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SOUTHSIDE SKATEPARK

510 IOWA ST. SOUTH HOUSTON, TEXAS 77587 PHONE 713-946-0414 FAX 713-946-0034
WWW.SOUTHSIDESKATEPARK.COM

PARTICIPANT AGREEMENT, RELEASE, AND ASSUMPTION OF RISKĀ 

In consideration of the services of Southside Skatepark, Lone Star Skateboards, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity of their behalf (hereinafter collectively referred to as "SSP"), I hereby agree to release, indemnify, and discharge SSP, 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, or other activities or sports known as dangerous but not mentioned above entails known and unanticipated risk that could result in physical or emotional injury, paralysis, death, or damage to myself to property, or to third parties, I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity.

THE RISK INCLUDE, AMONG OTHER THINGS: Collision with other participants, the walls, or other fixed objects; falling down; my own equipment failure or 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, bruises, loss or impairment of vision, damage to teeth, damage to internal organs, loss of limb, paralysis and death. Furthermore, SSP employees have difficult jobs to perform. They seek safety, but they are not infallible. 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 risk.

3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless SSP 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 SSP's equipment or facilities, including any such claims which allege negligent acts or omissions of SSP.

4. Should SSP 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 SSP, I agree to do so solely in the state of Texas, and I further agree that the substantive law of the state shall apply in that action without regard to the conflict of law ruses 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 SSP 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 SSP 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 I agree to be bound by its terms.

Date: November 27, 2021

First Participant's Name

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First Participant's Date of Birth*
First Participant's Information

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First Participant's Signature*
Second Participant's Name

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Second Participant's Date of Birth*
Second Participant's Information

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Third Participant's Name

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Third Participant's Date of Birth*
Third Participant's Information

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Fourth Participant's Name

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Fourth Participant's Date of Birth*
Fourth Participant's Information

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Fifth Participant's Name

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Fifth Participant's Date of Birth*
Fifth Participant's Information

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Sixth Participant's Name

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Sixth Participant's Date of Birth*
Sixth Participant's Information

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Seventh Participant's Name

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Seventh Participant's Date of Birth*
Seventh Participant's Information

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Eighth Participant's Name

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Eighth Participant's Date of Birth*
Eighth Participant's Information

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Ninth Participant's Name

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Ninth Participant's Date of Birth*
Ninth Participant's Information

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Tenth Participant's Name

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Tenth Participant's Date of Birth*
Tenth Participant's Information

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Parent or Guardian's Email Address

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Emergency Contact

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I CONFIRM THAT I AM THE PARENT/LEGAL GUARDIAN OF THE PARTICIPANT ABOVE AND ANY FALSE CLAIMS OR MISREPRESENTATIONS THAT I MAY HAVE MADE ON THIS DOCUMENT I TAKE FULL RESPONSIBILITY FOR AND WILL NOT HOLD SSP LIABLE FOR ANY ACCIDENTS THAT MAY OCCUR WHILE ON THE PREMISES. In consideration of "Minor" being permitted by SSP to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless SSP 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. Paragraphs 1 through 6 above are incorporated herein by reference for all purposes. Said paragraphs are binding on me as parent or guardian of the above named minor or as signatory to this document. I accept the risks in the above paragraphs for myself and on behalf of the above named minor. I make and affirm the waivers, indemnities and releases in the above paragraphs for myself and on behalf of the above named minor. I make and affirm the certifications and representations in the above paragraphs for myself and on behalf of the above named minor.
Parent or Guardian's Name

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Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

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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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