Member
______ WAIVER
OF RIGHTS, RELEASE OF LIABILITY, ASSUMPTION OF ALL RISKS, HOLD (MINOR PARTICIPANT) READ THIS
WAIVER OF RIGHTS, RELEASE OF LIABILITY, ASSUMPTION OF ALL RISKS AND
HOLD HARMLESS AGREEMENT CAREFULLY BEFORE YOU SIGN IT. THIS IS A LEGAL
DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS. BY SIGNING YOU ARE WAIVING
OR RELEASING VALUABLE LEGAL RIGHTS! In consideration
of being allowed to participate in any way (Activities) at the GRAFFITI
SKATE ZONE SKATE PARK(GSZ) (The Facilities) or related events and activities
at 1502 Port Malabar Blvd Palm Bay Fl or participation in any team related
or contest event here or outside of the facilities we(I) understand
and agree as follows:
2) I/We understand that the risks discussed above cannot be eliminated without jeopardizing the essential quality of the Activities and that the use of helmets and safety pads assist to reduce the risk but in no way eliminates the risks. Furthermore, I/We understand that the GSZ employees have difficult jobs to perform. Although they may seek safety they are not infallible. They may be unaware of a participants physical ability or fitness to participate. They might misjudge the weather, elements or terrain conditions. They may give inadequate warnings or instructions and the equipment being used might malfunction. I/We agree, accept and will assume all of the risks existing in this activity . I/We have agreed to allow the Minor Participant to participate in the Activities despite the known risks. The minor participant may not be covered under insurance owned by LOW GRAVITY INC, GSZ or the City of Palm Bay and I/We agrees to assume all the risks of skateboarding, inline skating and all other activities at the Facilities. 3) The minor participant
knowingly and willingly assumes all such risks and agrees to comply
with the stated and customary terms and conditions for participation.
The minor participant knows their own abilities and will use the Facilities
and/or mobile skate park ramps or parade float ramps within their own
skill levels
4) The Minor Participant agrees that if they observe any unusual significant hazard during their presence or participation, they will remove themselves from participation and bring such hazard to the attention of the nearest official or staff member immediately. 5) I/We on behalf of my heirs, assigns, personal representatives & next of kin do hereby release, waive and discharge LOW GRAVITY INC, GSZ or the City of Palm Bay including but not limited to their officers, directors, stockholders, agents, employees, staff, or independent contractors and their respective sureties, insurers, successors, assigns and legal representatives of all liabilities, claims, actions, damages, costs or expenses of any kind or nature whatsoever, including reasonable attorney and paralegal fees (whether incurred before or at trial, or in appellate or bankruptcy proceedings) which I/We may have against them arising out of or in any way connected to the Minor Participant’s participation in the Activities or presence at the Facilities. I/We understand that this waiver includes any claims based on the negligence simple or gross action or inaction of LOW GRAVITY INC, GSZ or the City of Palm Bay or any other person present at the Facilities. Regardless of whether the action of the above party or other person was active or passive and will indemnify and hold harmless LOW GRAVITY INC, GSZ and the City of Palm Bay , including but not limited to their directors, officers, stockholders, agents, employees, staff or independent contractors and their respective sureties, insurers, successors, assigns and legal representatives from all liabilities, claims, actions, damages, costs or expenses of any kind or nature whatsoever, including reasonable attorney and paralegal fees (whether incurred before of at trial, or in appellate or bankruptcy proceedings) which an other person may have against them based on any actual or claimed unintentional, negligent, wrongful or intentional act or omission by the Minor Participant arising from or as a result of the Minor Participant’s presence and participation in the Activities at the Facilities or outside participation in special skate park float or events. Further I/We agree to pay any and all attorney and paralegal fees prior to trial, at trial, or appellate or bankruptcy procedures of LOW GRAVITY INC, GSZ or the City of Palm Bay, their agents, employees, staff or independent contractors and their respective sureties, insurers, successors, assigns and legal representatives if I/We bring any action, claim or demand against the above parties for any reason for which this release applies.
6) This Agreement shall be binding upon my/our personal representatives, successors, heirs, assigns and other legal representatives by executing this agreement.
7) I/We agree that this agreement is intended to be constructed and interpreted as broad and inclusive as permitted by the laws of Florida. If any portion of this agreement is found or declared to be invalid or unenforceable, such invalidity shall not affect the remainder of this agreement not found to be invalid and the remainder of this agreement shall remain in full force an effect.
8) I/We warrant that I/We am/are the parent/parents or legal guardian/guardians of the minor participant have read and fully understand this Waiver of Right, Release of Liability, Hold Harmless and Indemnification Agreement and that no oral representations, statements or inducements apart from the forgone written agreement has been made. In the event that the signature of only one parent/legal guardian can be obtained, the signature of that parent/legal guardian represents that the parent/legal guardian is the primary legal custodian of the Minor Participant, and that the parent/legal guardian has the legal authority to sign this agreement. 9) I/We agree to ensure that the Minor Participant shall abide by all rules and regulations that LOW GRAVITY INC, GSZ and the City of Palm Bay may impose regarding the use of the Facilities and the participation in the Activities.
10) I/We agree and understand that this is a continuing release that applies not only to the Minor Participant’s present participation in the Activities or presence at the Facilities, but shall also apply to the Minor Participant’s future participation in any of the activities of presence at the Facilities. This release shall continue in effect until a written revocation is received by LOW GRAVITY INC. at which time the Minor Participant shall no longer be allowed to be present at the Facilities or to participate in any of the Activities. I have read this waiver and release of liability agreement and fully understand its terms. I understand that I have given up substantial rights by signing it and sign it freely and voluntarily without inducement.
(waiver must be notarized if not signed in the presence of an authorized employee of GSZ)
The foregoing
instrument was acknowledged before me this ____ day of ____________
20 , by _________________________________________
stamp - Type of Identification _________________________________________............... GSZ employee __________ ADVANCED STATUS DECLARATION - The use of full pads (helmet, elbow, knee) is required at all times. However if you choose not to wear your elbow or knee pads you do so at your own risk and LOW GRAVITY INC, GSZ or the City of Palm Bay will not be held liable for any injuries sustained as a result of your actions. Any injury resulting from refusal to wear recommended safety equipment will be the full responsibility of the participant. Helmets must be worn at all time with no exceptions. I/We the parent/legal guardian understand that by allowing our Minor Participant to participate without the use of recommended safety gear we are subjecting the Minor Participant to possible additional serious injury. I/We the parent/legal guardian also understand that any other possible injury resulting from the refusal to use the recommended safety gear will be the full responsibility of the Minor Participant and the parent/legal guardian and LOW GRAVITY INC, GSZ or the City of Palm Bay will not be held liable or responsible for your decision. I/We the parent/legal guardian agree that the Minor Participant is an advanced skater and understand the above described declaration. SIGN HERE :___________________________________
RULES AND REGULATIONS KNOW YOUR LIMITS, DON’T SKATE BEYOND YOUR ABILITY !! 1 - No abusive
behavior or foul language. A) first incident
- you will receive a warning.
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Phone ______________________
Other phone _____________________ |