Waiver and Release of Liability Parent/Guardian * First Name Last Name Email * Phone (###) ### #### Minor Name * First Name Last Name Minor Name First Name Last Name Minor Name First Name Last Name Minor Name First Name Last Name Minor Name First Name Last Name Checkbox * I understand that there are materials on premise that are considered choking hazards for children under the age of 3 years. Checkbox * I understand that parents/guardians are responsible for the supervision of children. Checkbox * I understand the philosophy to offer respect to others, materials, and the space. I will assist in encouraging gentle touches of others, soft voices inside, and respectful use of materials. Checkbox * I understand that myself and the children are responsible for keeping the space clean and will assist with putting materials away. Checkbox * I understand that food and drink are only allowed in the designated areas. I consent and authorize the use and reproduction by MHK Play Studio of any and all photographs and videos that have been taken of those on this form for any purpose, without compensation to me. * Yes No Materials within our space(s) have been donated by Kodo Kids, a STEM material company for education facilities. * I consent and authorize the reproduction by Kodo Kids, LLC, of any and all photographs and videos that have been taken of me during my family visits for education, sales, and marketing materials, without compensation to me. Yes No Would you like to be added to our listserv? Yes No Select As the parents and/or legal guardian of the person under age 18, I have read this Waiver, Consent, and Release of Liability. I fully accept the terms and conditions of the Release including the full and general release, indemnity and hold harmless of the Company and the agreement to never file a lawsuit against the Company. I have considered the risks involved and believe the opportunity for the person under age 18 to participate in the Activities and use the Premises is worthwhile and useful to the person under age 18's development. I have discussed the risks with the person under age 18 and have determined that we should accept those risks in this agreement. I agree to undertake all duties and responsibilities to educate, control and protect the person under age 18 from all of the risks involved or maybe all of the risks involved in Activities or of the Premises. I agree to make all decisions concerning the person under age 18's participation and involvement. Yes No Thank you!
