top of page
Child's Birthday

To participate in activities set forth by Full Spectrum Learn & Play, the parent(s), or guardian(s) of each child (participant) must submit a completed copy of this waiver, assumption of risk of all claims each may have, and the accompanying health, emergency contact and limited power of attorney in case of emergency form. I have agreed to allow my child to participate in said activity and affirm that my decision and my child’s participation are voluntary based upon my own evaluation of the appropriateness of the activity for my child and my child’s appropriateness for the activity.

WAIVER. In consideration for Full Spectrum Learn & Play accepting my child to participate in structured activities, I, for myself; my child; and my heirs, personal representatives or assigns, do hereby waive, release, and hold harmless Full Spectrum Learn & Play, Full Spectrum Behavioral Solutions, its owners, management, staff/externs, and contractors (herein after “Full Spectrum”) from all claims of any kind that rise out of my child’s participation in any activities within Full Spectrum. I hereby discharge Full Spectrum from all liability stemming from our participation in the activity, and covenant not to sue Full Spectrum for all such claims.


ASSUMPTION OF RISK: Participation in Full Spectrum’s activities including ABA therapy, enrichment classes, open play, private events, and general physical activity inevitably carries with them certain inherent risks that cannot be eliminated regardless of the safety precautions and care taken to avoid injuries. The specific risks vary from one activity to another, but the risks inherent in Social Skills Groups activities range from 1) minor injuries such as scratches, bruises, and sprains; (2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions; to (3) catastrophic injuries including paralysis and death. I have reviewed the programs at Full Spectrum, evaluated their appropriateness for my child, and acknowledge that I have had access to Full Spectrum personnel to ask any questions and resolve any concerns. I know, understand, and appreciate these inherent risks and assume sole, exclusive, and full responsibility for my child’s injury or harm any manner related to Full Spectrum’s activities. To minimize risk, I have instructed my child to obey all rules, instructions, and staff directions to the best of his/her ability.


INDEMNIFICATION AND HOLD HARMLESS: I also agree to indemnify and hold harmless Full Spectrum Learn & Play and Full Spectrum Behavioral Solutions from any and all claims, actions, results, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought by myself, my child, their representative, or any other person or third party as a result of my child’s participation in any activities and to reimburse them for any such expenses, costs, and damages incurred.


SEVERABILITY: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of Arizona and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.


ACKNOWLEDGEMENT OF UNDERSTANDING: I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.


MEDICAL: I understand that I should obtain health insurance for my child coverage prior to participating in any Full Spectrum activity. I further understand that I am solely responsible for my child’s medical expenses. I attest that my child is in good physical health, and I have disclosed on the written enrollment any limitations to safe participation in activities for my child including all conditions that require accommodation and medication. I understand that Full Spectrum will not administer medications and that I am solely responsible for ensuring that my child is properly receiving his/her medication at all times during activities.

EMERGENCY TREATMENT: I hereby give my permission that Full Spectrum Learn & Play and Full Spectrum Behavioral Solutions team is authorized to give my child reasonable first aid, or if my child should require emergency medical or surgical treatment, he/she may be treated at the nearest emergency facility by the physician in attendance and any other health care professionals to consult. I hereby authorize the Full Spectrum and their authorized representatives to disclose any of my child’s health-related information to any healthcare provider and I consent to the admission of my child to the hospital, the administration and performance of all examinations and the administering of medicine, treatment, anesthetics, operations, x-rays or other procedures which the physicians attending to my child deem necessary for the emergency care and treatment. I hereby agree to accept responsibility for any financial indebtedness occurring in transport, in the emergency room, or clinic treatment of my child at the emergency facility utilized. Further, I understand that, upon my arrival at the hospital, I will authorize continued medical care.


I hereby and forever release and discharge the Releasees (defined below) from any and all claim or liability arising out of or resulting from (i) any first aid, use or administration of an injection or other medical procedures, or related action or inaction rendered by a Releasee or (ii) a decision by any Releasee or any agent or representative of a Releasee to exercise the power to consent to medical or dental treatment that has been granted and authorized by me herein.


I also understand that it is my responsibility to notify Full Spectrum team if my child contracts a contagious illness (including, but not limited to, pink eye, chicken pox, whooping cough, fever). Further, there are no health-related reasons or problems that would restrict my child from participating in Full Spectrum activities.

By signing below, I acknowledge that I have read, understand this waiver of liability, assumption of risk, and agree to its terms.

Date

Learn & Play Café Waiver

bottom of page