Skateboarding Instruction

Skateboarding Instruction
You can reach me at AlmSk8Instructor@gmail.com at any time!
Requested Date
Rider's Name *

First Name Last Name
Riders Date of Birth

Month Day Year
Date
Age
Best Contact Email *

Confirmation Email example@example.com
Best Contact Phone Number *
Where did you want to session? *

Crown Point Skatepark Hammond Skateprak Highland Skatepark Munster Skatepark

Please acknowledge the following *

I understand as a rider over 18 years of age or as the guardian of the rider that safety equipment is highly recommended. (Helmet, Elbow Pads, Knee Pads and Wrist Guards)
Please acknowledge the following *

I understand no equipment is provided during this training. I am responsible for bringing a skateboard and all safety equipment I choose to use.
Is the rider over the age of 18?

Yes No

Please Read and them acknowledge your understanding of our Release of Liability Waiver
* If under 18 years of age a parent or Guardian must sign for you
Riders Signature *

Clear
Riders Name *

First Name Last Name
Date *

Month Day Year
Date
Legal Guardian Signature *

Clear
Legal Guardian's Name *

First Name Last Name
Date *

Month Day Year
Date
Should be Empty: