Fun Spaces, Inc March 2015

On behalf of myself, my spouse, and each child designated (my “Child”), I enter into this Registration Form Agreement (“Agreement”) with Fun Spaces, Inc (“Fun Spaces”), a North Carolina Corporation, regarding the provision by Fun Spaces of a supervised play program for my child(ren).

Service Use: Subject to this Agreement and other terms as drop-in, short-term child care for my Child on a flexible time basis which includes participation in art and play activities. Fun Spaces may only be used for a period of four hours or less on a regular basis. If for any reason a child is present for more than four hours, I agree that this will not occur on a regular basis and does not constitute regular care. Fun Spaces does not provide transportation.

Future Visits: This Agreement, the Registration Form and the Release will be kept on file with Fun Spaces. It will continue to constitute binding obligations for any future visits my Child may have with Fun Spaces. However, this Agreement does not obligate Fun Spaces to continue to provide services, and Fun Spaces reserves the right to refuse admission to any child for any reason without liability.

Payment: Payment for Fun Spaces services will be due in advance of care in cash, check, charge or debit card in the amount agreed to by the event host. Fun Spaces may refuse to accept payment by check, and may charge a fee of $35 for any returned check. Fun Spaces may charge a service fee for any unpaid invoices. No refunds are given within 30 days of an event.

Health Policies: My Child is in excellent health and physical condition and has no medical, psychological, physical or mental condition which has not been disclosed to Fun Spaces on the attached Registration Form. My Child does not have any infectious, contagious or communicable diseases. Illness: In the event my Child becomes sick with a contagious illness after visiting with Fun Spaces, I agree to notify Fun Spaces as soon as possible to enable Fun Spaces, in its discretion, to notify each family of all the children who may have been exposed. I will indemnify Fun Spaces from any disease passed on to another child regardless of disclosure.

Medical Procedures:

a) General Medical Guidelines/Discretion: Although Fun Spaces provides a safe environment it is possible my child could get injured. In such event, I authorize Fun Spaces to follow its internal procedures, including simple first aid as reasonably appropriate; however, I understand Fun Spaces shall not be required to strictly follow those guidelines when, in its judgment, circumstances may require otherwise.

b) Medical Authorization: In the event Fun Spaces determines emergency medical attention is necessary for my Child, Fun Spaces is authorized by me or whoever signs my child in for that day, (“Authorized Representative”), to act as an agent for me and to give my permission for my Child to be attended by a physician in such circumstances as Fun Spaces deems necessary.

Safety/Indemnity: I agree that Fun Spaces may take action which it considers prudent to protect the safety of my Child, and other children visiting Fun Spaces. I further agree to indemnify, defend and hold Fun Spaces (and its owners, officers, directors, agents and employees) harmless from and against all actions, claims, or liability, including attorney fees and court costs, directly or indirectly caused by my Child or resulting from any inaccuracy or omission made by me in completing the Registration Form.

Additional Requirements:

a) As a condition to my use of the services, I have accurately completed and signed the Registration Form and Release. I understand that Fun Spaces will rely on this information in caring for my Child.

b) I agree to pay all cost and attorney fees arising out of any action relating to this Agreement, the Registration Form or the Release for collection purposes or otherwise.



Fun Spaces, an on-site child care service, provides a fun and safe environment for children. However, in any child care program, injuries may occur. In order for Fun Spaces to be able to provide drop-in child care services to you, it is necessary that you assume certain risks. Thus, as a requirement to receive our services, Fun Spaces is requesting that you sign this release.

1. I, on behalf of myself, my spouse, and each child designated on the Registration Form (my “Child”), waive and release all rights and hold harmless, causes of action and claims against Fun Spaces and its owners, officers, directors, agents, and employees, for any and all loss of or damage to property or injuries suffered by my Child during the time my Child visit with Fun Spaces, including the possible negligence of Fun Spaces, but excluding gross negligence and intentional misconduct. I understand that the provision of child care contains risk of injury to persons and damage to property, and that by signing this release I engage Fun Spaces to provide temporary child care for my Child at my own risk. I represent that I am authorized to sign this release on behalf of the child(ren) listed.

2. Also, I grant Fun Spaces ownership and the right to use photographs that are produced from my child’s participation with their service and may be used for exhibits, publications, or other medium presentation by Fun Spaces. I also grant Fun Spaces my absolute and irrevocable consent to use my child’s photograph without further approval on my part. I release Fun Spaces, and its assignees and designees, from any and all claims and demands arising out of or in connection with the use of such photographs including, but not limited to, any claims for defamation, invasion of privacy or right to publicity.

3. I have been given an opportunity to ask questions and obtain answers to my satisfaction regarding any and all aspects of Fun Spaces and the Release, including, but not limited to, future risks, complications and costs. By signing this Release, I have not relied on any promises or statements made by Fun Spaces other than those contained in the written information supplied to me by Fun Spaces.

4. I understand that this Release will be kept on file with Fun Spaces and will continue in effect for this and any future visits my Child may make with Fun Spaces.