Joy Riders VT Release of Liability Waiver
  • Release of Liability Waiver

  • Format: (000) 000-0000.
  • Date of Birth
     - -
  •  By participating in this activity I acknowledge:

    1) The risk of injury or illness from the activities involved in this sport is significant,
    including the potential for permanent paralysis and death; and while particular rules,
    equipment, and personal discipline may reduce this risk, the risk of serious injury or
    illness does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH
    RISKS, both known and unknown, EVEN IF ARISING FROM THE
    NEGLIGENCE OF THE RELEASEES, NAMED OR OTHERWISE DEFINED
    BELOW, and assume full responsibility for my participation AND OTHERWISE
    HOLD HARMLESS THE RELEASEES; and,


    2) I am responsible for myself. I willingly agree to comply with all event rules, venue
    rules, and to follow the directions of the event officials and conditions for
    participation. If, however, I observe any unusual or significant hazard during my
    presence or participation, I will remove myself from participation and bring such
    hazard to the attention of the nearest official immediately; and,


    3) I, for myself and on behalf of my heirs, assigns, personal representatives and
    next of kin, HEREBY RELEASE AND HOLD HARMLESS Joy Riders VT,
    Vermont Skate Society, Green Mountain Roller Derby, the City of Burlington, Burlington Parks and Recreation and any other the event host, sponsor, organization or club associated with this or any other event; and the officers, directors, officials, agents, and/or employees of those entities, as well as other participants, sponsoring agencies, commissions, advertisers, volunteers, and, as applicable, the owners, lessors, and/or managers of any premises used for any club activities and/or special events (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, or DISABILITY to myself, including my DEATH, or any other loss or damage to my person or my property (“DAMAGES”), WHETHER such Damages are the direct or proximate result of actions OF THE RELEASEES, NEGLIGENT OR OTHERWISE.


    4) I also acknowledge that photographs and video may be taken of me in my
    participation in, and attendance at this event or club activity, and hereby freely
    agree to allow without restriction all uses of such photos and videos in the reporting
    of club activities, and/or in the promotion of such, its location, other sporting events,
    sport in general, and/or related purposes.

    By signing below I acknowledge that 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.

  • AGREE (Liability Waiver)*
  • Equipment Rental Acknowledgement
    By Using the Equipment provided to me at this event, I acknowledge the following:

    1) The Equipment is being provided to me by Joy Riders, VT, LLC, and is owned by Joy Riders, VT who is solely responsible for the care and maintenance of the Equipment and regularly inspects and maintains the equipment according to their own maintenance policies.

    2) I and Joy Riders, VT agree that the Equipment being provided to me
    consists of the following: roller skates, roller blades, knee pads, elbow pads, wrist
    guards, and helmet, (the “Equipment”). We further agree that the Equipment being
    provided by Joy Riders VT and has been accepted by me, “AS IS”, and that Joy
    Riders, VT make no warranty and/or guarantee, be it express, implied or otherwise, regarding the suitability of the Equipment for any purpose, except that it meets the description, above. Furthermore, we agree that I have had the opportunity to inspect the Equipment and accept full responsibility for the care and condition of the Equipment while it is in my possession, reasonable wear and tear excepted.


    3) I agree to use the Equipment in compliance with the rules of the Event, the event
    venue, and any instruction I receive from Event coaches and volunteers. If,
    however, I notice or experience any Equipment malfunction, I will immediately
    remove myself from participation, and bring such malfunction to the attention of the
    nearest official for its inspection, repair, and or replacement; and,

    4) I agree to be responsible for all costs incurred by Joy Riders VT to repair and/or replace any Equipment that is damaged or destroyed as a result, either direct or proximate, of my actions, be they intentional, reckless, or the result of gross or ordinary negligence, while the Equipment is in my possession.

  • AGREE (equipment rental)
  • Date*
     - -
  • Should be Empty: