Birthday Party Waiver - Becky's Mindful Kitchen

REQUIRED READING AND WAIVER

Parent/Participant Information for Birthday Parties and Events. Additional text regarding waivers for adult events as well as an easier to read format of kid waiver is found below.

If you book an event at BMK, it is your responsibility to ensure all guests have been sent this link and fill out waiver form. Parking Instructions found below.

BMK Birthday Party Waiver & Photo Release - Must be filled out and submitted before attending any party or event

I understand the following: My child/myself may be exposed to a variety of foods during class and tasting foods throughout the program. I understand and acknowledge that Becky’s Mindful Kitchen cooking classes and events have inherent risks, dangers, and hazards related to preparing food in a home kitchen and working with tools and appliances and that my child’s/my own participation in such classes and events may result in injury. I will provide closed toe shoes for my child/myself to wear while in the kitchen. I assume full responsibility for any injuries or damages resulting from my child’s/my participation in this program. As the legal guardian of the minor child/as an adult, I accept the risks inherent in the preparation, cooking, and eating of food that has been prepared during cooking classes. I understand that these classes and camps are educational and not a substitute for a meal and will make sure to provide an adequate meal prior to class- there is no meal provided during the camp or class. I hereby release Becky’s Mindful Kitchen, all owners and employees from any and all liability for damage, losses, or personal injury resulting from my child’s/my participation in any Becky’s Mindful Kitchen cooking class or event. If my child or myself, has an allergy or medical (mental or physical) conditions that will impact their involvement in the camp/event or behavioral limitations/issues, I will inform BMK before an event. I understand that exposure to allergens can happen despite best intentions. If my child’s behavior is disruptive to others and does not resolve with verbal warnings, I will come pick up my child and he/she may not be able to return to camp. If my actions are disruptive and I am disrespectful to others or the property, I understand that I may be asked to leave and will be responsible for finding a safe ride home and will not receive a refund. I understand that my child/I may be outside in a garden/timber setting and interacting with chickens and goats. I will dress my child/myself appropriate for the weather and provide sun and bug protection. I accept the risks inherent to gardening and interaction with chickens, goats and playing in the woods, zip line, archery, using hatchets, knives, starting fires, cooking around fires, saws, tree house and all available in the woods at BMK and release Becky’s Mindful Kitchen, all owners and employees from any and all liability for damage, losses or personal injury resulting from my child’s/my participation in outdoor activities. I understand the importance of checking my child for ticks. I agree to not send my child/myself to class if he/she/I has(ve) had a fever or diarrhea in the past 72 hours, an active cough, or frequently needs to blow his/her nose. I acknowledge that if my child has environmental allergies that are presenting as a cold, I will communicate that to Becky. I grant BMK permission to use photos and/or videos of myself and/or my family taken during BMK activities to be used in its promotional materials, locally and nationally. By signing this waiver, I acknowledge that I have carefully read it and understand the contents. I am aware that this is a release of liability. If I am signing on behalf of a minor, I am giving the minor permission to participate in classes and events at Becky’s Mindful Kitchen

Date of birthday party and host name *

Thank you for taking the time to read the waiver and parking instructions! If you do not agree to the waiver, I cannot have your child attend an event.

Number children covered under your signature.

Selected Value: 1

For only 1 child no need to adjust as it is set to 1 as default.

Name- add the first names of all siblings attending by separating with a comma. Use second form slot if more space is needed. *

First

Last

Name (copy)

First

Last

By checking this box, I acknowledge that I have carefully read the waiver provided on this page and understand the contents. I am aware that this is a release of liability. If I am signing on behalf of a minor, I am giving the minor permission to participate in classes and events at Becky’s Mindful Kitchen. I grant BMK permission to use photos and/or videos of myself and/or my family taken during BMK activities to be used in its promotional materials, locally and nationally. I have read the parking/drop off instructions. *

I agree to the above.

I have provided the host of the birthday party emergency contact information as well as information regarding any medical conditions of my child that may impact their ability to safely participate with any activities during the party, including food allergies. *

Name of Parent/Guardian *

First

Last

Email *

Parking Instructions

Here is diagram as well as a short novel explaining how drop off and parking works here! 4139 Crosheck Rd NE, Solon, IA

A few things to note for the drive:

If the GPS tells you to take Jordan Creek Rd, be advised that it is a long gravel road .
Please do not arrive more than 10 minutes early for an event unless you communicate with me first. I run BMK and Stoic Edge Consulting along with running my household and parenting- which means, I am not sitting around anxiously awaiting your arrival, but instead am running around preparing for your arrival. Trust your GPS arrival time, and check the map provided below to make sure you know where you are going.

When you turn onto Crosheck:

You will turn left at the big red barn- your first left.

The house at the top of the hill is NOT my house or BMK. That is our neighbor as is the play structure. DO NOT block their driveway or walk on their grass.

Zero parking allowed on the street or in front of the garden or red barn.

If you know that only 4 cars are attending your event, you may park in front of the house at the BOTTOM of the drive.

BUT…..

If you are attending a public event or one that has more than 4 cars, please follow these instructions:

Drive down the driveway.

If you are dropping your kiddo off, there is a sign to your right that says “drop off here”. It is right by the paved path in front of the red chicken coop. Drop off your kiddo and then continue driving forward, circle around the turnaround and drive back up the driveway and enjoy your time until pick up! you’d

Not dropping off a kid? Or you arrived early?

Drive down the driveway, ignore the ‘drop off here’ sign, continue to circle around the driveway (do not park in front of the house) and drive up the driveway until you just about get to the neighbor’s driveway. At that point you will see a sign that says “Parking starts here”. That’s where you park. On the right hand side, facing up the hill so that you are able to easily drive straight out at the end of the event. Simply line up behind the car in front- keeping turn around clear.

There is room for 2 cars on the driveway so one can drive down while the other drives up.

The entrance to BMK is in the back of the home- follow the path past the red chicken coop and blue goat cottage to the back deck.

BMK is between Solon, North Liberty, and Iowa City – just 25 minutes from Cedar Rapids.

4139 Crosheck Rd. NE, Solon, IA

Waiver for all events. See additional waiver below for kid specific events

By Purchasing a Private Event, I have agreed to the following and understand it is my responsibility to share this with my guests. Your attendance is your signature.

BECKY’S MINDFUL KITCHEN WAIVER AND RELEASE

In consideration of participating in Becky’s Mindful Kitchen (BMK) activities, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence BMK and its owners, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as “Releasees”), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows:

I acknowledge that participating in BMK activities involves known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death, and property damage. Risks include, but are not limited to, broken bones, torn ligaments or other injuries as a result of falls or contact with other participants; death as a result of drowning or brain damage caused by near drowning in ponds or creeks; (there is a pond on the neighboring property to BMK and shallow creek beds on BMK) medical conditions resulting from physical activity; and damaged clothing or other property. I understand such risks simply cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity.
I expressly accept and assume all of the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation.
I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands, or causes of action which are in any way connected with my participation in this activity, or my use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.
I represent that I have adequate insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume – and bear the costs of – all risks that may be created, directly or indirectly, by any such condition.
In the event that I file a lawsuit, I agree to do so in the state where Releasees’ facility is located, and I further agree that the substantive law of that state shall apply.
I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.
“By participating in BMK activities , I agree to release BMK, from claims of negligence for bodily injury or death in connection with activities on BMK property, and from any liability for other claims, including loss of property, to the fullest extent of the law.”
I agree to comply with Covid safety rules outlined by BMK and not attend events if exposed to Covid. Currently there are not any covid restrictions in place.
I agree not to attend a BMK event or send my child to BMK if a fever, diarrhea or vomiting has been present in the last 24hr.
I agree to inform BMK of any allergies (food or other) prior to attending an event at BMK and understand that I may need to bring my own ingredients.

RELEASE, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT

Activities included but not limited to: Farm animal interactions, treehouse, timber adventures, ninja obstacle course, cooking classes (oven, stove and knife use), obstacle course, trail hiking, pizza oven, zipline, rock climbing, fire starting, hatchet use, knife use, bugs, animals.

The above list is not intended to be and is not exhaustive. There may be BMK activities the undersigned participates in which are not listed above; but said activities are intended to be and are included in the terms and conditions of this release.

By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence.

Further, I grant BMK permission to use photos and/or videos of myself and/or my family taken during BMK activities to be used in its promotional materials, locally and nationally.

I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms.

Kid Specific Events and Camps

I understand the following:

My child/myself may be exposed to a variety of foods during class and tasting foods throughout the program.

I understand and acknowledge that Becky’s Mindful Kitchen cooking classes and events have inherent risks, dangers, and hazards related to preparing food in a home kitchen and working with tools and appliances and that my child’s/my own participation in such classes and events may result in injury. I will provide closed toe shoes for my child/myself to wear while in the kitchen. I assume full responsibility for any injuries or damages resulting from my child’s/my participation in this program.

As the legal guardian of the minor child/as an adult, I accept the risks inherent in the preparation, cooking, and eating of food that has been prepared during cooking classes. I understand that these classes and camps are educational and not a substitute for a meal and will make sure to provide an adequate meal prior to class- there is no meal provided during the camp or class.

I hereby release Becky’s Mindful Kitchen, all owners and employees from any and all liability for damage, losses, or personal injury resulting from my child’s/my participation in any Becky’s Mindful Kitchen cooking class or event.

If my child or myself, has an allergy or medical (mental or physical) conditions that will impact their involvement in the camp/event or behavioral limitations/issues, I will inform BMK before an event. I understand that exposure to allergens can happen despite best intentions.

If my child’s behavior is disruptive to others and does not resolve with verbal warnings, I will come pick up my child and he/she may not be able to return to camp. If my actions are disruptive and I am disrespectful to others or the property, I understand that I may be asked to leave and will be responsible for finding a safe ride home and will not receive a refund.

I understand that my child/I may be outside in a garden/timber setting and interacting with chickens and goats. I will dress my child/myself appropriate for the weather and provide sun and bug protection. I accept the risks inherent to gardening and interaction with chickens, goats and playing in the woods, zip line, archery, using hatchets, knives, starting fires, cooking around fires, saws, tree house and all available in the woods at BMK and release Becky’s Mindful Kitchen, all owners and employees from any and all liability for damage, losses or personal injury resulting from my child’s/my participation in outdoor activities.

I understand the importance of checking my child for ticks.

I agree to not send my child/myself to class if he/she/I has(ve) had a fever or diarrhea in the past 72 hours, an active cough, or frequently needs to blow his/her nose. I acknowledge that if my child has environmental allergies that are presenting as a cold, I will communicate that to Becky.

I grant BMK permission to use photos and/or videos of myself and/or my family taken during BMK activities to be used in its promotional materials, locally and nationally.

By signing this waiver, I acknowledge that I have carefully read it and understand the contents. I am aware that this is a release of liability. If I am signing on behalf of a minor, I am giving the minor permission to participate in classes and events at Becky’s Mindful Kitchen