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Skate Park Release Waiver 

 

 Saddleback Valley Community Church (“SVCC”) wants everyone using the facilities at The Ryan Shecklers SkatePark to have a safe and enjoyable experience. To provide a good time for all participants, SVCC asks that you complete this Assumption of Risk, Waiver and Release Agreement (“Agreement”). This signed Agreement must be on file in the Refinery office. If you are under 18 years of age, the Agreement must be signed by your parent or legal guardian. 

Participant Information: 

Last Name First Middle 

(Hereinafter referred to as “PARTICIPANT”) 

Birth Date Home Phone Cell Phone 

Street Address 

City State Zip Code 

Email Address 

PARTICIPANT’s Parent or Legal Guardian Information if PARTICIPANT is Under the Age of 18: PARTICIPANT’s Parent or Legal Guardian’s Last Name First Name Street Address (If different from PARTICIPANT’s) City State Zip Code Home Phone Cell Phone Email Address ASSUMPTION OF THE RISK: I understand that use of The Ryan Sheckler Skate Park facilities is an inherently dangerous activity that can result in serious bodily injury. I understand that there is a strong likelihood that anyone using The Ryan Sheckler Skate Park facilities will have an accident. I further understand that if someone has such an accident, there is a strong likelihood they will sustain serious injuries. I further understand that various degrees of skill and experience are required for safely using the diverse ramps and features of The Ryan Sheckler Skate Park facilities and that it is within the PARTICIPANT’s sole discretion to determine what areas of The Ryan Sheckler Skate Park facilities are safe for the PARTICIPANT. With that understanding, and in consideration for the privilege of using The Ryan Sheckler Skate Park facilities, I, on my own behalf and/or on behalf of the minor PARTICIPANT under my legal guardianship, knowingly and willfully assume all the risk of any injury that may occur while I and/or the minor PARTICIPANT under my legal guardianship use The Ryan Sheckler Skate Park facilities. This Assumption of Risk applies to accidents caused by the design, construction, maintenance or supervision of the facilities, the conduct of the PARTICIPANT and/or the conduct of any other individuals using The Ryan Sheckler Skate Park facilities. 

EXPRESS RELEASE AND WAIVER OF ALL CLAIMS: I, on my own behalf and/or on behalf of the minor PARTICIPANT under my legal guardianship, expressly agree to defend, indemnify, hold harmless and release SVCC, its officers, directors, employees, volunteers, agents, representatives and related entities from any and all claims, losses, or damages of any kind, including but not limited to serious physical injury and/or death, which may arise from use of The Ryan Sheckler Skate Park facilities. I understand that by signing this Agreement I am waiving significant legal rights on my own behalf and/or on behalf of the minor PARTICIPANT under my legal guardianship. I understand that if I, and/or the minor PARTICIPANT under my legal guardianship, am injured while using The Ryan Sheckler Skate Park facilities, I will not sue or make any claim against SVCC, its officers, directors, employees, volunteers, agents, representatives and related entities or the Ryan Sheckler Skate Park, The Sheckler Foundation, or any other related entities. I, on my own behalf and/or on behalf of the minor PARTICIPANT under my legal guardianship, knowingly and willfully acknowledge that this RELEASE AND WAIVER OF ALL CLAIMS applies to accidents caused by the design, construction, maintenance or supervision of the facilities, the conduct of the PARTICIPANT and/or the conduct of any other individuals using The Ryan Sheckler Skate Park facilities. MEDICAL RELEASE: In the event I or the minor PARTICIPANT under my legal guardianship sustains any injury while using The Refinery Skate Park facilities and I cannot promptly authorize necessary medical treatment, I hereby give permission to any licensed physician, surgeon, emergency health care provider, clinic, or hospital to secure proper treatment, and to order anesthesia, for my myself and/or the minor PARTICIPANT unde. The minor PARTICIPANT under my legal guardianship is allergic to the following medications: . 

ADDITIONAL TERMS AND CONDITIONS: This Agreement applies whether I and/or the minor PARTICIPANT under my legal guardianship is an observer, a bystander, or an active participant at activities at The Ryan Sheckler Skate Park facilities. I, and/or the minor PARTICIPANT under my legal guardianship, agree to adhere to all posted rules pertaining to use of The Ryan Sheckler Skate Park facilities. I and/or the minor PARTICIPANT under my legal guardianship understand that SVCC’s staff, volunteers, pastors, interns, agents or representatives have the right to immediately revoke the privilege of using The Ryan Sheckler Skate Park facilities if they, in their sole discretion, believe I, and/or the minor PARTICIPANT under my legal guardianship have violated those rules. I, and/or the minor PARTICIPANT under my legal guardianship, agree that if SVCC captures a photograph, video or digital image of me and/or the minor PARTICIPANT under my legal guardianship using The Ryan Sheckler Skate Park facilities, SVCC has the right to use that photograph, video or digital image to encourage participation in SVCC ministries. SVCC has the right to revoke the Agreement at its own discretion. I HAVE READ THIS ASSUMPTION OF RISK AGREEMENT AND WAIVER AND RELEASE AGREEMENT AND FULLY UNDERSTAND ITS TERMS. I UNDERSTAND THAT BY SIGNING THIS AGREEMENT I HAVE GIVEN UP SUBSTANTIAL LEGAL RIGHTS. I SIGN THIS AGREEMENT FREELY, VOLUNTARILY AND WITHOUT ANY INDUCEMENT. 

PARTICIPANT’s Signature Date 

Print PARTICIPANT’s Name 

If PARTICIPANT is under than 18 years of age: 

I, AS THE PARENT/LEGAL GUARDIAN OF THE PARTICPANT HAVE READ THIS ASSUMPTION OF RISK AGREEMENT AND WAIVER AND RELEASE AGREEMENT. I FULLY UNDERSTAND ITS TERMS AND UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS ON BEHALF OF THE MINOR PARTICIPANT UNDER MY LEGAL GUARDIANSHIP. I SIGN THIS AGREEMENT FREELY, VOLUNTARILY AND WITHOUT ANY INDUCEMENT. 

Parent/Legal Guardian Signature Date 

Print Parent/Legal Guardian’s Name

First Participant's Name

First Name*

Middle Name

Last Name*

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

YOUR INSTAGRAM HANDLE:
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

YOUR INSTAGRAM HANDLE:
Third Participant's Name

First Name*

Middle Name

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

YOUR INSTAGRAM HANDLE:
Fourth Participant's Name

First Name*

Middle Name

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

YOUR INSTAGRAM HANDLE:
Fifth Participant's Name

First Name*

Middle Name

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

YOUR INSTAGRAM HANDLE:
Sixth Participant's Name

First Name*

Middle Name

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

YOUR INSTAGRAM HANDLE:
Seventh Participant's Name

First Name*

Middle Name

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

YOUR INSTAGRAM HANDLE:
Eighth Participant's Name

First Name*

Middle Name

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

YOUR INSTAGRAM HANDLE:
Ninth Participant's Name

First Name*

Middle Name

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

YOUR INSTAGRAM HANDLE:
Tenth Participant's Name

First Name*

Middle Name

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

YOUR INSTAGRAM HANDLE:
Parent or Guardian's Email Address

Email
Check to receive information from Saddleback Student Ministries
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's 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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

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

YOUR INSTAGRAM HANDLE:
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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