PRINT NEATLY AND CLEARLY
WITH INK ONLY!
Full completion of this form is necessary for participation at New Gen Skatepark.
PARTICIPANT
AGREEMENT, RELEASE,
In consideration of the services of New Gen Skatepark, their agents, owners, officers, volunteers,
participants, employees, and all other persons or entities in any capacity on
their behalf (hereinafter collectively referred to as “NGS”, I hereby agree to
release, indemnify, and discharge NGS, on behalf of myself, my children, my
parents, my heirs, assigns, personal representative, and estate as follows:
1.
I acknowledge that my participation in skateboarding, in-line skating,
BMX bicycling, Soap shoes, scooters, or other activities or sports known as
dangerous but not mentioned above entails known and unanticipated risks that
could result in physical or emotional injury, death, or damage to myself, to
property, or to third parties. I understand that such risks simply cannot be
eliminated with out jeopardizing the essential qualities of the activity.
The risks include, among other things: Collision with other participants, the walls, or
other fixed objects, falling down; my own equipment failure of the failure of
others’ equipment; my own or others’ negligence; and objects or conditions on
the surface that may cause me to fall; broken bones, sprains, head and back
injuries, abrasions, and bruises. Furthermore, NGS employees have difficult
jobs to perform. They seek safety, but they are not infalliable.
They might be unaware of a participant’s fitness or abilities. They may give
inadequate warnings or instructions, and the equipment being used might
malfunction.
2.
I expressly agree and promise to accept and assume all of the risks
existing in this activity. My participation in this activity is purely
voluntary, and I elect to participate in spite of the risks.
3.
I hereby voluntarily release, forever discharge, and agree to indemnify
and hold harmless NGS 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 NGS’ equipment or facilities, including any such claims which allege
negligent acts or omissions of NGS.
4.
Should NGS 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.
5.
I certify that I have adequate insurance to cover any injury or damage
I may cause or suffer while participating, or else I agree to bear the costs of
such injury or damage to myself. I further certify that I am willing to assume
the risk of any medical or physical condition I may have.
6.
In the event that I file a lawsuit against NGS, I agree to do so in the
state of South Carolina, and I further agree that the substantive law of that
state shall apply in that actions without regard to the conflict of law rules
of that state. 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 signing this document, I acknowledge that if
anyone is hurt or property is damaged upon entering NGS or during my
participation in this activity, I may be found by a court of law to have waived
my right to maintain a lawsuit against NGS on the basis of any claim from which
I have released them herein. I have had sufficient opportunity to read this
entire document. I have read and understood it, and agree to be bound by its
terms.
(Participant’s Information) Signature________________________________________________________Date____/____/____
Print First Name_____________________________________Print
Last Name_________________________________________
Street Address_______________________________________________________Apt.
#________
City___________________________State_______Zip__________Phone(____)_____-_________
Emer. Contact
Phone(____)____-______Emer. Contact
Name__________________________(Circle One)
Skateboard Inline BMX
Other
D.O.B____/____/____Age____
Email_________________________________________________________________________
In consideration of ________________________(Print
Minor’s Name)(“Minor”) being permitted by NGS to participate in its activities
and to use its equipment and facilities, I further agree to indemnify and hold
harmless NGS from any and all Claims which are brought by, or on behalf of Minor,
and which are in any way connected with such use or participation by Minor.
Parent’s or Guardian’s Signature_____________________________________Realationship
To Minor______________Date____/____/____
Print First Name_________________________________Print
Last Name______________________________________________________
Driver’s License Number______________________________________State_________ Notary
Stamp:
IF
PARENT/GUARDIAN IS NOT PRESENT, FORM MUST BE NOTARIZED.
Notary Signature____________________________________________
Notary Date____/____/____
Shop Employee Initials______
Data Entry Employee______