Summer Activity Permission Form

Child's date of birth(Required)
Child's date of birth
Child's date of birth
Child's date of birth


We want to make sure children are protected from getting sunburned. A to Z Building Blocks provides spray sunblock. All children must use sunblock that is provided by A to Z Building Blocks unless otherwise noted.
Please mark the one that applies.(Required)

Offsite Activities * 3 years and older

I understand that the safety of all children is important and if my child is not behaving appropriately on field trips, I will be called to come and pick my child up from the venue. I also understand if my child doesn’t not stay with the group on a field trip that I will be contacted immediately, and the teacher will not be able to go after my child.
If my child leaves the group of children, I would like the teachers to: *(Required)

A to Z Inflatable Water Slide and Bounce Houses *3 years and older

I understand that participating in the use of the water slide and bounce houses, inflatables and games from A to Z Building Blocks, LLC involves risk, danger, and hazards that may cause serious personal injury or death and injuries are a common and ordinary occurrence. I voluntarily elect to participate in playing on the water slide and bounce houses, from A to Z Building Blocks, LLC and I fully understand this involves jumping on air filled entertainment toy(s) games such as inflatable jousting and other yard games and I fully understand the health and safety risks associated with these types of activities. I, therefore, assume all risk of injury and/or death associated with this event. I will not hold A to Z Building Blocks, LLC, its agents, owners, shareholders, employees, or anyone affiliated with A to Z Building Blocks, LLC, liable for any circumstances of this event. I release and hold harmless and agree not to bring any action or suit against A to Z Building Blocks LLC, its owners, officers, shareholders, agents and employees “A to Z Building Blocks, LLC” releases from any liability resulting from any personal injury to myself, including death, or damage to my property which is caused by the breach of any express or implied warranty or the negligent act or omission of any A to Z Building Blocks, LLC release in the design, location, construction, inspection, maintenance and repair on or about the bounce house, inflatables and games from A to Z Building Blocks, LLC inventory. I hereby confirm that I am in good physical condition and do not suffer from any disabilities or physical conditions that place me or others at risk or otherwise physically inhibit participation in this event. By this waiver and release, I assume any risk and take full responsibility and warranty of any and all claims of personal injury and death or damages to, but not listed, my use of A to Z Building Blocks, LLC property or engaging in A to Z Building Blocks, LLC activities or other activities on or near the premises on the dates the item is used. I acknowledge that I have read, understand, and fully agree to the terms of this waiver and release and its contents. I understand and confirm that by signing this waiver and release, I have given up considerable future legal rights. I sign this waiver and release voluntarily, under no duress or threat of duress, without inducement, promise, or guarantee being communicated to me. My signature is proof of my intent to execute a complete and unconditional waiver and release of all liabilities in force under the law. I am eighteen (18) years of age or older and mentally competent to enter into this waiver. If the individual participating in the use of the bounce house, inflatables and games from A to Z Building Blocks, LLC is a minor, I am signing as a parent or legal guardian of said minor. I represent that I have the full authority to do so, realizing that this release is binding upon the minor child as well as myself.
Inflatables permission(Required)


The following section is only used for school age children that will be going swimming, skating, and trampoline parks.
Mark the one that applies(Required)


Please read through the following rules with your child. Here are the rules for the swimming pool. We would like families to go over these rules with your child and make sure they understand them. All children must always follow the rules. If a child does not follow the rules 100% of the time, they will not be allowed to go back to the swimming pool due to safety reasons.

  1. If your child cannot swim, they will always need to have a life jacket on, and parents need to provide it. Parents need to make sure teachers are aware of this before the summer begins.
  2. Children are not allowed to go in farther than 5 ft 5 inches deep of water even if they can swim.
  3. Children are not allowed to go off the diving boards.
  4. Children must always be with a teacher and no wandering the swimming pool area.
  5. The teacher will wait outside the bathroom door while children are in the bathroom.
  6. Children must not play in the bathroom.
  7. Children must not bring money with them to the swimming pool.
  8. Children must get out of the water every hour to have sunblock reapplied.


We need to know if your child can swim or not.
Please mark the option that applies.(Required)



My child and I have read the rules each section thoroughly and agree to follow all rules. By signing this form, I understand that I am releasing liability for A to Z Building Blocks, if my child is not staying with the teachers and following the rules on field trips or while playing on the inflatable equipment.
My child(ren) and I agree to this form(Required)
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Today's Date(Required)