Roller Skating Lesson Fall 2018
Session Dates: Oct 3-Nov 14
Skater Name *
Your answer
Skater Age *
Your answer
4-H Member?
Parents Name *
Your answer
Phone Number *
Your answer
If you plan on dropping your child off at lessons, what is the best number to contact you in case of an emergency? *
Your answer
Email Address *
Your answer
You will be receiving an email with an invoice for fees within a week. *
Online payment information is included at the bottom of the email. If you are unable to pay on line, please bring your check or cash with you to the first class.
Required
Liability Waiver *
I am aware that this activity is a potentially dangerous activity and involves certain risks including, but not limited to risks from body contact, falls and collisions, physical confrontation with fellow participants and/or non-participants, carelessness, auto accidents, contact with equipment, weather conditions and communicable diseases, heat exhaustion, drowning, ear infection, eye and skin irritation, motion sickness, stolen personal property, food poisoning, risks of physical exhaustion. I understand these risks and ON BEHALF OF MYSELF, OR MY CHILD, OR WARD, I AGREE TO INDEMNIFY AND RELEASE HIGH COUNTRY SPORTS ARENA, ITS AFFILIATES, OFFICERS, VOLUNTEERS, AGENTS, AND EMPLOYEES AND ALL SPONSORS FROM ALL LIABILITY, CLAIMS, DAMAGES, AND ACTIONS, AND RELATED COSTS AND EXPENSES (INCLUDING REASONABLE ATTORNEYS FEES), THAT MAY ARISE OUT OF MY OR MY CHILD OR WARDS PARTICIPATION IN THIS ACTIVITY. As a participant of parent/guardian, I hereby consent to emergency treatment for myself or my child or ward as a result of accident or injury. I further agree to pay any and all costs incurred as a result of said treatment. I have fully read this LIABILITY RELEASE, including the Participation Behavior printed on reverse, and understand their content. Furthermore, I HAVE EXPLAINED THE SIGIFICANCE OF THIS RELEASE OF LIABILITY TO MY CHILD OR WARD
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