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School of Skatin/ Anchor Skate Supply Mini Ramp

In consideration of being allowed to participate in any way in the Anchor Skate Supply LLC,Penny Lane Black and White LLC and School of Skatin LLC or related events, activities including use of Mini Ramp Halfpipe and other skate ramp obstacles. Please print participant’s name: TBD

The undersign acknowledge, appreciate and agree that: 1. The risk of injury from the activities

involved in this Evants/program or Mini Ramp/ Skate Ramps is significant, including the potential for permanent paralysis and death, & while participating may cause serious injury 2. Equipment and personal discipline may reduce the risk, the risk of serious injury does exist; and, 3. I KNOWINGLY & FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, & assume full responsibility for my participation; and, 3. I willingly agree to comply with stated & customary terms & conditions for participation. If however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation & bring such hazard to the attention of the nearest staff - member immediately; and, 4. I, for myself & on behalf of my heirs, assigns, personal representatives & next of kin, HEREBY RELEASE AND HOLD HARMLESS Anchor Skate Supply LLC, Penny Lane Black and White LLC and School of Skatin LLC , their officers, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, & if applicable, owners and lessors of premises used to conduct the event (“release”), WITH RESPECT TO ANY & ALL INJURY, DISABILITY, DEATH, OR LOSS OR DAMAGE TO PERSON OR PROPERTY, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I have read this release of liability & assumption of risk agreement. I fully understand its terms, understand that I have given up substantial rights by signing it & sign it freely and voluntarily without any inducement. 




 1.Florida Law creates substantial limitations on liability to encourage and promote the availability of Action Sports facilities and to further promote the many benefits of Action Sports activities.


2. Anchor Skate Supply LLC, Penny Lane Black and White LLC and School of Skatin LLC hereby fully invokes any and all limitations of liability that may exist under current statutory law and Appellate Law Interpretation including but not limited to the specific legislative intent of Florida Statute 316.0085.


I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Anchor Skate Supply LLC, Penny Lane Black and White LLC and School of Skatin LLC from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Anchor Skate Supply, LLC programs, competitions , Special Events, demonstrations, equipment or facilities, including any such claims which allege negligent acts or omissions of Anchor Skate Supply LLC, Penny Lane Black and White LLC and School of Skatin LLC  IN THE EVENT LITIGATION ARISES OUT OF OR RELATING TO Anchor Skate Supply LLC, Penny Lane Black and White LLC and School of Skatin LLC  ENFORCEMENT OF THIS WAIVER, OR IF ANY LEGAL ACTION IS INITIATED BY YOU ARISING OUT OF OR RELATED TO THIS WAIVER, YOU AGREE THAT Anchor Skate Supply LLC, Penny Lane Black and White LLC and School of Skatin LLC WILL BE ENTITLED TO RECOVER ITS REASONABLE ATTORNEYS' FEES, COSTS AND EXPENSES INCURRED IN INVESTIGATING, PREPARING FOR, PROSECUTING, DEFENDING AGAINST OR OTHERWISE LITIGATING ANY SUCH ACTION. I further certify that I am willing to assume the risk of any medical or physical condition I may have. In the event that I file a lawsuit against Anchor Skate Supply LLC, Penny Lane Black and White LLC and School of Skatin LLC I agree to do so solely in the state of Florida, County of Pinellas in a court of competent jurisdiction. I further agree that the substantive law of the State of Florida shall apply in that action. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document I acknowledge that if anyone is hurt or property is damaged upon my participation in this activity, I acknowledge my intention is to have waived my right to maintain a lawsuit against Anchor Skate Supply LLC, Penny Lane Black and White LLC and School of Skatin LLC .Further, I may in fact owe to Anchor Skate Supply. LLC the reimbursement for Attorney Fees and costs incurred by Anchor Skate Supply LLC, Penny Lane Black and White LLC and School of Skatin LLC . I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.









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*
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.


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*

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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