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BASE VILLAGE COMPANY, INC.

Waiver of Liability and Release - Use of the Ice Rink

Every person, or a parent/legal guardian of a person under the age of 18 (a “Minor”), desiring to use or participate in activities at the Rink, must complete this Waiver of Liability and Release (the “Waiver and Release”).

PLEASE READ THIS WAIVER AND RELEASE VERY CAREFULLY AND MAKE SURE YOU UNDERSTAND IT. 

COVID-19 coronavirus (“COVID-19”) is extremely contagious and is believed to spread mainly from person-to-person contact. Methods of transfer include, but are not limited to, physical contact, contact through breath, and contact with stable surfaces. Additional information about COVID-19 and COVID-19 symptoms may be found at https://www.cdc.gov/coronavirus/2019-ncov/index.html and https://covid19.colorado.gov/about-covid-19. Base Village wants to make sure that you understand the potential risks of COVID-19 before you decide to use the Rink. There may be other risks and dangers, a complete listing of which is not possible and cannot be anticipated, and you assume all such risks and dangers, whether or not described here, known or unknown. 

By signing this Waiver and Release, you recognize and acknowledge the contagious nature of COVID-19 and the threat that COVID-19 poses to the health of individuals, and you voluntarily and knowingly assume the risk that you or your Minor may be exposed to or infected by COVID-19 at the Rink, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. You understand and acknowledge that the risk of becoming exposed to or infected by COVID-19 at the Rink may result from the actions, inactions and/or omissions of yourself and/or others.

By signing this Waiver and Release you certify that you have received any and all information that you deem necessary or important in making an informed choice regarding your own or your Minor’s use of the Rink, and you voluntarily agree to assume all risks and accept sole responsibility for any injury to you or your Minor (including, but not limited to, personal injury, disability, death, illness, damage, loss, claim, liability, or expense, of any kind), that you or your Minor may experience or incur in connection with the use of the Rink.

You agree to indemnify and hold Base Village, its officers, employees, agents, consultants, independent contractors, and representatives (collective, the “Base Village Indemnitees”) harmless from any claim, liability, damage, loss, injury (including death), cost or expense relating to COVID-19 which may result from your participation, or the participation of your Minor, in any activity in or around the Rink. You further agree to release, waive and discharge, and covenant not to sue the Base Village Indemnitees for any and all claims, demands, losses, costs, expenses or causes of action whatsoever arising out of any claim, liability, damage, loss or injury (including death) relating to COVID-19 as a direct or indirect result of your participation, or your Minor’s participation, in any activity at the Rink. This release of liability and indemnity applies to you, the undersigned, your Minor, as well as any of your personal representatives, assigns, heirs and next of kin. By signing this Waiver and Release, you agree that you and your Minor will only use the Rink and participate in activities at the Rink while in good health and free of COVID-19 symptoms, including, but not limited to, fever, cough, or shortness of breath.

You agree that you: (1) have received sufficient information regarding the use of the Rink to assess the potential degree of risk involved, and the extent of possible injury; (2) understand the activities and potential risks; (3) have carefully read and fully understand the effect of relinquishing the rights that you hereby waive; and (4) voluntarily sign this Waiver and Release.


First Participant's Name

First Name*

Last Name*

Phone*
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
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
IF MINORS UNDER 18 YEARS OF AGE WILL BE UTILIZING THE RINK, PARENT OR GUARDIAN MUST READ AND SIGN BELOW: I am the parent or legal guardian of the minor(s) listed below. I acknowledge that I have read this Waiver and Release and have full knowledge and understanding of its contents. I hereby agree to the terms of the Waiver and Release on behalf of the named minor(s), and give my consent for the named minor(s) to utilize the Rink. I acknowledge that by signing this Waiver and Release on behalf of the minor(s) that the minor(s) shall be bound by all terms of this Waiver and Release.


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*

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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