Liability Waiver

Signee Information

First Name *

Last Name *

Your Date of Birth *

Phone *

Email Address *

Address *

Address Line 2

City *

State/Province *

Zip/Postal Code *

PLEASE READ

Please add all additional adults and children at the bottom of the waiver. This option is under participant. The signee does NOT need to be added as a participant. If there are any questions call our office at 530-780-5559

Tours

All guests touring the facility must sign and agree to terms to continue with tour of facility even if not applicable.

Facility Access Agreement*

This Play Facility Access Member Agreement (“Agreement”) is made and entered into on the date of execution below (“Effective Date”) between Member and Sensory Innovations LLC (“Sensory Innovations”) to access Play Facility (“Facility”) and services offered by Sensory Innovations.

Facility Access*

Your access to and use of the Facility (and resources contained therein) is conditional upon your acceptance and compliance with the terms, conditions, notices, policies and disclaimers contained in this document and other documents received by Sensory Innovations (collectively as “Terms of Use”). Your use of, and/or access to, the Facility constitutes your agreement to the Agreement and Terms of Use. If you do not agree to the Agreement and Terms of Use, please do not utilize the Facility.

Services Provided*

You understand that the services provided at the Facility by Sensory Innovations do not include medical advice of any kind.

Fees*

The total fee for your use of the Facility shall be based on your selection of the Package Options provided by Sensory Innovations.

Membership Cancellation Fee; 30 day notice required*

You may cancel your membership at any time for any reason. If you cancel you membership without a 30 day notice there is a $50.00 charge that will be charged to the card on file.

Membership Pause*

You may pause you membership at any time for any reason. This is only for 2 full months and will automatically restart after the 2 month pause. You are still required to pay a full month of your current membership in the case of wanting to cancel after a pause AND give a 30 day cancelation notice.

Pro-Visit Cancelation and No Show (OT/PT Pro-Visit)*

You may cancel your OT/PT appointment at any time for any reason. If you cancel your appointment in less than 24 hours or No Show to an appointment there is a $50.00 charge that will be charged to the card on file. This is not applicable if your paying for a monthly membership. Please select I Agree to continue

Facility reservations may be cancelled at any time.

Please read carefully *

You hereby agree to relinquish all claims, suits, attorney fees, damages, liability and any and all future rights to the same based on any and all negligent acts of Sensory Innovations and any and all of the named agents and employees entirely harmless and free of liability for any and all negligent acts on the date of signature and all future visits to the Sensory Innovations facility up to a 1 year period from the signature date. You have the opportunity, if you wish, to speak with a representative of Sensory Innovations for further explanation of the terms contained herein before signing.

Please read carefully *

You hereby acknowledge and agree that I have carefully read and fully understand the terms of this Agreement, and that I have been afforded an opportunity to request further explanation of the terms of this Agreement.

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Sign Here

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.