Go Skate Day 2022

I, the undersigned First Name* Last Name*, am a participant in the event/program/activity over 18 years old or parent/legal guardian of a child participating in the event/program/activity. If I am signing for a child/youth participating in this event/program/activity, my child's name is   Child's First Name   Child's Last Name.

Participant or Child's Date of Birth: Date of Birth*    

Participant's Address: Street Address*   Address Line 2* 

  City*   State*   Zip*    .

Participant or Parent/Legal Guardian's Phone Number:   

 Area Code*   Phone Number*   .

Participant or Parent/Legal Guardian's Email Address:   Email*   

By participating or allowing my child to participate in the event/program/activity, I voluntarily release liability and forever discharge Orange County Public Schools, The Get A Board Foundation, Inc., Galactic G Skate Shop, City Of Orlando, their officers, directors, employees, contractors, subsidiaries, volunteer, sponsors, donors, agents, skateboarding, surfing or safety equipment manufacturers from any and all claims, demands, or causes of action, which are connected with myself or my child's participation in the event/program/activity, the use of the new, awarded or refurbished skateboard or donated safety equipment I or my child have been awarded for participating in the event/program/activity.  The scope of this release of liability shall include, but not be limited to, potential equipment defects, property damages, losses or personal injuries encountered in connection with the carrying out of the event/program/lesson, activity, participation or practicing of skateboarding, surfing or all other action sports activities.   Participant or Parent Initials*     

As a parent or legal guardian, I affirm that I am completely aware that skateboarding or surfing are a potentially hazardous sports. I agree to take full responsibility for any potential property damages, losses or personal injuries which may be caused by my child harming another individual or their property while learning, practicing or participating in skateboarding, surfing or related action sports activities during the event/program/lesson, activity, participation or practicing of skateboarding, surfing or all other action sports activities.   Participant or Parent Initials*

Further, I hereby give permission to the Get A Board Foundation to use any photographs, media footage or likeness taken by its officers, employees, agents, partners, sponsors or contracted agencies of either myself or my child/ren during participation in this program, class or event. I agree such photographs shall be property of the Get A Board Foundation, Inc., and I am not entitled to compensation of any kind for the use of such photographs or media.    Participant or Parent Initials*      

The information I've given in this form is complete and accurate. By electronically signing this form on   Date*   , I confirm that I have fully informed myself of the contents of this Participation and Release of Liability Form by thoroughly reading and understanding the contents, before signing, below. I warrant that I possess all the rights, powers, and privileges of a parent, legal guardian or participant over 18 years old, necessary to execute this document with binding legal effect on behalf of myself OR my child.

               

   Signature*   

{input3:1597640777723-firstname} {input3:1597640777723-lastname}