SKATE PARK PERMISSION SLIP

Voluntary Release, Acknowledgement and Acceptance of Risks by Participant
(Please read carefully before signing)

Participant Name : _____________________________________ Date: ____________
Address: _______________________________________________________________
_______________________________________________________________________
Phone: _________________________

In order to participate in this activity, I agree to hold Harvest Church Inc., any promoters, officials, advertisers, and property owners harmless, and I waive any right to make claims or lawsuits against them. I acknowledge that this is not an essential service provided by Harvest Church, Inc.

I understand and acknowledge that the activities I am about to voluntarily engage in as a participant have certain risks. I understand that these risks known or unknown, anticipated or unanticipated may also result in injury, death, illness, disease or damage to myself or my property or other third parties. I voluntarily agree and promise to accept and assume all responsibilities, and injuries, death, illness, disease or damage to myself or my property arising from my participation in this activity.

This waiver does not apply to any injuries or damages that are the result of willful, wanton, or intentional misconduct. My participation in this activity is voluntary and no one is forcing me to participate in spite of the risks. I understand the effect of this waiver and acceptance of risk on my legal rights.

My signature indicates that I have read this entire document, understand it completely, acknowledge that it cannot be modified or changed in any way by oral representations, and agree to be bound by its terms. This agreement shall be binding on behalf of myself, my heirs, assigns, personal representative and estate.

Signature: ________________________________________________

If participant is under 18 years old, this release must be co-signed by a parent or legal guardian.

Parent/Guardian: _____________________________ Date: _____________

RULES OF THE HARVEST CHURCH SKATE PARK

1. Skating is restricted to the skating area.
2. All skaters must have a registration card.
3. All skaters must wear a helmet and the following protective equipment is suggested: Elbow and knee pads; wrist guards; protective footwear
4. All protective gear and equipment must be designed for skateboard/in-line skating and be in good condition. Harvest Church reserves the right to refuse to allow anyone to skate if his or her protective gear and equipment are not adequate.
5. All skaters agree to act in an orderly, safe, and considerate manner while on the premises and in the skating area.
6. Everyone is to wait his/her turn. Reckless or dangerous skaters will be requested to leave the skating area and the premises immediately.
7. All injuries, whether major or minor in nature, are to be reported to the management immediately. In the case of a serious injury, the injured person will not be moved and all skating on that ramp shall cease immediately.
8. Only one skateboarder is permitted on a board at one time.
9. No bicycles, roller skates, alcohol, tobacco products or drugs are permitted in this facility.
10. No food or drinks are allowed in the skating area.
11. No children younger than age 12 will be allowed in the skating area.

I, ________________________________, have read the rules of the skate park and I understand them and agree to follow them.

Signature: ____________________________________________________

Parent/Guardian Signature: _______________________________________

HARVEST CHURCH SKATE PARK REGISTRATION CARD
Applicant Information (Please Print)

Name: _____________________________________________________

Address: ___________________________________________________

City/Town: ____________________State/Zip: _________________

Home Phone: ___________________________

Emergency Contact Name: ______________________Phone: ____________

I am/we are aware of the nature of the skateboard/in-line skating activities available through Harvest Church Skate Park. I/we hereby give permission for my/our child to participate.

I/we release Harvest Church and its employees and agents from any liability for injuries that may arise out of my/our child's participation in these skateboard/in-line skating activities.

Parent/Guardian Signature: _____________________________

Date: ______________


Participant Signature: _________________________________

Date: ______________

Harvest Church Skate Park
Representative Signature: _____________________________
Date: ______________