Pixel Pulse Waiver

Add every player before you arrive, including adults and minors. If you’ve signed your waiver during a previous visit, you do not need to sign it again. This waiver experience is designed for Pixel Pulse Play families, parties, and groups.

Read carefully before signing. Pixel Pulse Play operates next-generation interactive physical gaming attractions in Vaughan, Ontario.

All attractions involve active physical movement. This waiver is a release of liability, assumption of risk, indemnity, medical authorization, and consent agreement.

Parent or Guardian

First name *Last name *Date of birth *

GenderEmail address *Phone number *City / Town *

Common health conditionMedical notes

Additional Family Members

Your single signature covers everyone listed. Add every adult and minor entering the active play zones today.

No additional family members added yet.

Visit Details

Party IDParty / guest of honorVisit date *

Party time

Terms & Acknowledgements

I understand Pixel Pulse Play attractions involve inherent and other risks, including slips, trips, falls, collisions, equipment contact, fast movement, climbing, jumping, running, aiming, sensory stimulation, and the acts or omissions of other participants. I voluntarily assume these risks for myself and all named participants.To the fullest extent permitted by applicable law, I release, waive, and discharge Pixel Pulse Play, its owners, directors, officers, employees, contractors, landlords, agents, insurers, successors, and assigns from claims, losses, damages, costs, and expenses arising from participation, including ordinary negligence, on behalf of myself and all named participants.I agree that all named participants will follow posted rules, attraction guidelines, staff instructions, age/height/weight restrictions, and safety directions. I confirm each participant is physically and medically fit for active gameplay and will stop participating if unsafe, unwell, or instructed by staff.I authorize Pixel Pulse Play staff to seek emergency medical assistance for myself or any named participant if needed, and I accept responsibility for medical, ambulance, transportation, or related costs not covered by insurance or public health coverage.I confirm I am the parent, legal guardian, or authorized adult for every participant under 18 listed in this form and have legal authority to sign this waiver, release, and consent on their behalf.I consent to Pixel Pulse Play collecting, using, storing, and disclosing the information in this form as reasonably needed to administer waivers, operate the venue, manage safety incidents, contact guardians or emergency contacts, and comply with legal or insurance requirements.Optional - I consent to Pixel Pulse Play capturing photos and videos of myself and family members during our visit for marketing, social media, and promotional materials.

Signature

Draw your signature *

Draw signature here

Your signature legally covers yourself and all named family members.

Print full legal name *Date signed *

I have read, understood, and voluntarily agree to all terms in this waiver and release of liability, on behalf of myself and every family member listed above. I confirm I am 18 years of age or older, legally competent to enter this agreement, and signing of my own free will. I understand this agreement is intended to be governed by the laws of Ontario and applicable Canadian law.

Securely recorded · Vaughan, Ontario · pixelpulseplay.ca