Please Read the following Statement and enter your name and the date below.
By entering your name you are agreeing to the following conditions.

In the event of an emergency, I hereby authorize any and all medical attention to be
administered, to my child (children) as is deemed necessary by an attending physician or nurse. 
I understand and agree that I am financially responsible for any care so provided.  In
consideration of the opportunity to have my child (children) participate in the activities sponsored
by Corporate Kids Events, Inc., I hereby assume all risks and waive all claims against the
corporation, it’s respective officers, director, employees, agents and representatives for bodily
injury or death and for damage to or loss of any property directly or indirectly arising from or in
connection with any activities involving Corporate Kids Events, Inc. except to the extent directly
and solely caused by the willful misconduct of the corporation or its agents.  I also understand
and agree that management reserves the right to decline or discontinue enrollment based upon
the management’s assessment of physical disabilities or medical conditions requiring an amount
of attention or medical expertise beyond the company’s formal scope of ability. Corporate Kids
Events has my permission to take photos of my children at this event. Pictures may be used for
digital photo CD for client and promotion for future events (Group Events, only).

Parent/guardian warrants that the child has no allergies or disabilities, which have not been
noted above.

I hereby grant permission for Corporate Kids Events, Inc. to take whatever steps necessary to
obtain emergency medical care if warranted. If the parent cannot be reached emergency

personnel will be called. Corporate Kids Events does not administer medication of any kind.