City of Marshfield

  Marshfield Skatepark   

Competition or Special Event Waiver                               Marshfield WI 54449

 


Date:  _____________   Ticket #: ____________    Activity:           Skateboard             In-Line Blades           BMX Bikes

                                                                        Check one

Name:  PLEASE PRINT:_________________________________  _______________________  Birth Date:____________

                                                 (Last)                                                (First)

 

EXPRESS CONTRACTUAL ASSUMPTION OF ALL RISKS WAIVERS OF AND RELEASE FROM ALL LIABILITY FOR ANY NEGLIGENCE, INDEMNITY FOR ALL THIRD PARTY CLAIMS IN CONSIDERATION OF THE COMPETITION EVENT OF THE CITY OF MARSHFIELD SKATEPARK (hereafter addressed as The City).

 

We know that skateboarding, in-line skating, and bicycle riding are inherently dangerous sports and activities in which We choose to voluntarily participate at our own risk.  We are aware that the usual risks, hazards and dangers of personal injury, death, and disability or property damage and loss, necessarily increases when using ramps, curbs, steps, half pipes, inclines or declines, bowls or any other structure and device.  We know that the risks, hazards, and dangers include but are not limited to, uncontrollable boards and bicycles, falling, jumping, landing, performing tricks, colliding with other users, staff, media personnel, and spectators.  We also understand that these risks, hazards, and dangers are further increased when other persons, whether or not of the same level of experience or skills, are present at the same time and using the same facilities.  (All of the above-defined activities are collectively referred to throughout this agreement as the “Hazardous Activities”.

 

By this agreement, it is our intention to relieve The City of any duty to any participation and to assume the entire risk of any of the damages, which might occur, or as a result of use of or presence at the park.  By this agreement, We also intend to release, discharge and absolve The City from any and all liability for any active or passive negligence whatsoever by The City, and to waive and relinquish any claim or cause of action against The City and promise not to sue or exercise any legal right to seek damages from The City.

 

In consideration of utilizing The City skatepark facility and participating in the competition event.  We agree as follows:

 

1.  As to my participation in any activity, including but not limited to, the Hazardous Activities and as to any and                 all liability for the Damages which I may suffer or incur due to any cause whatsoever, while in the interior or exterior of the premises of The City of Marshfield Skatepark, I hereby agree:

 

a.       To waive any and all claims for Damages that I may have against The City, their members, managers, employees, officers, associates, contractors, volunteers, sponsors, vendors, or exhibitors, or any other person or company in any way associated with The City (collectively referred throughout this agreement as “The City”).

 

b.      To release The City from any and all liability for the Damages that I may suffer, incur, or that my next of kin may suffer as a result of my participation in any activity, including but not limited to, the Hazardous Activities while at the City of Marshfield Skatepark: and

 

c.       To hold harmless and indemnify The City from any and all liability for the Damages to any third party resulting from my participation in any activity, including but not limited to, the Hazardous Activities while at The City.

 

2.    This waiver and release of liability and indemnification agreement (collectively referred to hereafter, as “Waiver and Release”) shall be effective and binding upon my heirs, next of kin, family, relatives, guardians, conservators, executors, administrators, trustees, and assigns in the event of my injury, disability, or death.

 

3.       I have read, understand, and agree to be bound to the Park Rules (which are posted in the Marshfield Skatepark) governing my conduct while using the Marshfield Skatepark.  I understand these rules are strictly enforced.           

 

My parent or legal guardian and I hereby certify that we have completely read and understand this Waiver and Release and its terms.  Prior to signing this Waiver and Release, and have had the opportunity to ask questions about the Waiver and Release or The City, I am aware, that by signing this Waiver and Release, I and my parent or legal guardian assume all risks and waive and release certain rights that I and my heirs, next of kin, family, relatives, guardians, executors, administrators, trustees, and assigns may have against The City.

 

Participant Signature X: ____________________________________________________________________  Date: __________________

 

Name (print): First _______________________ Last: _________________________________ Address: __________________________

 

City: __________________________________ State: _______  Zip: ________ Phone: (    )  _____________________________Age: ___

 

Emergency Contact: __________________________________________________________________  Phone: ______________________

 

Parent/Legal Guardian of the State:

 

Signature: ________________________________________________________________________________   Date: _________________

 

NOTARY SIGNATURE required if advance registration is mailed or delivered by participant of an age 18 or over. If the participant is under age 18, a NOTARY SIGNATURE is required of the parents’ signature if the parent does not accompany the participant or advance registration is mailed or delivered.

 

Subscribed and sworn to before me this _____________ day of ___________________________________.

 

Witness my hand and official seal. ___________________________________________________________

                                                                            NOTARY PUBLIC