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Release of Liability and Waiver
for Family Fun And Skate LLC

1080 Wadhams MI 48074

  1. THE UNDERSIGNED, PARENT OR LEGAL GUARDIAN ACKNOWLEDGE THE RISK INVOLVED IN ROLLER SKATING IN CONSIDERATION OF MY SELF AND OR CHILD BEING ALLOWED TO PARTICIPATE IN ANY SKATING ACTIVITIES AND OR ANY OTHER ACTIVITYS AT FAMILY FUN AND SKATE FACILITIES. I AGREE TO THE FOLLOWING:
  2. I ACKNOWLEDGE AND FULLY UNDERSTAND THAT MYSELF OR THE CHILD OR CHILDEREN WILL BE ENGAGING IN ACTIVITIES THAT INVOLVE RISK OF INJURY WHICH MIGHT BE FROM ACTIONS INACTIONS OR NEGLIEGENCE OF OTHERS ON MY SELF OR CHILD AND FURTHER THAT THERE MAYBE RISKS NOT REASONABLY FORESEEABLE:
  3. ON BEHALF OF MY SELF AND MINOR CHILD LISTED AGREE TO ASSUME ALL RESPONSIBILITY OF INJURY OR OF PERSONAL DAMAGES.
  4. THE PARTICIPANTS AGREE TO FOLLOW POSTED REGULATIONS AND RULES WHILE INSIDE FAMILY FUN AND SKATE ROLLKER RINK OR ON OUTSIDE PREMISIES FAILURE TO ABIDE BY THESE REGULATIONS WILL BE FORSED TO EXIT THE BUILDING WITHOUT REFUND AT THE DISCREATION OF STAFF OR MANAGEMENT AND OR BAND FROM THE PROPERTY WITH FURTHER PROCACUTION OF THE LAW EXTENED WITH LOCAL LAW ENFORCMENT IF APPLICABLE.
  5. I ACNOWLEGE THAT I AM RESPOSIBLE FOR THE PICKUP AND DROP OFF OF SAID CHILD OR CHILDREN.
  6. I HAVE READ THE ABOVE WAVIER AND RELEAESE AND UNDERSTAND THAT BY SIGING DIGITLY OR WITH WRITTEN SIGNATURE I HAVE GIVEN SUBSTANTIAL RIGHTS ON BEHALF OF MYSELF OR MY CHILD AS THE RESPONSIBLE PARTY.

‚ÄčDate signed: October 24, 2021

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*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
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*

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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