In consideration of
letting___________________________________________,(name
of minor) my minor child/ward (“child”), being allowed to participate in any
way in the __________________________________________________, (name of event)
the undersigned acknowledges, appreciates, and agrees that;
1. The risk of injury to my
child from the activities involved in these programs is significant, including
the potential for permanent disability and death, and while particular rules,
equipment, and personal discipline may reduce this risk, the risk of serious
injury to me does exist; and,
2. FOR MYSELF, SPOUSE AND
CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown,
EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES others, and assume full
responsibility for my child’s participation; and,
3. I willingly agree to comply
with the stated and customary terms and conditions for participation. If I
observe any unusual significant concern in my child’s readiness for
participation and/or in the program itself, I will remove my child from
participation and bring such to the attention of the nearest official
immediately; and,
4. I, for myself, my spouse, my
child, and on behalf of my/our heirs, assigns, personal representatives and
next of kin, HEREBY RELEASE Gravity Sports International LLC, it’s officers,
officials, agents and/or employees, 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 , DISABLILTY, DEATH, or loss or damage to person or property
incident to my child’s involvement or participation in these programs, WHETHER
ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest
extent permitted by law,
5. I, for myself, my spouse, my
child, and on behalf of my/our heirs, assigns, personal representatives and
next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the
above Releasees from any and all liabilities incident
to my involvement or participation in these programs, EVEN IF ARISING FROM
THEIR NEGLIGENCE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY
AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I
HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND
VOLUNTARILY WITHOUT ANY INDUCEMENT.
Signed in the presence of a notary public.
X__________________________
_____________________________ Date Signed __________
(PARENT/GUARDIAN SIGNATURE)
(PRINT NAME)
X__________________________ _____________________________ Date Signed __________
(PARENT/GUARDIAN SIGNATURE)
(PRINT NAME)
UNDERSTANDING OF RISK
I understand the seriousness
of the risks involved in participating in this program, my personal
responsibilities for adhering to rules and regulations, and accept them as a
participant.
X________________________
_________________________ Date Signed: ____________
(PARTICIPANT SIGNATURE) (PRINT
NAME)
This
form MUST be notarized.
STATE OF___________________________________________________
County
of_________________________________________
On this_______ day of_________ 200__,
before me personally came_____________________________
known
to me, and known by me to be the parent or guardian of
_____________________________
Notary Public
Signature:__________________________________
My commission
expires:
__________________________________