Michigan United Skates of America

United Skates of America, Inc.

Assumption of Risk and Complete Release and Waiver of Liability
Please show confirmation at admission window when arriving
Adult or Parent Name*

First NameLast Name
Date of Birth*

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FOR PARTICIPANTS OF MINOR AGE
This is to certify that I, as parent or (legal guardian), am legally responsible for this participant, and I agree to DISCHARGE and RELEASE RINK 62 from all liability arising out of or connected with my child’s participation in roller-skating.
Child's Name & Birth Date
Phone Number*
Email*
example@example.com
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Street Address

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In consideration of permission to use today and on all future dates, the property, facilities, and services (the “Facilities”) of United Skates of America, Inc., (“USA”), I, the undersigned (skater or spectator), hereby expressly agree:

1.      THAT roller skating is a participation sport and a dangerous activity. I understand that roller skating and the use of roller skates involves a risk of injury to any and all parts of my body. I HEREBY AGREE TO FREELY & EXPRESSLY ASSUME & ACCEPT ANY & ALL RISKS OF INJURY WHILE I AM ROLLER SKATING OR AS A SPECTATOR at this facility either caused by the negligence of the roller skating rink or others;

2.      An inherent risk of exposure to COVID-19 exists in any public place where people are present. COVID-19 is an extremely contagious disease that can lead to severe illness and death. By visiting the facilities, you voluntarily assume all risks related to exposure to COVID-19.

3.      TO RELEASE USA and at the successors, , affiliates, officers, directors, employees, agents and assigns from any demands, claims, actions, causes of action, suits, damages, costs or expenses (collectively “Claims”) arising out of my use of or presence at the Facilities, or the use of USA skates or equipment, including but not limited to Claims for bodily injury arising out of the negligence of other skaters or spectators or arising out of the negligence or other fault of USA or skates or other equipment supplied by USA, to the extent permitted by the laws of the applicable jurisdiction.

4.      THAT THIS RELEASE shall be binding upon my heirs, administrators, executors, assigns and legal representatives.

5.      THIS RELEASE also binds me as parent or legal guardian of the minors listed below, to release and discharge USA from any liability arising out of those minors’ activities or presence at the Facilities to the extent permitted by applicable law. I acknowledge responsibility for the minors listed below at the Facilities;

6.      I understand the rink does not provide instructions to skaters unless I specifically signed up for classes. The rink has free wrist guards available for use by every patron. I further understand that the rink has no obligation to provide safety equipment wrist/ elbow/knee guards or helmets.

7.      IF I IGNORE THIS AGREEMENT AND FILE SUIT, I WILL BE HELD RESPONSIBLE FOR ALL ATTORNEY FEES AND COURT COSTS INCURRED BY USA.

In the event that one portion of this agreement shall be deemed unenforceable, then said provision shall be severed from the remaining provisions of the agreement & those remaining provisions shall be enforced.
We reserve the right to refuse admission to anyone not meeting the standards of good taste and to evict persons not following the policies of this facility.
I HAVE READ AND UNDERSTAND THIS AGREEMENT. I UNDERSTAND THAT BY MAKING AND SIGNING THIS AGREEMENT I SURRENDER VALUABLE RIGHTS, INCLUDING, BUT NOT LIMITED TO, MY RIGHT TO SUE.*

Yes
WHAT IS YOUR SKATING ABILITY LEVEL?*

BEGINNERINTERMEDIATEADVANCED
DO YOU HAVE HEALTH INSURANCE? IF NO, WE STRONGLY RECOMMEND YOU DO NOT SKATE*

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Date Signed*

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Date
Signature*

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By proceeding, I am agreeing to the Privacy Policy and the Rules of the Rink.
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United Skates of America, Inc.