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ACKNOWLEDGEMENT AND WAIVER

CJ’s SKATEPARK

A division of the Canadian Skateboard Park & School Association
A NOT-FOR-PROFIT CORPORATION

560 Hensall Circle, Mississauga, ON, Canada L5A 1Y1 | 905 272 6888 | www.CJsSKATEPARK.com

I/WE UNDERSTAND THAT SKATEBOARDING, SCOOTER RIDING, INLINE SKATING AND ANY OTHER ACTIVITIES CARRIED OUT IN THE FACILITY ARE INHERENTLY RISKY SPORTS ACTIVITIES IN WHICH PARTICIPANTS MAY SUFFER SERIOUS INJURY OR FATALITY.

I/WE FURTHER UNDERSTAND THAT THE RISK OF INJURY MAY ARISE FROM A VARIETY OF SOURCES INCLUDING BUT NOT LIMITED TO TERRAIN, EQUIPMENT, FACILITIES, TEMPERATURE, WEATHER, CONDITION AND ACTIVITIES OF PARTICIPANTS, SPECTATORS, OFFICIALS AND EVENT PERSONNEL.

I/WE HEREBY ASSUME ALL RISKS ASSOCIATED WITH ATTENDANCE AT OR PARTICIPATION IN EVENTS AT CJ’s SKATEPARK INCLUDING ORGANIZED COMPETITION, TRAINING, EDUCATION AND ALL OTHER ACTIVITIES ASSOCIATED WITH SKATEBOARDING, SCOOTER RIDING, INLINE SKATING AND ANY OTHER ACTIVITIES CARRIED OUT IN THE FACILITY. I/WE ALSO ACKNOWLEDGE THAT CJ’s SKATEPARK MAY FROM TIME TO TIME ENGAGE IN OUTINGS, INCLUDING TRIPS TO OTHER OUTDOOR PUBLIC SKATEPARKS, PUBLIC SWIMMING POOLS, OFFSITE DEMOS AND COMPETITIONS, AND I/WE AUTHORIZE SUCH OUTINGS.

I/WE HEREBY WAIVE ANY RIGHTS THAT MIGHT ACCRUE TO ME OR TO ANYONE ON WHOSE BEHALF I/WE AM SIGNING THIS WAIVER, INCLUDING A CHILD EITHER BY VIRTUE OF COMMON LAW, THE OCCUPIERS’ LIABILITY ACT (ONTARIO) OR ANY OTHER STATUTE IN FORCE FROM TIME TO TIME, TO SUE FOR DAMAGES SUSTAINED: A) AS A RESULT OF INJURY SUSTAINED OFFSITE OR ON THE PREMISES OF CJ’s SKATEPARK; B) DURING MY PARTICIPATION IN ANY EVENT OFFSITE OR AT CJ’s SKATEPARK; AND, C) AS A RESULT OF THE USE OF ANY EQUIPMENT BELONGING TO CJ’s SKATEPARK WHETHER OR NOT THE INJURY ARISES AS A RESULT OF THE NEGLIGENCE OF CJ’s SKATEPARK, ITS EMPLOYEES, AGENTS OR VOLUNTEER PARTICIPANTS. IN THE EVENT OF AN INJURY, CJ’s SKATEPARK WILL TAKE ALL REASONABLE STEPS TO CONTACT PARENT/GUARDIAN. IN THE EVENT THAT CJ’s SKATEPARK IS UNABLE TO CONTACT PARENT/GUARDIAN, PARENT/GUARDIAN AUTHORIZES CJ’s SKATEPARK TO CONTACT SUCH MEDICAL EMERGENCY PERSONNEL AS CJ’s SKATEPARK MAY THINK NECESSARY.

I/WE FURTHER AGREE TO INDEMNIFY AND HOLD HARMLESS CJ’s SKATEPARK FROM ANY CLAIMS MADE BY OR THROUGH ME BY THIRD PARTIES AGAINST CJ’s SKATEPARK.

I/WE FURTHER WARRANT THAT, IF I/WE AM SIGNING THIS WAIVER ON BEHALF OF A CHILD UNDER THE AGE OF 18 YEARS, I/WE AM A PARENT OR LEGAL GUARDIAN OF SUCH CHILD AND AM LEGALLY ENTITLED TO SIGN SUCH WAIVER.

I/WE FURTHER ACKNOWLEDGE THAT EVENTS MAY BE PHOTOGRAPHED AND FILMED. I/WE CONSENT TO THE USE OF ANY PICTURE(S) OR VIDEO(S) FOR THE PURPOSE OF NORMAL PUBLICITY AND PROMOTION OF CJ’s SKATEPARK AS WELL AS FOR NEWS RELATED PUBLICATIONS AND PUBLIC SERVICE ANNOUNCEMENTS, WITHOUT CHARGE.

I/WE ALSO GIVE CJ’s SKATEPARK PERMISSION TO SEND MONTHLY E-BLASTS AND OTHER RELATED PARK INFORMATION.

I/WE CONFIRM THAT I/WE HAVE HAD AN OPPORTUNITY TO OBTAIN LEGAL ADVICE BEFORE SIGNING THIS ACKNOWLEDGEMENT AND WAIVER AND HAVE

I/WE UNDERSTAND THE COVID-19 VIRUS HAS A LONG INCUBATION PERIOD AND CARRIERS MAY NOT SHOW SYMPTOMS AND BE CONTAGIOUS. I ACKNOWLEDGE THAT CJ'S SKATEPARK WILL NOT BE RESPONSIBLE IN THE EVENT I CONTRACT THE VIRUS AND RELEASE CJ’S SKATEPARK AND ITS OFFICERS, DIRECTORS, SHAREHOLDERS AND EMPLOYEES FROM ANY LIABILITY RESULTING THEREFROM.

Proper safety equipment must be worn at all times including skate shoes or running shoes. Visit our website for more information: CJsSKATEPARK.com

PARENT OR GUARDIAN MUST SIGN THIS IF YOU ARE UNDER 18 YEARS OLD.
Provision of false information or signature releases said parties from any and all liabilities, loss, cost claim or damage whatsoever.

Today's Date: April 18, 2021

First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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*

Middle 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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