARTIES, JOINTLY AND SEVERALLY, FROM AND AGAINST ANY
AND ALL CLAIMS, ACTIONS, DEMANDS, RIGHTS, LOSSES, COSTS, DAMAGES,
EXPENSES, SETTLEMENTS, JUDGMENTS, CAUSES OF ACTION AND LIABILITIES
OF ANY KIND WHATSOEVER, WHETHER FORESEEN OR UNFORESEEN,
INCLUDING ATTORNEYS’ FEES, IN LAW OR IN EQUITY, ARISING OUT OF OR
RESULTING FROM ANY CLAIM RELATED TO MY CHILD’S PARTICIPATION IN
THE SERVICES, INCLUDING WITHOUT LIMITATION, MY OR MY CHILD’S
BREACH OF THIS AGREEMENT OR PREMISES RULES AND POLICIES, ANY
INDIVIDUAL WE INVITE TO THE PREMISES, OR ANY OTHER THIRD PARTY
CLAIM RELATED TO THE SERVICES.
18. Covenant Not to Sue. I agree, for myself, my Child, and all my heirs, not to sue the
Released Parties or initiate or assist in the prosecution of any claim for damages or cause of
action against the Released Parties which I, my Child, or my heirs may have as a result of
any personal injury, death or property damage my Child may sustain while on or using the
Premises or while participating in the Activity.
19. Transition. Upon reaching the age of majority or becoming an adult member of the Gym,
my Child assumes all rights, responsibilities, and liabilities associated with their participation
in cheerleading activities. The terms and conditions of this Agreement shall continue to apply
to my Child in their individual capacity. My Child, upon reaching the age of majority or
becoming an adult member, hereby agrees to sign a separate waiver acknowledging their
understanding of the risks involved and releasing the Gym, its staff, employees, and
volunteers from any and all liability. This separate waiver shall be signed within thirty (30)
days of my Child reaching the age of majority or becoming an adult member.
20. Waiver of Terms. No waiver of any term or right in this Release and Waiver of Liability
agreement shall be effective unless in writing, signed by an authorized representative of the
waiving party. The failure of any party to enforce any provision of this agreement shall not
be construed as a waiver or modification of such provision, or impairment of its right to
enforce such provision or any other provision of this agreement thereafter.
21. Survival. Any provision of this Release and Waiver of Liability agreement providing for
performance by either party after termination of this agreement shall survive such
termination and shall continue to be effective and enforceable.
22. Governing Law and Venue. This Release and Waiver of Liability agreement will be
governed by and interpreted in accordance with the laws of the Commonwealth of
Pennsylvania, without giving effect to the principles of conflicts of law of such state. I agree
that any action arising out of this Release and Waiver of Liability agreement must be brought
exclusively in any state or federal court located in Berks County, Pennsylvania.
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23. Compliance with Laws. In the performance of the terms of this Release and Waiver of
Liability agreement and use of the Premises, the parties shall comply with all applicable
federal, state, regional and local laws, rules and regulations.
24. Severability. If any provision or portion of this Release and Waiver of Liability agreement
shall be held by a court of competent jurisdiction to be illegal, invalid, or unenforceable, the
remaining provisions or portions shall remain in full force and effect.
25. Entire Agreement; Modification; Binding Effect. This Agreement is the entire agreement
between the parties with respect to the subject matter hereof and supersedes any prior
agreement or communications between the parties, whether written, oral, electronic, or
otherwise. No change, modification, amendment, or addition of or to this agreement shall be
valid unless in writing and signed by authorized representatives of the parties. This
agreement shall be binding upon and inure to the benefit of the successors, assigns, and legal
representatives of the parties.
26. Parental Consent: I, the undersigned parent or legal guardian of the minor child, have read
the above and understood the foregoing assumption of risk, and release of liability, and agree
to its terms on behalf of my child and myself. I understand that by signing below, I am giving
up substantial rights on behalf of my child and myself.
Signature
(Required)