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Rose City Rollers

Roller Skating and Photography RELEASE AND WAIVER

IN CONSIDERATION of choosing to participate in the sport of Roller Skating / Outdoor Skating or Indoor Skating and/or to participate in public and/or private event activities, including without limitation those activities which may involve athletic activities or recreational equipment (each an “Activity” and collectively, “Activities”), at the Hangar at Oaks Amusement Park, or affiliated Rose City Rollers (herein referred to as “Releasee”) Public or Privately hosted events involving our rented equipment (each a “Location” and collectively, “Locations”), the undersigned, on behalf of myself and, if applicable, in my capacity as parent* or legal guardian* of the persons listed below (collectively hereinafter referred to as “participant”, "I", “me” or “my”), hereby agree as follows:

1. ACKNOWLEDGES, agrees, and represents that the Undersigned has, or will immediately upon entering and continuously thereafter, inspect such Locations and does further warrant that the Undersigned's participation in the Activities, constitutes an acknowledgment that the Undersigned has inspected the Location, and that it is safe and reasonably suited for the purposes of ROLLER SKATING, and further agrees and warrants that if, at any time, the Undersigned is in or about the Location and feels anything to be unsafe, the Undersigned will immediately advise the Rose City Rollers representative of such unsafe condition(s) and will leave the Location.

2. HEREBY RELEASES, WAIVES, DISCHARGES, AND COVENANTS NOT TO SUE the Rose City Rollers and it's landlord, Oaks Amusement Park, or it’s governing body the WFTDA (Women’s Flat Track Derby Association), facility operators, officials, participants, any persons at the Location, including rescue personnel, sponsors, advertisers, owners and lessees of premises on which the Activities are conducted, premises inspectors, Event inspectors, surveyors, underwriters, consultants, and others who offer recommendations, directions, or instructions, or engage in risk evaluation or loss control activities regarding the premises or Event(s), and each of them, their officers, directors, agents, and employees, all for purposes herein referred to as "RELEASEES," from all liability to the Undersigned, the Undersigned's personal representatives, assigns, heirs, and next of kin FOR ALL LOSS OR DAMAGE SUSTAINED BY THE UNDERSIGNED, AND ANY CLAIM OR DEMANDS RESULTING THEREFROM, ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES OR OTHERWISE, while the Undersigned is in or upon the Location, and/or competing, observing, working for, or for any purpose participating in the Activities.

3. HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Releasee from any loss, liability, damage, or cost they may incur due to the presence of the Undersigned in or upon the Location or in any way competing, officiating, observing, or working for, or for any purpose participating in the Activities, and whether caused by the negligence of the Releasees or otherwise; and

4. HEREBY ASSUMES FULL RESPONSIBILITY FOR THE RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE due to negligence of Releasee or otherwise while in or upon the Location, and/or while competing, observing, working for, or for any purpose participating in such Activities

5. EXPRESSLY acknowledges that the ACTIVITIES ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. EACH OF THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.

6. FURTHER expressly agrees that the foregoing Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement extends to all acts of negligence by the Releasees, INCLUDING NEGLIGENT RESCUE OPERATIONS.

7. “I grant full permission to the Released Parties to use, without further notification, authorization or compensation to me or anyone on my behalf, my name and likeness, as well as any photographs, videotapes, motion pictures, recordings, or other record of the Activities (or any excerpt thereof) in any and all media, whether now known or hereafter to become known, worldwide and in perpetuity, and I represent and warrant that no further permission is required for the Related Parties to use any record of the Activities as provided herein. “

I AM 18 YEARS OF AGE OR OLDER, HAVE READ AND UNDERSTAND THE TERMS OF THIS AGREEMENT, UNDERSTAND THAT I AM GIVING UP I AM 18 YEARS OF AGE OR OLDER, HAVE READ AND UNDERSTAND THE TERMS OF THIS AGREEMENT, UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BY SIGNING THIS AGREEMENT, HAVE SIGNED IT VOLUNTARILY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE, ORAL OR WRITTEN, AND INTEND THIS AGREEMENT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. I AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

*Participants under the age of 18 must have waiver signed by a parent or legal guardian.

PHASE 1 reopening Covid-19 - YOU MUST attest to the following / resign this waiver every time you skate/support/attend a Rose City Rollers event in the Hangar, on Oaks Park Property, or use our Skatemobile gear.

Do you have any of the following symptoms of COVID 19: 

·                     A fever of 100.4 degrees Fahrenheit or higher 

·                     A cough 

·                     Shortness of breath or difficulty breathing 

·                     New loss of Taste or Smell 

·                     Chills  

·                     Diarrhea 

·                     Sore Throat 

·                     Vomiting 

 NO

I Agree

 

Have you been asked by a Doctor or Public Health Official to Self-Quarantine anytime in the past 14 days? 

NO

I Agree
 

 

Have you been exposed anytime in the past 14 days to people exhibiting the above COVID-19 symptoms, including visiting or working at a facility with confirmed cases? 

NO

I Agree
 

 

IF YES to any of the above, you MUST NOT participate until you are able to confidently attest NO to the above.

I understand that, should I participate in ANY Rose City Rollers community activity, roller skating or otherwise, I am required to keep a 6 foot distance from non household attendees, and MUST wear a mask if the event organizers require it.

I acknowledge my voluntary exposure to the associated risks of participating in voluntary activities at this time.  

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

Email*

Confirm Email*
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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*
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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