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This waiver is for all players/skaters at Southside Ice Arena to participate in on ice skating activities. 

Waiver and Liability Release Form

In consideration of Open Skating, Stick and Puck, and Drop In Hockey, Freestyle Figure Skating, Private Event Rentals, Birthday Parties, at Southside Ice Arena I agree as follows:

I fully understand and acknowledge that Southside Ice Arena  Facility has: (a) inherent risks, dangers, and hazards and such exists in participation such activities; (b) my participation in such activities and/or use of any equipment may result in injury or illness including, but not limited to bodily injury, disease, strains, fractures, partial and/or total paralysis, death or other ailments that could cause serious disability; (e) these risks and dangers may be caused by the negligence of the owners, employees, officers, or agents of the above listed facility/business/property; the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes. Risks and dangers may arise from foreseeable or unforeseeable causes including but not limited to, fires, explosions, slips, falls, and all other dangers associated with the demonstration listed above, and (d) by my participation in these activities and use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or other conduct of the owners, agents, officers, or employees of facility/business/property owner, or by any other person.

I, on behalf of myself, my personal representatives and my heirs hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify the above-listed facility/business/property owner, their agents, officers, and employees, and any agents, officers, and employees of from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my participation in the above-listed event or use of equipment or any other outdoor activities at the above listed location. I specifically understand that I am releasing, discharging and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the above-listed facility/business/property owner, their agents, officers, and employees, and any agents, officers, and employees of Southside Arena.

I also agree to the following: the undersigned acknowledges that he/she is aware of the risks and hazards involved in participating in the above-listed activity as well as any associated use of equipment, or other materials associated with the activity including, but not limited to, ingress and egress at the facility, walking, climbing stairs, skating, playing hockey and lifting. I voluntarily participate therein although knowing such dangers and hereby release the above-listed facility/business/property owner, their agents, officers, and employees, and any agents, officers, and employees of against any and all liabilities, claims, demands, actions and causes of action whatsoever, arising out of or relating to any loss, damage, including death, that may be sustained by me in connection with my participation in this activity. This release shall be binding upon the administrators and/or executors of my estate, my heirs, and distributees. The venue of any dispute that may arise out of this agreement, or otherwise between the parties shall be in either the county of the above-listed facility or if Southside Arena is a named party, in the state of Michigan.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
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

Email*

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

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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