Dissent Skateboarding Waiver Form

If you answered 'No' to the above please leave the next section blank and continue to 'Adult Name' section.

PARTICIPATION WAIVER

PLEASE REVIEW & SIGN THE WAIVER FOR ALL PARTICIPANTS

You must either be the person listed below or the parent, legal guardian or Responsible Adult (as defined below) of that person in order to sign the waiver.

This is a legally binding document. Do not sign unless you wish to be bound by its terms.
In consideration and as a condition of being allowed to participate in the services and activities, including, but not limited to, skateboard, scooter, inline skates and any other related activities (collectively referred to herein as “ACTIVITIES”), provided by DISSENT LIMITED and its agents, owners, officers, directors, principals, volunteers, participants, clients, customers, invitees, employees, independent contractors, insurers, facility operators, land and/or premises owners, and any and all other persons and entities acting in any capacity on its behalf (collectively referred to herein as “DISSENT LIMITED”), I hereby acknowledge and agree to the following:

1. I am a competent adult aged 16 years or older.
2. In so far as this waiver and release of liability agreement (“agreement”) is signed by me on behalf of a child who is under the age of 16 years (“child”), I confirm that child’s full name and age are printed above and that either (i) I am the parent / guardian of that child; or (ii) where I am not the parent / guardian of that child I certify that the child’s parent(s) or guardian(s) (as the case may be) of that child has(/have) granted permission for me to assume responsibility for that child (“Responsible Adult”) and for me to have the right to sign this agreement on their behalf.
3. I acknowledge that this agreement will be used by DISSENT LIMITED and will govern my actions and responsibilities whilst participating in (or, if applicable, whilst the child participates in) the ACTIVITIES.
4. My (/the child’s) involvement and/or participation in the ACTIVITIES is voluntary, and I am acting under my own free will (on behalf of the child in my capacity as parent, guardian or Responsible Adult, as applicable).
5. I acknowledge that my(/the child’s) participation in the ACTIVITIES may be physically demanding and that the risk of injury from the ACTIVITIES is significant, including the potential for serious bodily injury, permanent disability, paralysis and loss of life. I also acknowledge that such risks cannot be eliminated entirely without jeopardizing the essential qualities of the ACTIVITIES and that while particular rules, equipment and self-discipline may reduce the risks, the risk of injury does still exist.
6. I acknowledge that there is potential for risks and dangers that may not be obvious or reasonably foreseeable at this time.
7. To reduce the risks, I agree (on behalf of the child as parent, guardian or Responsible Adult, as applicable) to follow (and, if applicable, procure that the child follows) the rules established for participation in the ACTIVITIES, including the rules posted in and around the DISSENT LIMITED facility, and all instructions given to me by DISSENT LIMITED before and during my participation in the ACTIVITIES.
8. I confirm that I have read (and/or have had read to me), understand and will follow (and, if applicable, procure that the child follows) the rules established for participation in the ACTIVITIES and the reasonable instructions given to me by DISSENT LIMITED.

1. I certify that I have (/the child has) no medical conditions or health concerns that make it dangerous to participate in the ACTIVITIES in a safe manner for myself (/himself or herself) or others and that if I have any concerns in this regard, DISSENT LIMITED has been informed or will be informed prior to my(/the child) undertaking any of the ACTIVITIES.
2. I accept sole responsibility for my own (/the child’s) conduct and actions whilst participating in the ACTIVITIES.
3. DISSENT LIMITED will only accept liability for any loss or damage you may suffer undertaking the ACIVITIES or otherwise if that loss or damage is caused by DISSENT LIMITED’s failure to carry out DISSENT LIMITED’s obligations under this agreement or to a reasonable standard or by breach of any duties imposed on DISSENT LIMITED by law (including if DISSENT LIMITED causes death or personal injury to you by DISSENT LIMITED’s negligence) unless that failure is attributable to:
(i) your own fault;
(ii) the provision of services or products by a third party to DISSENT LIMITED or by the actions of a third party to DISSENT LIMITED
(iii) events which DISSENT LIMITED could have foreseen or forestalled even if DISSENT LIMITED had taken all reasonable care”.

1. I agree (/on behalf of the child, if applicable) to indemnify, hold harmless and promise not to sue (and, if applicable, procure that the child shall not sue) DISSENT LIMITED for any and all liabilities or claims arising as a result of participation in the ACTIVITIES or any activities incidental thereto, wherever, whenever, or however the same occur, whether caused by negligence or otherwise, except to the extent that DISSENT LIMITED accepts liability at clause 12 above.
2. Except as set out in clause 12 above I confirm that I am 100% liable for all medical expenses incurred as a result of any injury or property damage during participation by myself(/the child) in the ACTIVITIES.
3. I consent and agree that DISSENT LIMITED may take photographs or digital recordings of me(/the child) participating in the ACTIVITIES and use these in any and all media for training, promotional or other safety purposes. I further consent that my identity (and, if applicable, the child’s entity) may be revealed therein or by description, text or commentary. I waive any rights, claims or interest to inspect or approve the use of the photograph and/or recording with respect to myself (and, if applicable, the child), and understand that there will be no financial or other remuneration of anykind.
4. I consent to receive (/for the child to receive) treatment that may be deemed advisable in the event of injury, accident, and/or illness as a result of my (/the child) participating in the ACTIVITIES.
5. I agree that entering into this agreement indicates permanent waiver and release of liability with respect to myself (and, if applicable, the child). I understand that this agreement will be kept on file for future visits. I understand that if I wish to revoke this agreement I must contact DISSENT LIMITED and obtain their agreement to such revocation in writing.
6. I understand that this waiver, release of liability and image release is intended to be as broad and inclusive as permitted by the laws of England and Wales (with respect to myself and, if applicable, the child). I further agree that if any part/s of this agreement are held invalid the remainder will continue in full force and effect.
7. I agree that this agreement is governed by the laws of England and Wales and that the venue for any legal proceedings shall be the courts of England and Wales.

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL.

I have read and accepted the waiver terms and conditions.

Please sign here: