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.

!