This form MUST be completed signed and processed by Als Skate Co Pty Ltd before you are permitted to enter the facility and/or participate in events run by Als Skate Co Pty Ltd. If you are under 18 years of age a parent or legal guardian MUST sign this form and provide an emergency contact number. Access to this property is by the discretion of Als Skate Co Pty Ltd. By entering the property and/or participating in an event you accept Als Skate Co Pty Ltd rules, regulations and codes of conduct (including the protective equipment policy outlined below). Please complete your personal details and ensure the form is properly signed.

All persons must complete this document prior to participation.
The activities described include adventurous recreational activities and are not without inherent risk. Als Skate Co Pty Ltd thanks you for reading this document carefully. TO Als Skate Co Pty Ltd, its directors, employees, principals, agents and independent contractors, I confirm the following is true and correct and Als Skate Co Pty Ltd has relied on my answers in allowing me to participate in recreational activities of and incidental to things including skateboarding, rollerblading and scooter riding (“the activities”). In consideration of Als Skate Co Pty Ltd permitting me to participate in the activities:

Express Voluntary Assumption of Risk:

I understand that I, and 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 Als Skate Co Pty Ltd and all persons or corporations associated directly or indirectly with the conduct of activities from all claims, demands and proceedings arising out of my 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 my participation in the activities. This release shall extend to and include Als Skate Co Pty Ltd and owner partners, managers, officers, employees, agents, contractors, any club, organization 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 I participate in the activities, I will independently inspect the related facilities and equipment. I will immediately advise Als Skate Co Pty Ltd of any unsafe condition that I have observed. I 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 Als Skate Co Pty Ltd (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 to the following at all times whilst I am taking part in the activities:

  • Helmets must be worn by ALL participants.
  • All lesson participants aged 12 and under must wear kneepads and elbow pads.
  • Kneepads, elbow pads and wrist guards are recommended for all participants.
  • Closed toe footwear must be worn by all participants.

Physical Fitness:
I have independently assessed the activities and I am 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 Als Skate Co Pty Ltd.

Medical Treatment:
I consent and consent on behalf of the child for whom this waiver has been signed to receiving any medical treatment (e.g. first aid treatment) that Als Skate Co Pty Ltd considers reasonably necessary during or after the activities. This includes the calling of an ambulance.

Personal Property:
I hereby acknowledge that I have the sole responsibility for my 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. Als Skate Co Pty Ltd is not responsible for my decision to participate in the activities and I was not induced by Als Skate Co Pty Ltd to do so. I acknowledge my registration is not transferable to any other person. I have read this document, understand its contents and complete it of my own free will.

First Participant's Name

First Name*

Last Name*

First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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


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

Emergency Contact's Name*

Emergency Contact's Phone Number*
Name & likeness release
Do you grant permission to Als Skate Co Pty Ltd operators and owners, their successors and sponsors to use my name, image 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?*
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*


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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