Laurel Oaks Skate Club - Registration Form
Hi Laurel Oaks Families,

Thanks for your interest in your child joining the after-school skate club - the Skater Blade Hustlers!

Due to growing demand, not all children who sign up may be admitted into future program seasons. We are currently only able to accommodate 20 active participants, and we’ve noticed that several students who signed up have not been attending regularly or have opted out of skating once present.
This season our goal is to take the skaters 8 years+ off-site, to skate rinks & parks outside of Laurel Oaks.

*A completed registration form is needed for EACH PARTICIPATING CHILD.
*If your child is selected to join the Skate Club after registering, you will immediately be contacted via email to confirm your child's acceptance in the program.

Program Dates, 4-6pm
1. Tuesday, October 21
2. Tuesday, October 28
3. Tuesday, November 4
4. Tuesday, November 11 (*talent show)
5. Tuesday, November 25 (*post-season party)

Program includes: 
  • Equipment: skates, helmet, protective gear
  • Skate lessons & supervision from a Skate Instructor & youth development professional
  • 2 hrs of activities & games
  • Safe learning environment
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Email *
Some of the group from the Winter 2025 season.
Skater's Full Name (first & last) *
Skater's Birthday *
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Skater's CURRENT Shoe Size: *
What school does the skater attend? *
If your child is 8 years and older, do you give them permission to travel outside of Laurel Oaks to different skate locations? *

Skaters 8 years old and older, will have the opportunity to visit other skate locations outside of Laurel Oaks.
We're excited to be able to provide more skate opportunities and allow all of the skaters to have more safe skate spaces to enjoy!

Current location options include:

  1. The American Tobacco Trail @ Solite Park (4704 Fayetteville Rd, Durham, NC 27713)
  2. Balance Distribution - Local private inline skate shop (4608 Industry Ln Unit E, Durham, NC 27713)
  3. Pavilion at Durham Central Park (501 Foster Street, Durham NC 27701)
  4. Durham Skatepark (505 Rigsbee Ave, Durham, NC 27701)
    **I'm working on getting us to Wheels! (indoor rink)

While off-site, all skate club rules apply. Poor behavior can disqualify a skater from going off-site.
Coaches (adult volunteers) will transport skaters in their personal vehicles. The age minimum is based on NC state law. 

What allergies does the skater have? *
If no allergens, then type "n/a" or "none"
Parent/Guardian Name (first & last) *
Parent/Guardian Phone Number *
Parent/Guardian email address *
If you don't have an email address, please enter Jasma Rankin's email:  jrankin@dha-nc.org
Parent/Guardian Home Address *
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Relation to Student *
Liability Waiver - Signature Needed (*Type Parent/Guardian name) *
STILL SKATING ATHLETIC WAIVER AND RELEASE OF LIABILITY.

READ BEFORE SIGNING
All participants must sign

In consideration of being allowed to participate in any way in the Still Skating, LLC. athletic/sports program,
related events and activities, the undersigned acknowledge, appreciate and agree that:
1. The risk of injury from the activities involved in this program is significant, including the potential for
permanent paralysis and death. And while particular rules, equipment and personal discipline may reduce
this risk, the risk of serious injury does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING
FROM THE NEGLIGENCE OF THE RELEASES or others. And assume full responsibility for my
participation; and
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however,
I observe any unusual significant hazard during my presence or participation; I will remove myself from
participation and bring such attention of the nearest official immediately; and
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY
RELEASE AND HOLD HARMLESS Still Skating, LLC their officers, officials, agents, and or employees,
whether paid or not, other participants, sponsoring agencies, sponsors, advertisers and if applicable,
owners and lessors of premises used to conduct the event ("Releasees"). WITH RESPECT TO ANY AND
ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property. WHETHER ARISING FROM
NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
5. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY
UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHT BY
SIGNING IT, AND SIGN FREELY AND VOLUNTARILY WITHOUT INDUCEMENT.
Photo & Video Release *
I grant permission to Skill Skating and its representatives to photograph, video record, and/or otherwise capture my (or my child’s) image and likeness during club activities. I understand that these images may be used for promotional, educational, or informational purposes in print, online, and social media materials. I acknowledge that no compensation will be provided for the use of these images.  
Is there anything you want to share?
A copy of your responses will be emailed to the address you provided.
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