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DECLARATION AND WAIVER RELEASE AND INDEMNITY DEED

This document must be completed prior to participation.

The activities described include adventurous recreational activities and are not without inherent risk. LVLUP AUS ACADEMY & TRAINING FACILITY (LVLUP GROUP PTY LTD) thanks you for reading this document carefully.

TO LVLUP GROUP its directors, employees, principals, agents and independent contractors collectively referred to as LVLUP AUS ACADEMY & TRAINING FACILITY  confirm the following is true and correct and LEVEL UP has relied on my answers allowing me to participate in recreational activities of and incidental to things including skateboarding, scooter riding, roller skating, agressive inline, Mountain bike, Parkour & BMX {the activities}. In consideration of LVLUP AUS ACADEMY & TRAINING FACILITY  permitting us to participate in the activities:

Name and Likeness Release: I hereby grant permission to LVLUP AUS ACADEMY & TRAINING FACILITY  operators and owners, their successors and sponsors to use images and likeness in direct connection with the activities for promotional broadcasting or reporting purposes in any and all manner and media, unless restricted by Privacy Legislation. Express Voluntary Assumption of Risk I understand that each participant in the activities will be engaging in activities involving a real risk of serious injury or even death from various causes including but not limited to equipment failure, accidents with other participants, spectators, course or weather conditions or other causes. I voluntarily accept all risks necessarily flowing from my participation which could result in loss of life or injury.

Liability Release and indemnity:I hereby release LVLUP AUS ACADEMY & TRAINING FACILITY  and all persons or corporations associated directly or indirectly with the conduct of activities from all claims, demands and proceedings arising out of our participation and hereby indemnify them against all liability (including liability for their negligence and the negligence of others) for all injury loss or damage arising out of or connected with our participation in the activities. This release shall extend to and include LVLUP AUS ACADEMY & TRAINING FACILITY  and owner partners, managers, officers, agents, contractors, any club, organisation and volunteers including medical and paramedical personnel appointed for the activities, the owners, licensees and occupiers of land on which the activities or any part of it are conducted or which is involved directly or indirectly with the activities in any manner whatsoever and promoters, sponsors and activities organizers. This release and indemnity continues forever and binds my heirs, executors, personal representative and assigns.

Equipment and Facilities Inspection: I agree that before we participate in the activities, I will independently inspect the related facilities and equipment. I will immediately advise LVLUP AUS ACADEMY & TRAINING FACILITY  of any unsafe condition that I have observed. We will refuse to participate in the activities until all unsafe conditions observed by me have been remedied. I acknowledge that reasonable safety precautions are undertaken by LVLUP AUS ACADEMY & TRAINING FACILITY  (Such as supervision, helmet and safety checks), but such are a service to me and other participants and are not a surety of safety.

Protective Equipment: As an activities participant I hereby agree that all participants are to wear a suitable helmet, closed toe footwear plus protective clothing, (full pads are at your deiscretion) as a minimum protective equipment requirements at all times whilst we are taking part in the activities.

Physical Fitness: I have independently assessed the activities and agree that we are all physically fit to participate in the activities in which I have chosen to participate and have not been advised otherwise by a medical practitioner. I do not have any possibly relevant pre-existing medical or physical conditions which have not been disclosed to LVLUP AUS ACADEMY & TRAINING FACILITY 

Medical Treatment: I consent for whom this waiver has been signed to receiving any medical, e.g. first aid treatment that LVLUP AUS ACADEMY & TRAINING FACILITY  considers reasonably necessary during or after the activities.

Personal Property: I hereby acknowledge that we have the sole responsibility for our personal property during the activities. I acknowledge the terms and conditions of this document are contractual in nature, are intended to have legal effect and are not a mere warning or recital. LVLUP AUS ACADEMY & TRAINING FACILITY  is not responsible for my decision to allow all peoples to participate in the activities and we were not induced by LVLUP AUS ACADEMY & TRAINING FACILITY  to do so. I acknowledge our registration at LVLUP AUS ACADEMY & TRAINING FACILITY  is not transferable to any other person. I have read this document and understand its contents and complete it of my own free will.

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
What Sport Activities will your group be using? *
Skateboard
BMX
Scooter
Roller Skates
Inline
I understand there is no sliding down ramps like a slide and if I do, I maybe asked to leave?*
No
Yes
I understand that if I hire/use any equipment available that I am liable on behalf of myself and/or my group and will be required to reimburse LVLUP ACADEMY & TRAINING FACILITY if they are not returned at the end of the hire period, are damaged or broken whilst they are in my possession.*
No
Yes
I understand that if I am are under the age of 18, helmets must be worn at all times whilst participating in the park.*
No
Yes
I as a spectator / parent / guardian / non rider understand that under no circumstances can I enter the skatepark riding area to help my child or children that I am responsible for as LVLUP GROUP insurance does not cover this. *
YES
NO
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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