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Information and Release Form
Vitals:
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Pickup Info:

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Terms & Conditions:

Please read carefully and acknowledge that you understand and agree to the terms set forth below by ticking the two checkboxes.


Release of Liability*


I acknowledge that Let's Playgroup is organized and always maintained with the students’ safety and security a top priority, but accidents may happen.  I understand that playgroup is held outside in a public park and that my child will be participating in physical outdoor activities (incl. running & climbing), which may involve wood branches, sticks, stones and earth.

While Let’s Playgroup will follow and implement measures according to CDC and NYS DOH guidelines, I understand that there is a risk of exposure to COVID-19 associated with my child’s participation in playgroup, including but not limited to social contact and interaction with Let’s Playgroup’s employees and other children.

To help reduce the spread of COVID-19 and to protect Let’s Playgroup’s employees and other children, Let’s Playgroup encourages all children and parents to adhere to all safety and health guidelines, as outlined in  Let’s Playgroup’s Summer 2020 guidelines , which also contain links to the guidelines from the CDC and NYS DOH.

Notwithstanding the foregoing, I understand that the above guidelines do not completely eliminate my child’s risk of exposure to COVID-19 and, should my child experience any COVID-19 related symptoms (such as fever, cough, body aches, or shortness o breath), I am advised to keep my child home, not to bring my child to Let’s Playgroup, and follow the advice of my healthcare provider, clinic, or hospital. In such case, I will immediately alert Let’s Playgroup of such symptoms.

Regardless of any steps taken by Let’s Playgroup to reduce the risks associated with the COVID-19 pandemic, I knowingly and freely, assume all such risks, both known and unknown, relating to my child’ care at Let’s Playgroup, including arising from, or relating to COVID-19.

In consideration of Let's Playgroup accepting this registration and permitting the participation of the above named child in such activities, which I believe to be educational, on behalf of myself and my family, I hereby release, discharge, indemnify and hold harmless Let's Playgroup, its employees, representatives and agents from any and all claims, actions and liabilities arising out of or in connection with the above named child’s participation in any aspect of the activities provided, even in the case of Let's Playgroup's negligence.

Tuition & Payment*


A non-refundable deposit of 25% of the tuition is required and due upon execution of this agreement. The deposit will be applied towards the last month’s tuition. Tuition is payable in full at the beginning of each month.

Media Release*


I do hereby consent and agree that Let’s Playgroup - Playing with Nature  has the right to take pictures and short videos of my child and use them on their website without compensation. My child’s name and identity  will not be revealed. 

Signature*


By  signing this form electronically I certify that my answers are  correct and complete. I am the legal guardian/parent of the child  listed above and I agree to the terms listed in this form .

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