Roller Skate Accident Waiver and Release of Liability

Fishers of Men Bible and Music Center

By my signature below, I acknowledge that I am aware of, appreciate the character of, and voluntarily assume the risks involved in participating in all activities associated with roller skating.

By my signature below, on behalf of myself, my child(ren), next of kin, successors in interest, assigns, personal representatives, and agents, I hereby:

  1. Waive any claim or cause of action against and release from liability the Fishers of Men Bible and Music Centers as well as West Laurel Baptist Church, its officers, board members, employees, and agents for any liability for injuries to my person, my child(ren) or property resulting from my child(ren) use of the facility or participation in the activity listed above;
  2. Agree to indemnify and hold harmless the Fishers of Men Bible and Music Center as well as West Laurel Baptist Church, its officers, board members, employees, and agents for any claims, causes of action, or liability to any other person arising from my child(ren) use of the facility or participation in the activity listed above;
  3. Consent to receive any medical treatment deemed advisable in the event of injury, accident or illness during these activities; and
  4. Acknowledge that a participant under 18 years of age signing below as a minor child, a signature is required by the parent or legal guardian of the minor child to participate

I HAVE READ THIS ASSUMPTION OF RISK, WAIVER OF LIABILITY AND RELEASE AGREEMENT. I CONSENT TO MEDICAL TREATMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Student /Participant Information

Parent Emergency Contact Information

The participant understands and acknowledges the inherent risks associated with the activity/event. The participant releases the organization and its representatives from any claims or liabilities arising from participation in the activity/event. The participant agrees to indemnify and hold the organization harmless from any claims brought against the organization as a result of their actions or negligence.

I HAVE READ THIS ASSUMPTION OF RISK, WAIVER OF LIABILITY AND RELEASE AGREEMENT. I CONSENT TO MEDICAL TREATMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
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