Acknowledgement of Risks:   I, the undersigned parent or legal guardian hereby acknowledge that my above-named child wishes to participate in activities at Play Date Cafe WI. I understand and acknowledge that even in a controlled indoor environment designed for young children, there are inherent risks associated with participation in indoor play and recreational activities, including but not limited to: 

• Slips, trips, and falls;

• Collisions with other children;

• Injuries resulting from the use of play equipment, structures and toys;

• Exposure to germs, bacteria, viruses, or communicable illnesses;

• Unpredictable behavior of other children;

• Choking hazards. 

On behalf of myself and my Child, I knowingly and voluntarily assume all such risks, both known and unknown. 

Medical Authorization:  In the event of an emergency, I authorize Play Date Cafe WI to seek medical assistance for my Child if necessary and agree to be responsible for any medical expenses incurred. 

Health Representation:  I represent that: 

I. My Child is physically able to participate in activities;

II. My Child does not have any condition(s) that would make participation unsafe, or I have disclosed such condition to Play Date Cafe WI;

III. My Child is not experiencing any symptoms of illness that could pose a risk to others.

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Supervision Requirement:  I acknowledge that I must remain on the premises and supervise my Child at all times, including within the play area, cafe, and restrooms. I acknowledge that Play Date Cafe WI is a parent-supervised facility and does not provide childcare services nor are they responsible for supervising or monitoring individual children. I acknowledge that I am solely responsible for my Child’s safety, behavior and interactions with others. 

Right to Terminate Participation:  Play Date Cafe WI reserves the right to ask parents and their children to leave the premises if rules are not followed or for safety reasons without refund, including if a parent or guardian leaves the premises or fails to provide adequate supervision.

Photography & Video Release:  I grant Play Date Cafe WI permission to take photographs and videos of my Child during activities on the premises and to use them for promotional and marketing purposes, including but not limited to on social media platforms, newsletters and website content, either in print or on the internet.

Waiver & Release of Liability:  I, on behalf of myself and my Child, do hereby release, waive, and discharge Bumbakk LLC d/b/a Play Date Cafe WI, its owners, employees, and agents, from any and all claims, demands, causes of action, losses, or liabilities for any injuries, illnesses or damage that may occur during, as a result of, or related to my Child’s participation in the indoor play activities.