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ROLL-A-RAMA

RELEASE AND WAIVER OF LIABILITY

I, the undersigned Participant, and/or parent or legal guardian of Participant, acknowledge and understand that roller skating is an inherently dangerous activity that involves both known and unknown risks of accident, property damage, seriously bodily injury, disability, and/or death. Some of these risks include the risk inherent in skating such as falling and coming into contact with ramps and walls, latent or apparent defects or conditions in equipment or property, and passive or active negligent acts of myself or a third- party. I further warrant that I understand that the above list of risks is not complete or exhaustive and that those and other risks known or unknown, anticipated or unanticipated may also result in property damage, seriously bodily injury, disability, and/or death to myself or third parties.

I, the undersigned Participant, and/or parent or legal guardian of Participant, voluntarily agree and promise to accept and assume responsibility for any and all injury, death, illness, disease or damage to myself or my property arising from my participation in this activity. I further warrant that I understand that Roll-A- Rama, nor its owners or operators, do not assume any liability for loss, damage, or any kind of injury sustained by myself or my property while using the skating rink and/or participating in roller skating.

I, the undersigned Participant and/or parent of legal guardian of Participant, assume all risks associated with using the skating rink and/or participating in roller skating. By signing this release and waiver of liability and using the skating rink at Roll-A-Rama, I hereby fully and forever release and agree to discharge, indemnify, and hold harmless Roll-A-Rama, their employees, agents, owner(s), and operator(s) from any and all liabilities, claims, demands, damages, rights of action, suits or causes of action, present or future, whether they be known or unknown, anticipated or unanticipated, resulting from or arising out of my use of intended use of said skating rink premises, facilities, or equipment.

I, the undersigned Participant and/or parent of legal guardian of Participant, further warrant that I am in good physical health sufficient to use the skating rink and/or participate in roller skating; that I am not under the influence of alcohol or any illegal drugs; that I am not taking any medication that would prevent Participant from safely using the skating rink and/or participating in roller skating. I further warrant that I agree to follow all rules posted by Roll-A-Rama on the premises and any instructions from the operating staff of the rink.

I, the undersigned Participant, and/or parent or legal guardian of Participant, recognize that this a release of liability. I further warrant that this Release and Waiver of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under West Virginia law. I further warrant that I have read and fully understood the terms included herein prior to signing this document.

Today's Date: April 25, 2025

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

Relationship*

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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