Complete a waiver for myself
Complete a waiver for myself and children
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Adult Information

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( Age must be at least 18 years old )

Contact Information

Play Waiver

Please read the waiver below and fill out the required fields found in the following form sections. All liability language from the waiver will apply to all persons listed below.

In Consideration of being allowed to enter the play area and/or participate in any party and/or program at Mezanmi Play Cafe, the undersigned, on his or her behalf, and on the behalf of the participant(s) identified below, acknowledges, appreciates and agrees to the following conditions:

I represent that I am the parent or legal guardian of the participant(s) named above, or I have obtained permission from the parent/legal guardian of the participant(s) named above to execute this agreement on their behalf. I agree that the participant(s) named above and I shall comply with all stated and customary terms, posted safety signs, rules, and verbal instructions as conditions for participation in any party and/or program at Mezanmi. In addition, if I observe any hazard during our participation, I will bring it to the attention of the nearest Mezanmi employee or official immediately.  I understand that I am responsible for my child’s safety and behavior at all times each visit.

I am aware that there are inherent risks associated with participation in Mezanmi programs, parties and I, on behalf of myself and the participant(s) named, knowingly and freely assume all such risk, both known and unknown, including those that may arise out of the negligence of other participants; and,

I, for myself and the participant(s) named, and our respective heirs, assigns, administrators, personal representatives, and next of kin, hereby release and hold harmless, Mezanmi Play Cafe, LLC, and Mezanmi management, their affiliates, officers, members, agents, employees, other participants, and sponsoring agencies from and against any and all claims, injuries, liabilities or damages arising out of or related to our participation in any and all Mezanmi programs, activities, parties, and the use of the play area.


By signing this waiver, I agree that all information is complete and accurate.