Waiver Release Form

I, the above-identified Parent or Guardian, have been presented with this Consent, Waiver & Release (the “Release”) because I have chosen to visit, participate, and brought the above-identified Child to participate in the activities and/or event (the “Event”) by Kiddiewinks LLC, an Illinois limited liability company (“Kiddiewinks”) at is premises addressed at 112 Barrington Commons Court, Barrington, Illinois 60010 (the “Premises”). I acknowledge that as a condition of my and my Child’s participation at the Event on the Premises, I am required to READ, UNDERSTAND AND SIGN this Release and abide by the terms and conditions of my participation contained in this Release, and all other rules of participation set by Kiddiewinks, which includes all rules already posted within the Premises or subsequently verbally instructed by an owner, manager, employee, contractor, agent and other representatives of Kiddiewinks (each an “Affiliate”). Therefore, I hereby acknowledge and agree as follows:

1. I understand that the Premises is not a day care center, nor does Kiddiewinks provide any form of child care services, and that it remains my responsibility to supervise my Child at all times, even though I may not be present while my Child is participating in the Event on the Premises. I acknowledge that, despite the fact the Event is not inherently of a dangerous nature, I understand that if I choose to leave my Child unattended, I remain responsible for the Child’s well-being and safety.

I HEREBY ACKNOWLEDGE that I have voluntarily chosen not to be present with my Child at all times while participating in the Event on the Premises, despite my responsibility to supervise my Child at all times, and I therefore acknowledge and agree that Kiddiewinks shall not be liable for any loss or damage to person or property as a result of my failure or the failure of anyone at the Event or the Premises to supervise or otherwise attend to my Child. I certify that I am the parent or legal guardian of the above-identified Child, and I have authority to waive rights on my Child’s behalf. In the event I bring any children other than the Child (the “Unrelated Children”) to attend the Event on the Premises of whom I am not the parent or legal guardian, I agree to indemnify, defend and hold harmless Kiddiewinks and its Affiliates to the fullest extent of the law in the event that Kiddiewinks suffers any loss or damage as a result of the Unrelated Children’s presence at the Event on the Premises.

If the Child will be left unattended and/or unsupervised by the Parent/Guardian at the Event on the Premises, then the Parent’s/Guardian’s must initial here to acknowledge and certify that he/she read, understood and agree to abide by the above statement:

2. I understand that, while there is nothing inherently dangerous with the Event or on the Premises, I am aware that physical injury and/or death, as well as damage to the Premises, may result due to my Child not adhering to the rules and instructions provided by Kiddiewinks, including its Affiliates, and/or as a direct result of my non-supervision of my Child. I understand that there will be other participants of various ages attending the Event on the Premises. I therefore understand that I must, and I must cause my Child to abide by the rules and policies instituted by Kiddiewinks as a condition of my Child’s attendance of the Event on the Premises.

I HEREBY voluntarily choose to allow my Child to attend the Event on the Premises despite the risks. Even if I am not present while my Child is attending the Event on the Premises, I fully assume responsibility for all risks of physical harm or property damage in any form to me or my Child that may occur as a result of our attendance to the Event on the Premises, however caused, to the fullest extent allowed by the law. I acknowledge and agree that I or my Child may be dismissed by any Affiliate of Kiddiewinks if we do not abide by the rules and policies instituted by Kiddiewinks.

If the Child will be left unattended and/or unsupervised by the Parent/Guardian at the Event on the Premises, then the Parent’s/Guardian’s must initial here to acknowledge and certify that he/she read, understood and agree to abide by the above statement:

3. Because I am aware of the risks of attending and/or leaving my Child unattended and/or unsupervised at an Event on the Premises, and because I nevertheless choose to do so, that Kiddiewinks should not be responsible for any loss, liability or damage that happens as a result of my or my Child’s attendance and/or leaving my Child unattended and/or unsupervised at the Event on the Premises, unless it is due to Ladybugs’ own intentional misconduct.

I HEREBY agree to defend, indemnify, hold harmless, waive and release forever Kiddiewinks and all of its Affiliates from any loss, liability, damage, or costs, including court costs and attorneys' fees that any of them may incur due to my attendance at an Event on the Premises, however caused, unless it is the direct result of the intentional misconduct of Kiddiewinks.

If the Child will be left unattended and/or unsupervised by the Parent/Guardian at the Event on the Premises, then the Parent’s/Guardian’s must initial here to acknowledge and certify that he/she read, understood and agree to abide by the above statement:

4. I understand that if I authorize Kiddiewinks to use this Release as a multi-use consent, waiver, and release, that I will not be required to sign a separate consent, waiver and release every time I attend an Event on the Premises. I agree that it would be more convenient for me and Kiddiewinks to use this Release as multi-use, but I also understand that from time to time Kiddiewinks may update or otherwise modify their consent, waiver and release, and if that happens I accept that I will be required to sign the new consent, waiver and release for me and my Child to attend the Event on the Premises.

I HEREBY authorize this Release to be a multi-use consent, waiver and release that remains in effect for all of my future attendance of an Event on the Premises, unless Kiddiewinks request that I sign a new consent, waiver and release, in which case I agree that the new consent, waiver and release will replace this Release, unless otherwise stated therein.

5. I, on behalf of myself and my Child, agree that Kiddiewinks is not liable to us for any personal property that is damaged, lost, or stolen while on or about the Premises, whether or not Kiddiewinks was negligent.

6. By attending the Event, on behalf of myself and my Child, I hereby grant to Kiddiewinks the irrevocable right and permission to photograph and/or record us on the Premises and to use the photograph and/or recording for all purposes, including, without limitation, advertising and promotional purposes and other commercial purposes, in any manner and all media now or hereafter known, in perpetuity throughout the world, without restriction as to alteration. I, on behalf of myself and my Child, waive any right to inspect or approve the use of the photograph and/or recording, and acknowledge and agree that the rights granted by this Release are without compensation of any kind.

8. If a dispute arises out of or relates to this Release and/or Kiddiewinks pertaining to an incident that occurs during the Event or while on the Premises, involving a single claimant, or claimants who are related or asserting claims arising from a single incident, and if the dispute cannot be settled through direct negotiations, and unless the parties agree on a different mediation or non-binding arbitration process, the parties agree first to try in good faith to settle the dispute by mediation administered by the American Arbitration Association (the “AAA”) under its Commercial Mediation Procedures available at http://www.adr.org before resorting to non-binding arbitration. Thereafter, any unresolved claims shall be submitted to non-binding arbitration administered by the AAA in accordance with its Non-Binding Consumer Arbitration Rules, except that Rule R-2(e) is amended to allow an answer to be filed within thirty (30) calendar days.

In-person hearings will take place pursuant to the Non-Binding Consumer Arbitration Rules in the city of Chicago, Illinois. Except as may be required by law, neither a party nor an arbitrator may disclose the existence, content, or results of any non-binding arbitration hereunder without the prior written consent of both parties.

The parties agree to mediation and non-binding arbitration of any and all claims, disputes and grievances, not otherwise excepted herein, arising out of or relating to this Release, attendance of the Event, and/or while on or about the Premises. A copy of the Rules mentioned herein may be obtained from the AAA by visiting AAA’s website at http://www.adr.org. The scope of this Release is intended to be as broad as possible under applicable law, and shall include all types of negligence, tort, contract, statutory and administrative actions.

9. To the extent permitted by law, I promise to indemnify and pay Kiddiewinks for any attorneys’ fees and/or costs incurred to enforce Section 8 above, including all costs associated with any collection efforts.

For purposes of this Release, the word "including" is deemed to be followed by the words "without limitation," and the word "or" is not exclusive. This Release constitutes the sole and entire agreement of the parties to this Release regarding the subject matter herein, and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, regarding such subject matter. This Release shall be binding on and shall inure to the benefit of Kiddiewinks and its respective heirs, executors, administrators, legal representatives, successors, and permitted assigns. All matters arising out of or relating to this Release shall be governed by and construed in accordance with the internal laws of the state of Illinois without giving effect to any choice or conflict of law provision or rule (whether of the state of Illinois or any other jurisdiction). After arbitration, any claim or cause of action arising under this Release may be brought only in the state court located in the Cook County, Illinois. On my own behalf, and on my Child’s behalf, I hereby irrevocably consent to the exclusive jurisdiction of such court.