Walnut City Rollers New Years Skate Registration 
When: January, 1, 2025; 12pm-4pm
Where: Yamhill County Fairgrounds, Leslie Lewis Pavillion | 2070 NE Lafayette Ave, McMinnville, OR
Contact us at 971-267-2960 or skate@walnutcityrollers.org

NO SKATE RENTALS AVAILABLE AT THIS EVENT!!! YOU MUST BRING YOUR OWN SKATES!!! BUT IT'S FREE.

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!!!ATTENTION!!! THERE WILL BE NO SKATE RENTALS
This is a bring your own skates event.
Hi! We are excited to skate with you!
This registration form is for one person only. We ask that a waiver be completed for each person in your group. Adults need to complete their own, and one for each minor in their custody for the event. By pre-registering, you don't have to sign the waiver at the event and can get right to skating one you check in with our volunteers. Skating is fun, but it comes with risks so we want to make sure you understand the ground rules so we can all have fun at skate night!
Last Name of Skater, First Name of Skater *
I Acknowledge that skate rental is NOT available and I have to bring my own skates. *

WAIVER AND CONSENT

I acknowledge that roller skating is an inherently dangerous activity, and that participating in, or being in a room with roller skating could expose me to the risks and dangers of roller skating. I acknowledge that physical, and psychological injuries are all possible, including sprains, strains, bruises, broken bones, hurt feelings, hurt pride, lost limbs, death and/or dismemberment. The above listed injuries are not exhaustive, and have been provided for purely illustrative purposes.

I hereby accept these risks, and agree to not hold Walnut City Rollers, its agents, officers, or volunteers, liable for any injuries or harms resulting from my attendance at Walnut City Rollers events. I hereby waive my right to legal redress for any harm or wrong arising from my participation in Walnut City Rollers events, and to release Walnut City Rollers from all liability relating to injuries that may occur as a result of my participation in, or attendance at Walnut City Rollers events.

If I have a condition, known or unknown to me that increases my likelihood of suffering harm or injury form participating in Walnut City Rollers events, I agree to hold Walnut City Rollers blameless and release them from all liability for injuries that I might suffer as a result of such a condition.

I understand that pictures, video or audio recordings, and other forms of media may be made at Walnut City Rollers events and used for purposes including but not limited to advertising, fundraising, or community outreach. I hereby consent to and authorize the use by Walnut City Rollers, its officers and volunteers, of my image, voice and/or likeness as follows: Walnut City Rollers shall have the right to photograph, publish, re-publish, adapt, exhibit, perform, reproduce, edit, modify, make derivative works, distribute, display or otherwise use or reuse my image, voice and/or likeness in connection with any product or service in all markets, media or technology now known or hereafter developed in Walnut City Rollers’ products or services, as long as there is no intent to use the image, voice and/or likeness in a disparaging manner. Walnut City Rollers may exercise any of these rights itself or through any successors, transferees, licensees, distributors, or other parties. I acknowledge receipt of good and valuable consideration in exchange for this Release, which may simply be the opportunity to participate in Walnut City Rollers events, or to represent Walnut City Rollers in its promotional and advertising materials as described above.

I affirm that my participation, attendance, or presence at Walnut City Rollers events is voluntary and that I have been made aware of the risks. In accepting this waiver I agree to the term above.


I acknowledge and accept the risks as they have been stated above. *
Required
To acknowledge and accept these risks as they have been stated above for yourself, please type your full name.  
-OR-
Please note that a new registration must be submitted for each skater.  If you are only submitting this for yourself please skip to the next waiver.
To acknowledge and accept these risks as they have been stated above for a minor in your custody please name the minor and then type your full name.
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