CALVARY OF ALBUQUERQUE SKATE PARK REGISTRATION

Skaters Name: _____________________________________________________________________ Skaters Address: ___________________________________________________________________ City: _______________________________________ State: _______________ Zip: _____________ Phone: _________________________________ Email: ____________________________________ Parent/Legal Guardian Name (if under 18) ______________________________________________ Emergency Contact Name: _____________________________ Phone: ______________________ Skaters Date of Birth: ___________________ Name of School: ____________________________ EXPRESS WAIVER OF LIABILITY
I/we acknowledge that skating, skateboarding, and rollerblading (hereinafter referred to as skating) can be dangerous sports and activities in which we voluntarily choose to participate at our own risk. We are aware that the unusual risks, hazards, and dangers of personal injury death, disability, and property loss are increased when using ramps, curbs, steps, half-pipes, inclines, declines, bowls, rails, and other structures in the skate park. We know that the risks, hazards, and dangers include but are not limited to uncontrollable boards, falling, jumping, landing, performed tricks, colliding with other users, staff, volunteers, and spectators. We understand these risks and dangers are increased when other persons are present at the same time using the same facilities. Risks also vary depending on the skaters abilities and experience of those also using the facilities. We are aware that skaters do suffer from broken bones, loss of the body and death. By this agreement, we relieve Calvary of Albuquerque, its staff and volunteers of any duty to any participation and supervision and do assume the entire risk of any of the damages that might occur as a result of use of presence at Calvary of Albuquerque. By this agreement we also discharge and absolve Calvary of Albuquerque, staff and volunteers from any liability for any active or passive negligence. We further waive and relinquish any claim or action against Calvary of Albuquerque, its staff or volunteers for claims of personal injury, disability, death, medication, medical treatment, ambulance services, and the like or any other expense or property damage of loss due to use of the Calvary of Albuquerque skate park or due to supervision or maintenance of the skate park. We agree not to sue or use any legal recourse or exercise any legal right to seek monetary or other damages from Calvary of Albuquerque, its staff or volunteers. This waiver and release of liability and indemnication agreement shall be effective and binding upon our heirs, next of kin, family, relatives, guardians conservators, executors, administrators, trustees, and assigns in the events of any injury, disability, or death.

Signature_____________________________________________________Date________________ Signature of parent or guardian required if skater is under age 18.

RULES AND REGULATIONS

The skater agrees to abide by the rules and regulations of the Calvary of Albuquerque skate park. Skater agrees to submit to enforcement of these rules as well as enforcement of a moral standard and Christian principles. Skater may loose skating privileges if skater does not abide by the rules and regulations or the moral standard set by the Calvary of Albuquerque skate park. Skaters must agree to: No bikes or scooters in the Skate Park Helmets must be worn and buckled while skating No jumping the Skate Park fence No skating on Calvary church campus except in the Skate Park No profanity, ghting, or lewd behavior. No obscene clothing or skateboard decks No bringing in outside skate objects unless approved by staff Calvary Skate Park will not be responsible for any personal items left in the park

Parents: Calvary Skate Park is not a child care facility. Staff responsibilities consist of maintaing the park and administration of the Student Skate Ministries and also to enforcing rules and keeping a safe positive environment for the skate community to skate. *If your child is under the age of 18, a parent or a guardian must sign the waiver in front of a Calvary Skate Park Staff.

CONSENT FOR MEDICAL TREATMENT

In case of emergency, we hereby agree to the performance of treatment, including anesthesia, medical, dental, and surgery, as the attending doctor or physician may deem. Doctors Name: ___________________________________________________Phone: ___________________________ Dentists Name: ___________________________________________________Phone: ___________________________ Insurance Company: _______________________________________________Policy No. ________________________ Preferred Hospital: __________________________________________________________________________________ If the skater is not covered by insurance, skater (or legal guardian if under 18) agrees to assume full responsibility for all medical and medically related expenses. We agree not to hold Calvary of Albuquerque, its staff of volunteers responsible for any medical or dental procedure. I/we agree not to hold Calvary of Albuquerque, its staff or volunteers responsible for and medical or other expenses or procedures. __________________________. (initial)

PARENT CONSENT
We hereby verify that the skater is less than 18 years old. We have completely read and understand this waiver and release. Prior to signing this waiver and release, we have had the opportunity to ask questions about the waiver and release. By signing here we acknowledge we have read and understand the above rules and agree that failure to follow the rules may result in permanent or temporary excusal from the Skate Park.

Signature_____________________________________________________Date________________ Signature of parent or guardian required if skater is under age 18.