440.729.09094400 Renaissance Pkwy

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WARRENSVILLE HTS/ORANGE

440.729.0909 PgWorld.com

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4400 Renaissance PkwyWarrensville Hts/Orange

See Map Below For Directions

Please RSVP To:

Party Guest Registration and Waiver FormThis form MUST be filled out or your child(ren) will not be allowed to participate.

Child Name DOB Child Name DOB

Child Name DOB Child Name DOB

Address City Zip

Email Address

Emergency Contact Emergency Number• I realize that I am responsible for all medical expenses for my child(ren) that may be needed due to their participation at your facility.• I understand that participation involves motion, rotation and heights in a unique environment and as such carries with it the risk of injury. I am voluntarily allowing my child to participate in

this activity with knowledge of the risks involved and hereby agree to accept any and all inherent risks of property damage, personal injury or death. I hereby release Playground World, Inc. it’s affiliates, agents, owners and employees from any liability for accidents while participating at Playground World, Inc.

• To the best of my knowledge my child(ren) can safely participate. Please consult with Playground World staff for any specific equipment concerns. • Adults should remain within arm’s length of their children. Some items in the showroom could contain small parts and present a hazard to younger children. Some Equipment requires adult

assistance for younger children.• All safety rules must be observed including Trampoline Rules and Children MUST be attended by Adult when on MONKEY BARS.• No jewelry is to be worn and no food, drinks, or gum/candy will be consumed in the showroom area. Playground World, Inc. is not responsible for any personal items that are lost or stolen.• I grant to Playground World (PGW) the right to take photographs and/or video of myself and minor children within a PGW showroom for the sole purpose of posting to PGW’s social media sites.

Print Parent/Guardian NameBy signing this waiver I verify that I am the parent or legal guardian of the above-named child (ren) and that I have read, understand and agree to Playground World, Inc. Waiver Form.

Signature Date **If you have any questions regarding the above please see a Playground World employee**

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