Name: Kids in Motion Sensory Playground | Attleboro, MA
Address: 219 South Main St, Attleboro City, MA, US
Telephone: (774) 203-6463
Price range: $$

Child Information

Child's First Name *

Child's Last Name *

Date of Birth *

Age *

Grade/School (Optional)

Parent/Guardian Information

Parent/Guardian First Name *

Parent/Guardian Last Name *

Relationship to Child *

Email Address *

Phone Number *

Address

Street Address *

City *

State *

Zip Code *

Emergency Contact

Emergency Contact Name *

Relationship *

Emergency Contact Phone *

Medical Information

Please provide any medical information we should be aware of to ensure your child's safety.

Allergies *

Medical Conditions *

I authorize Kids in Motion LLC staff to seek emergency medical treatment for my child if necessary. *

Preferred Hospital/Medical Facility (Optional)

Preferred Doctor (Optional)

Review & Sign

Please read the waiver carefully, check all required acknowledgments, and sign below.

Kids in Motion LLC - Liability Waiver and Release Form

Kids in Motion LLC

217 South Main Street, Attleboro, MA 02703

(774) 203-6463

info@kidsinmotionllc.com

Assumption of Risk

I acknowledge and accept the risks involved in using this facility

Release of Liability

I release Kids in Motion LLC from all liability

Medical Authorization

I authorize emergency medical treatment if necessary

Photography and Media Release

I consent to photography and use of images for marketing

Facility Rules and Guidelines

I agree to follow all facility rules and guidelines

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

I consent to photography and use of images for marketing purposes (Optional)

I confirm that I have read and understand all facility rules and guidelines *

Your Signature

Type your full name below to provide your legal signature:

Type Your Full Name *

Signature Preview:

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Your typed name will serve as your legal signature

Date: October 26, 2025

Kids in Motion LLC Waiver