playdate pdx! a party at you‛re invited to pdx copy.pdfyou‛re invited to a party at playdate...

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You‛re invited to a party at PlayDate PDX! You‛re invited to a party at PlayDate PDX! R Party in honor of: Date: Time: RSVP to: RSVP by: Phone number: Address: 1434 NW 17th Street, Portland, OR, 97209 Website: www. PlayDatePDX.com PLEASE BRING YOUR OWN SOCKS and wear comfortable, loose fitting garments as PlayDate PDX parties are both fun and interactive See map on back A SIGNED WAIVER IS REQUIRED FOR ALL ACTIVITIES AT PLAYDATE The undersigned and on behalf of the participants below, acknowledges and agrees to these conditions: I am signing this form on behalf of myself and my child(ren).. We voluntarily agree to abide by the stated customary terms, rules and conditions for participation in any party and/or program at PlayDate. If I witness any hazard or peril during my participation, I will immediately bring it to the attention of an employee. I understand there is a risk of injury from any play equipment. I acknowledge that while rules, equipment design, and supervision reduce risk, the risk of possible injury does exist. I voluntarily assume all risks to include identified and unidentified, even if stemming from the negligence of other participants or employees. I, on behalf of my heirs, assigns, personal representatives, and next of kin, herby hold harmless PlayDate employees, owners and affiliates with respect to any and all injury, disability, loss or damage to person and/or property to the fullest extent of the law. I do hereby give permission to PlayDate, to make use of photographs and images taken during my activity in advertising and promotion activities. Use of my photographs and images by PlayDate may be done without further notice or obligation to me. Child‛s Name: Child‛s Name: ________________________________ ________________________________ Date: ___/___/___ Guardian or Adult (please print): Signature: ________________________ _______________________ Guardian or Adult (please print): Signature: ________________________ _______________________ PLEASE BRING YOUR SOCKS and wear comfortable, loose fitting garments as PlayDate PDX parties are both fun and interactive. !

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You‛re invited toa party at

PlayDate PDX!

You‛re invited toa party at

PlayDate PDX!

R

Party in honor of:

Date:

Time:

RSVP to:

RSVP by:

Phone number:

Address: 1434 NW 17th Street, Portland, OR, 97209Website: www. PlayDatePDX.com

PLEASE BRING YOUR OWN SOCKS and wear comfortable, loose fitting garments as PlayDate PDX parties are both fun and interactive

See map on back A S

IGN

ED W

AIV

ER I

S RE

QU

IRED

FO

R A

LL A

CTIV

ITIE

S A

T PL

AYD

ATE

The

unde

rsigne

d an

d on

beh

alf

of t

he p

articipa

nts

below,

ack

nowl

edge

s an

d ag

rees

to

thes

e co

nditions

:

I am

sig

ning

thi

s fo

rm o

n be

half

of

mys

elf

and

my

child

(ren

).. W

e vo

lunt

arily

agr

ee t

o ab

ide

by t

he s

tate

d cu

stom

ary

term

s, r

ules

and

con

diti

ons

for

part

icip

atio

n in

any

par

ty a

nd/o

r pr

ogra

m a

t Play

Dat

e. I

f I

witn

ess

any

haza

rd o

r pe

ril d

urin

g m

y pa

rtic

ipat

ion,

I w

ill im

med

iate

ly b

ring

it t

o th

e at

tent

ion

of a

n em

ploy

ee.

I un

ders

tand

the

re is

a r

isk

of in

jury

fro

m a

ny p

lay

equi

pmen

t. I

ack

nowl

edge

tha

t wh

ile r

ules

, equ

ipm

ent

desi

gn, a

nd s

uper

visi

on r

educ

e ri

sk, t

he r

isk

of p

ossi

ble

inju

ry d

oes

exis

t. I

vol

unta

rily

ass

ume

all r

isks

to

incl

ude

iden

tifi

ed a

nd u

nide

ntif

ied,

eve

n if

ste

mm

ing

from

the

neg

ligen

ce o

f ot

her

part

icip

ants

or

empl

oyee

s. I

, on

beha

lf o

f m

y he

irs,

ass

igns

, per

sona

l rep

rese

ntat

ives

, and

nex

t of

kin

, her

by h

old

harm

less

PlayD

ate

empl

oyee

s, o

wner

s an

d af

filia

tes

with

re

spec

t to

any

and

all

inju

ry, d

isab

ility

, los

s or

dam

age

to p

erso

n an

d/or

pro

pert

y to

the

ful

lest

ext

ent

of t

he la

w. I

do

here

by g

ive

perm

issi

on t

o Play

Dat

e, t

o m

ake

use

of p

hoto

grap

hs a

nd im

ages

tak

en d

urin

g m

y ac

tivi

ty in

adv

erti

sing

and

pro

mot

ion

acti

viti

es.

Use

of

my

phot

ogra

phs

and

imag

es b

y Play

Dat

e m

ay b

e do

ne w

itho

ut f

urth

er n

otic

e or

obl

igat

ion

to m

e.

Child

‛s N

ame:

Ch

ild‛s

Nam

e:

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

____

Dat

e: _

__/_

__/_

__

Guar

dian

or

Adu

lt (p

leas

e pr

int)

:

Sign

atur

e:

____

____

____

____

____

____

__

____

____

____

____

____

_ Gu

ardi

an o

r A

dult

(ple

ase

prin

t):

Si

gnat

ure:

____

____

____

____

____

____

__

____

____

____

____

____

_

PLEA

SE B

RING

YOUR

SOCK

S an

d we

ar c

omfo

rtab

le, l

oose

fit

ting

gar

men

ts a

s Play

Dat

e PD

X p

arti

es a

re b

oth

fun

and

inte

ract

ive.

!