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121 W.  Front St. Ave
Port Angeles, WA  98362

wintericevillage.com

ADULT & PARENTAL CONSENT, RELEASE AND WAIVER OF LIABILITY, AND ASSUMPTION OF RISK AGREEMENT

I give permission to myself, and to any minors for whom I am the parent or legal guardian listed on this waiver,  to skate and otherwise participate in related activities at Port Angeles Winter Ice Village, This agreement applies to myself, my successor, heirs, assigns, executors, and administrators, and any minor listed on this waiver.

1.  Agree that prior to  being in the Winter Ice Village as a skater or as an observer, and if I am providing consent to  Minor(s)’s presence in the Winter Ice Village as a skater or observer, I will inspect the facilities, equipment, and areas within the facility, and if either of us believes any of them are unsafe, I will immediately advise the manager on duty at the skating rink.

2.  Acknowledge that I fully understand that there is the risk of serious injury or death, economic losses, and emotional stress to me or any Minor(s) for whom I am signging, including but not limited to the following: my own actions or negligence or that of others, the condition of the facilities, the equipment, being at the location for the activity, the rules of play, or participating in any activity at the Winter Ice Village. 

3.  Release in every way Seaside Ice, LLC dba Ice-America, Ice-World International, The Chamber of Commerce of Port Angeles Washington, and the City of Port Angeles, and their respective officers, shareholders, members, directors, insurers, employees, and agents from any and all liability, loss, damage, claim, demand or cause of action brought against them as a result of my participation in the event or activity, whether they arise from negligence from any party;  If I am signing for a Minor(s), section 3 fully applies to them as well.

4.  I understand that all participants are recommended to wear head protection., and by declinging this head protection for me or any applicable Minor(s), I assume any and all risks of personal injuries to myself and/or the Minor(s) and authorize Seaside Ice, LLC dba Ice-America, Ice-World International, The Chamber of Commerce of Port Angeles Washington, and the City of Port Angeles to contact or employ a licensed physician to render any medical treatment that may be deemed necessary for me and/or the Minor(s), or to take and admit me and/or the Minor(s) to any hospital. If  medical treatment or hospitalization is required, I agree to pay all medical and hospital bills relating to said injuries that any treating medical professional deems necessary, even if I am not present to give agreement to treat in person. I agree to pay all damages relating to my and/or the Minor(s)’s permanent or partial disability or death, and any other damages to me and/or the Minor(s) property, caused by or arising from my presence or participation or that of any applicable Minor(s)’s at the Winter Ice Village.

5.   I agree with a Covenant not to sue or present any claim for personal injury, property damage, or wrongful death for or on behalf of myself or any applicable Minor(s) against Seaside Ice, LLC dba Ice-America, Ice-World International, The Chamber of Commerce of Port Angeles Washington, and the City of Port Angeles, or their respective officers, shareholders, members, directors, insurers, employees, or agents attributable to my or the Minor(s)’s participation in the event or activity;

6.  Agree that photographs, pictures, slides, movies, or videos of myself and/or the Minor(s) may be taken in connection with my or the Minor(s)’s participation or presence at the Winter Ice Village, and consent to the use of such photographs, pictures, slides, movies, or videos for any legal promotional purpose, without prior notificaton or compensation from Seaside Ice, LLC dba Ice-America, Ice-World International, The Chamber of Commerce of Port Angeles Washington, and the City of Port Angeles. I also agree that my identity athe identitiy of any applicable Minor(s) may be revealed by name, description, text, commentary, or otherwise, and waive any and all rights to the media mentioned above, as well as any compensation for their use. 

7.  Declare that I am in good health and have no physical condition that would prevent me from participation in the event or activity; This applies to any Minor(s) included on this release of liability as well.

8.  Acknowledge that Seaside Ice, LLC dba Ice-America and The Chamber of Commerce of Port Angeles Washington are not joint sponsors, joint venturers, partners, or otherwise jointly engaged in the above named event or activity;

9.  Agree to defend, indemnify, and hold harmless Seaside Ice, LLC dba Ice-America, The Chamber of Commerce of Port Angeles Washington, and the City of Port Angeles from any and all claims, including attorneys’ fees and costs, which may be brought against one or any of them, or any of their respective officers, shareholders, members, directors, insurers, employees, or agents by anyone claiming to have been injured as a result of my and/or the Minor(s)’s participation in the activity.

10. Agree that I will PROPERLY wear a mask that covers my mouth and nose while at the Winter Ice Village except when briefly eating and drinking, and will ensure that any applicable Minor(s)  above the age of five for whom I am responsible, will do the same. If I cannot or will not properly wear a mask without commenting, complaining, arguing, or being unpleasant about it, I will not enter the Winter Ice Village. I agree to observe and follow all established rules, safety requirements, protocols, and guidelines while at the Winter Ice Village, including those that exceed local, state, or Federal requirements. I agree that violation of any of these will result in removal from the Winter Ice Village and loss of entry fee. This includes but is not limited to requirements about wearing masks, maintaining safe skating practices, maintaining social distancing, properly using the skate aids, and following the directives of all Winter Ice Village staff members.

11. I agree that I willl treat all staff, volunteers, owners, or representatives of the Winter Ice Village with courtesy and respect, and that by sigining this waiver I acknowledge that I understand all the rules and regulations of the Winter Ice Village, and agree to follow them without comment or complaint. I also assume responsibility for any Minor(s) included on this release and will ensure that they also follow all rules, and twill also reat all representatives of the Winter Ice Village with courtesy and respect.

IMPORTANT:

THIS DOCUMENT RELIEVES Seaside Ice, LLC dba Ice-America, ICE WORLD INTERNATIONAL, THE CHAMBER OF COMMERCE OF PORT ANGELES WASHINGTON, THE CITY OF PORT ANGELES, AND OTHERS FROM ANY AND ALL LIABILITY FOR PERSONAL INJURY, WRONGFUL DEATH, AND PROPERTY DAMAGE CAUSED BY NEGLIGENCE. A PARENT OR LEGALLY APPOINTED GUARDIAN MUST SIGN.  ANY ADULT WHO SIGNS FOR A MINOR(S) IS DECLARING THAT THEY ARE A PARENT OR LEGAL GUARDIAN WITH FULL AUTHORITY TO GIVE PERMISSIONS FOR THE MINOR(S).

I UNDERSTANT THAT I AM ADVISED TO HAVE INDEPENDENT COUNSEL REVIEW THIS AGREEMENT. I HAVE READ THIS DOCUMENT, UNDERSTAND THAT I WILL GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN VOLUNTARILY.  I AM AWARE OF THE RISKS INVOLVED IN MY AND/OR THE MINOR(S)’S PARTICIPATION IN THE EVENT OR ACTIVITY. I UNDERSTAND THAT I HAVE THE RIGHT TO HAVE INDEPENDENT COUNSEL REVIEW THIS AGREEMENT AND WAS SPECIFICALLY ADVISED TO RETAIN COUNSEL TO REVIEW THIS AGREEMENT. I AM LEGALLY COMPETENT TO SIGN THIS RELEASE AND DO SO OF MY OWN FREE WILL.  I HAVE BEEN ADVISED THAT PARTICIPANTS SHOULD WEAR HEAD PROTECTION.

Date: January 20, 2022

First Participant Name

First Name*

Last Name*

Phone*
First Participant Date of Birth*
First Participant Signature*
Second Participant Name

First Name*

Last Name*
Second Participant Date of Birth*
Third Participant Name

First Name*

Last Name*
Third Participant Date of Birth*
Fourth Participant Name

First Name*

Last Name*
Fourth Participant Date of Birth*
Fifth Participant Name

First Name*

Last Name*
Fifth Participant Date of Birth*
Sixth Participant Name

First Name*

Last Name*
Sixth Participant Date of Birth*
Seventh Participant Name

First Name*

Last Name*
Seventh Participant Date of Birth*
Eighth Participant Name

First Name*

Last Name*
Eighth Participant Date of Birth*
Ninth Participant Name

First Name*

Last Name*
Ninth Participant Date of Birth*
Tenth Participant Name

First Name*

Last Name*
Tenth Participant Date of Birth*
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Zip Code

Please Enter Your Primary Residence (Home town) Zip Code *
HEAD PROTECTION
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 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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