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THE SKATE BARN
14921 US HIGHWAY 17N
HAMPSTEAD, NC 28443
910-270-3497 OR 910-270-3640

AGREEMENT FOR PARTICIPANTS AND/OR VOLUNTEERS RELEASE DISCHARGE, ACCEPTANCE OF RESPONSIBILITY AND ACKNOWLEDGEMENT OF RISKS. THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS. YOU MUST READ AND UNDERSTAND IT BEFORE INITIALING OR SIGNING IT.

I, the above-named person, being above age eighteen, or the legal guardian of the above-named person who is under 18, in consideration of the services of THE SKATE BARN, the rate charged for those services and the right to engage in skateboarding as a participant and/or volunteer, herby acknowledge, agree, promise and covenant with THE SKATE BARN and all other persons or entities, and release and discharge THE SKATE BARN and all other persons or entities, on behalf of myself, my heirs, assigns, personnel representative and estate as follows:

ACKNOWLEDGEMENT OF RISKS
I understand and acknowledge that the activity I am about to voluntarily engage in as a participant and/or volunteer, bears certain known risks and unanticipated risks which result in injury, death, illness or disease, physical or mental, or damage to myself, to my property or to spectators or other third parties. I understand and expressly acknowledge those risks may result in personal claims against THE SKATE BARN or claims against me by spectators or other third parties.

Among these risks are the following:
1) the nature of skateboarding itself (particular risks of activity);
2) the acts or omission, negligent in any degree, of THE SKATE BARN, its agents of employees, and other persons or entities;
3) latent or apparent defects or conditions in equipment, or property supplied by THE SKATE BARN, or other persons or entities;
4) use or operation, by myself or others, of equipment supplied by THE SKATE BARN, other persons or entities;
5) acts of other participants while skateboarding, employees and agent of THE SKATE BARN, or other persons;
6) weather condition;
7) my own physical condition, or my own acts or omissions;
8) first aid, emergency treatment or other services rendered;
9) consumption of food or drink

I understand and acknowledge that the above list is not complete or exhaustive, and that other risks, known or unknown, identified or unidentified, anticipated or unanticipated may also result in injury, expressly except those risks not specifically listed above as well.

ACCEPTANCE OF RESPONSIBILITY 
Being aware that skateboarding entails risks of injury to myself and a risk of injury to spectators or other third parties as a result of my action, I expressly agree, covenant and promise to accept and assume all responsibility and risk for injury, death, illness or disease, or damage to spectators or other third parties and their property arising from my participation in skateboarding. My participation in skateboarding is purely voluntary; no one is forcing me to participated, and I elect to participate in spite of the risks. I have read this page, and INITIAL show that I understand and agree:

I Agree

RELEASE
I hereby voluntarily release and forever discharge THE SKATE BARN, its agents or employees, and all other persons or entities from all liability, claims, demands, actions or rights of action, which are in skateboarding, including specifically but not limited to the negligent acts or omissions of THE SKATE BARN, its agents or employees, and all other persons or entities, for any and all injury, death, illness or disease and damage to myself or to my property. I further agree, promise and covenant not to sure, assert or otherwise maintain or assert any claim against any injury, death, illness or disease, or damage to myself or to my property, arising from or connected with my participation in skateboarding or from any claim asserted against me by spectators of other third parties.
IN SIGNING THIS DOCUMENT, I FULLY RECOGNIZE THAT IF I AM HURT OR IF MY PROPERTY IS DAMAGED WHILE I AM SKATEBOARDING, I WILL HAVE NO RIGHT TO MAKE A CLAIM OR FILE A LAWSUITE AGAINST THE SKATE BARN, OR ITS OFFICERS, AGENTS OR EMPLOYEES, EVEN IF THEY OR ANY OF THEM NEGLIGENTLY CAUSED THE BOLDILY INJURY OR PROPERTY DAMAGE. 
ACKNOWLEDGEMENT OF EFFECT OF THIS RELEASE AGREEMENT
I understand and acknowledge that by initialing and/or signing this document I have given up certain legal rights and/or possible claims which I might otherwise assert or maintain against THE SKATE BARN, its agents or employees, and other persons or entities, including specifically, but not limited to, rights, arising from or claims for the agents or employees, and all other persons or entities. I understand and acknowledge that by initialing and/or signing this document, I have assumed responsibility and legal liability for the claims or other third parties against me as a result of my participation in skateboarding.

REPRESENTATION OF PHYSICAL CONDITION
Are there any physical or mental conditions for which you have received medical treatment or for which you are currently receiving medical treatment? If so, please describe those conditions below:

ENTIRE AGREEMENT
I understand that this is the entire agreement between myself and THE SKATE BARN, its agents or employees, and that it cannot be modified or changed in any way by the representations or statements of an employee or agent of THE SKATE BARN, or by me. My signature below indicates that I have read this page and this entire document, that I understand it completely and agree to be bound by its terms.

DATE: April 27, 2025

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

AGE
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

AGE
Third Participant's Name

First Name*

Middle Name

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

AGE
Fourth Participant's Name

First Name*

Middle Name

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

AGE
Fifth Participant's Name

First Name*

Middle Name

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

AGE
Sixth Participant's Name

First Name*

Middle Name

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

AGE
Seventh Participant's Name

First Name*

Middle Name

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

AGE
Eighth Participant's Name

First Name*

Middle Name

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

AGE
Ninth Participant's Name

First Name*

Middle Name

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

AGE
Tenth Participant's Name

First Name*

Middle Name

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

AGE
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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:*
Emergency Contact

First Name*

Last 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.


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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

AGE
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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