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SKATEDOGS WAIVER
PARTICIPANT RELEASE OF LIABILITY

ALL PARTICIPANTS MUST WEAR A HELMET, KNEE PADS, AND ELBOW PADS
READ BEFORE SIGNING
PLEASE RETURN WAIVER TO INSTRUCTOR

  1. The risk of injury from the activities involved in skateboarding lessons, programs, or events, including the potential for permanent disability or death, and while particular rules, safety equipment, instruction and personal discipline may reduce the risk, the risk of serious injury to me does exist: and,
  2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation.
  3. I, for myself and on behalf of my/our heirs, assignees, personal representatives, persons under my guardianship, and next of kin, HEREBY RELEASE ADAM COHEN AND SKATEDOGS, WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, LOSS OR DAMAGE to person or property incident to my involvement or participation in skateboarding lessons, programs or events, including transportation to lessons, WHETHER ARISING FROM THE NEGLIGENCE OR THE RELESEES OR OTHERWISE, to the fullest extent permitted by law.
  4. I, for myself and on behalf of my/our heirs, assignees, personal representatives, persons under my guardianship, and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releases from any and all the liabilities incident to my involvement or participation in skateboarding lessons, programs or events, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent of the law.
  5. I have read the release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement. I also waive and release the use of my photograph or likeness for any reason or purpose.
  6. Coronavirus / COVID-19 Warning & Disclaimer: Coronavirus a/k/a COVID-19 is an extremely contagious virus that spreads easily through person-to-person or other contact. Federal and state authorities recommend social distancing as a means to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in programs or activities upon the Skatedogs premises could increase the risk of contracting COVID-19. Skatedogs in no way warrants that COVID-19 infection will not occur through participation in programs or activities upon the Skatedogs premises. I hereby certify that I have full knowledge of the nature and extent of the risks inherent in my and my child’s entry upon the Skatedogs premises; the use of any of Skatedogs facilities or equipment; and my child’s participation in any of the Skatedogs programs, and that I am voluntarily assuming said risks. I understand that I will be solely responsible for any loss or damage, including personal injury, property damage, or death, I sustain as a result of my entry upon the Skatedogs premises, the use of any of the Skatedogs facilities or equipment, and/or my participation in any of the Skatedogs programs, and that by signing this agreement I HEREBY RELEASE Skatedogs from all liability for such loss, damage, or death. I further certify that my child is in in good health and has no conditions or impairments, which would preclude their safe entry upon the Skatedogs premises, the use of any of the Skatedogs facilities or equipment, and/or their participation in any of the Skatedogs programs.

I want to participate in this hazardous sport.
I agree to assume full responsibility for all injuries and medical expenses incurred while participating in skateboarding lessons, programs, or events.

With less than 48 hours notice of a cancellation of a private lesson, participants will be charged in full for the missed lesson so that their instructor can be paid for the reserved time.

Today's Date: June 28, 2022

First Participant's Name

First Name*

Last Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
First Participant's Signature*
Second Participant's Name

First Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
Third Participant's Name

First Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
Fourth Participant's Name

First Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
Fifth Participant's Name

First Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
Sixth Participant's Name

First Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
Seventh Participant's Name

First Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
Eighth Participant's Name

First Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
Ninth Participant's Name

First Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
Tenth Participant's Name

First Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
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.
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.
Parent or Guardian's Name

First Name*

Last Name*

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

Parent 1 cell:

Parent 2 cell:
How did you hear about Skatedogs?*

Flyer received from:

Other:

What school or location will your child be skateboarding? *

Please initial to acknowledge that we are unable to accommodate make-up classes or camps. We will add a make-up date at the end of the session for any rained out classes. *
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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