THE EDGE SKATEPARK
125 Pacific Avenue
Winnipeg,
Manitoba, Canada R3B 0M1
204.947.2677
www.theedgeskatepark.com
IN ORDER TO SKATE YOU MUST DO
THE FOLLOWING:
Completely fill out both
sides of this form. We cannot accept signatures from host-families, friends,
grandparents, aunts, uncles, stepparents or other relatives.
Please print:
Participantıs Last Name:
______________________
Participantıs First Name: ____________________________________
Address:
________________________________ City ______________Province ___________ Postal Code ___________
Phone Number of Participant:
____________________ Birth
Date: ________________________ Age:___________
Name of Parent/Guardian:
____________________________
Phone # of Parent/Guardian: _______________________
License # of
Parent/Guardian:_________________________________________________________________________
The following
Authorization, Release and Indemnity form is a legally binding agreement. Please read it carefully before signing
it.
In
consideration for The Edge Skatepark, Youth For Christ (Winnipeg) Incorporated
and their directors, officers, employees, agents and volunteers (collectively
referred to as ³The Edge Skatepark²) permitting the Participant referred to
above (the ³Participant²) to enter upon the premises of and use The Edge
Skatepark and to participate in the programs and activities offered at The Edge
Skatepark, I agree to the following on my own behalf and on behalf of the
Participant and on behalf of our heirs, executors, successors, representatives
and assigns.
1. I
warrant that I am the person legally entitled to make decisions with respect to
the care and the affairs of the Participant. I warrant that I am entitled to enter into this agreement on
my own behalf, on behalf of the Participant and on behalf of any other parent
or guardian of the Participant.
2. I
understand that this agreement applies to facilities operated by and programs
offered by The Edge Skatepark. I
understand that this agreement applies whether the Participant is an observer,
a bystander or an active participant and whether the Participant is at any
premises owned or occupied by The Edge Skatepark, on an outing or activity
sponsored by The Edge Skatepark or travelling to and from such premises or
outing.
3. I
understand that skateboarding and in-line skating can be dangerous and can
result in injury, death or personal property damage to participants and to
others.
4. I
grant permission to the Participant to attend at the premises of The Edge
Skatepark, to use The Edge Skatepark facilities and equipment and to
participate in the programs and activities offered by The Edge Skatepark.
5. In
granting permission to the Participant to enter upon the premises of and use
The Edge Skatepark and to participate in the programs and activities offered by
The Edge Skatepark, I accept the condition of the ramps, equipment and other
facilities and property and I accept that the condition could change to become
more hazardous.
7. I
understand that the Participant must obey and show respect for the rules and
regulations of the Edge Skatepark, and I undertake sole responsibility to
advise the Participant of the necessity to do so.
8. On
behalf of myself, the Participant, any other parent or guardian of the
Participant and our heirs, executors, successors, representatives and assigns,
I release The Edge Skatepark from any liability, claim, action, suit or demand
whatsoever which may arise in connection with or during the participantıs
attendance at the premises of The Edge Skatepark, his/her use of The Edge
Skatepark facilities and equipment and his/her participation in the programs
and activities offered by The Edge
Skatepark. Without limiting the
generality of the foregoing, this release shall apply to any liability, claim,
action, suit or damage caused by the negligence of The Edge Skatepark, the
condition of the equipment or the premises or the actions of third parties.
9. I
agree on my own behalf, on behalf of any other parent or guardian of the
Participant and on behalf of the Participant to indemnify The Edge Skatepark
and hold it harmless against any liability, claim, action, suit or demand
whatsoever which may arise in connection with or during the Participantıs
attendance at the premises of The Edge Skatepark, his/her use of The Edge
Skatepark facilities and equipment and his/her participation in the programs
and activities offered by The Edge Skatepark. Without limiting the generality of the foregoing, this
indemnity shall apply to any liability, claim, action, suit or demand for
personal injury, death or property damage, including injuries, death or damage
caused by the negligence of The Edge Skatepark, the condition of the equipment
or the premises or the actions of third parties. This indemnity shall include indemnification for any
judgment, and for all costs incurred by The Edge Skatepark in connection with
litigation.
10. I agree on
my own behalf, on behalf of any other parent or guardian of the Participant and
on behalf of the Participant that we will not take legal action against The
Edge Skatepark or against any third party who may claim contribution or
indemnity from The Edge Skatepark with respect to any liability, claim, action,
suit or demand whatsoever which may arise in connection with or during the
participantıs attendance at the premises of The Edge Skatepark, his/her use of
The Edge Skatepark facilities and equipment and his/her participation in the
programs and activities offered by The Edge Skatepark. Without limiting the generality of the
foregoing, this agreement not to take legal action shall apply to any claim,
action, suit or demand for personal injury, death or property damage, including
injuries, death or damage caused by the negligence of The Edge Skatepark, the
condition of the equipment or the premises or the actions of third parties.
11. I
acknowledge that The Edge Skatepark may, at its discretion, revoke the
Participantıs privileges to attend at the premises of The Edge Skatepark, to
use The Edge Skatepark facilities and equipment and to participate in the
programs and activities offered by The Edge Skatepark.
12. In the
event that it appears to The Edge Skatepark that the Participant requires
medical or dental attention, testing or treatment (referred to as ³Treatment²)
of any kind while using The Edge Skatepark facilities and equipment or
participating in the programs and activities offered by The Edge Skatepark, I
authorize The Edge Skatepark to provide or to arrange for the provision of such
Treatment and to consent to such Treatment on behalf of the Participant and
myself as The Edge Skatepark in its discretion considers advisable. I agree to be responsible for any cost
of such Treatment and I appoint The Edge Skatepark as my agent in arranging for
such Treatment. The release and
indemnity provisions above apply to the provision of Treatment.
13. I warrant
that the information given on this form is correct and complete.
14. I have read this document, I
understand it and I agree to the terms set out above.
__________________________________ X
_____________________________Date _____ / _____ / _____
Witness
Adult Participant Age 18 or Older or Parent/Legal Guardian Signature
Relationship
to Participant ____________________
RELEASE FROM WEARING ADDITIONAL PADDING
Due
to the physical demand and nature of the activity of skateboarding, The Edge
Skatepark REQUIRES the use of a helmet, as well as additional padding (knee
pads and elbow pads). It is noted that some participants wish to risk
participating in the activity of skateboarding WITHOUT the use of additional
padding. This form is to verify that as an adult participant or the parent of a
youth participant you understand that The Edge Skatepark has REQUIRED the use
of additional padding, and you have decided to risk participating WITHOUT
the use of additional padding.
I
understand that the use of a helmet is always mandatory. I also understand that
the use of knee pads and elbow pads is also required, but by signing below, I
may choose to decline the use of these additional pads. I agree on my own
behalf, and on the behalf of the Participant to indemnify The Edge Skatepark
and hold it harmless against any liability, claim, action, suit or demand
whatsoever which may arise in connection with or during the Participants
attendance at the premises of The Edge Skatepark, use of the facilities and equipment,
and participation in the programs and activities offered by The Edge
Skatepark.
I have read
this document, I understand it and agree to the terms set out above.
__________________________________ X
_____________________________Date _____ / _____ / _____
Witness Adult
Participant Age 18 or Older or Parent/Legal
Guardian Signature
Relationship
to Participant ____________________