65 - USA Jackson -WAIVER

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 United Skates of America, Inc. 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
Address*

Street Address

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In consideration of permission to use today and on all future dates, the property, facility and services (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 USA, you voluntarily assume all risks related to expo-sure to COVID-19.

3.      I agree that I will release USA & all of it’s successors, assigns, affiliates, officers, directors, employees, and agents from any and all responsibility of liability for injuries or damages occurring at the rink regardless of whether it was caused or contributed to by the negligent conduct of USA. I agree no to make a claim against USA or sue USA for injuries or damages related to roller skating activities, the facility, and/or the use of the equipment. I agree to release USA from any such responsibility which results from the use of these roller skates or facilities.

4.      I hereby agree to release USA from any & all liability & duties arising from the New Jersey Roller Skating Rink Safety & Fair Liability Act, N.J.S.A. 5:14-1, et.seq.;

5.      I hereby agree to accept the terms and conditions of this contract. This document constitutes the final and entire agreement between USA and myself. I understand that USA has made no warranties expressed or implied to me.

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.
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 USA, and all of it’s successors, assigns, affiliates, officers, directors, employees, and agents for any common law negligence or liability under the New Jersey Roller Rink Safety & Fair Liability Act., N.J.S. A. 5:14-1, et.seq*

Yes
WHAT IS YOUR SKATING ABILITY LEVEL?*

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

YesNo
Date Signed*

MonthDayYear
Date
Signature*

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