Fall Registration Form

FALL Skateboarding Registration Form

Sept 21st - Oct 12th
EVERY SATURDAY

9am-10am

NO REFUNDS

ALL SKILL LEVELS

6yr-17yr
GULFTON LOCATION

6000 Chimney Rock Rd, Houston, TX 77081
Skater Name

First NameLast Name
#2 Skater Name

First NameLast Name
Skater Birth Date

MonthDayYear
#2 Skater Birth Date

MonthDayYear
Current Level
Parent Contact Name

First NameLast Name
Parent Contact Phone
Format: (000) 000-0000.
Parent Contact E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Comments / Questions:

July Payment

Skate Camp

$159 Quantity

Total

Payment Methods

Credit Card

Apple Pay

Google Pay

WAIVER OF LIABILITY In consideration of HTX SKATEBOARDING ACADEMY LLC, its owners, service providers, volunteers, participants, employees, lessors, insurers and agents and all other persons or entities, acting in any capacity on their behalf, I hereby release and discharge and, in the case I am executing this agreement on behalf of a minor whom I sign up, said minor releases and discharges HTX SKATEBOARDING ACADEMY LLC, on behalf of myself and the minor, all children, parents, guardians, heirs, assigns, personal representative and estate as follows: I acknowledge the inherent extreme risk in skateboarding activities, including those which could occur on skateboard ramps, rails, obstacles, and courses and result in physical or emotional injury, paralysis, death, or damage to me, property belonging to me, HTX SKATEBOARDING ACADEMY LLC and/or to third parties. I realize that these risks cannot be eliminated and include, among other things, falling, being struck by equipment, being struck by other participants, injury caused by my own negligence or other participants’ negligence. I understand that there are also unforeseeable accidents that may occur, and I assume all risk associated with such accidents. I agree that there are possible accidents, which I cannot foresee, and I assume all risk associated with such accidents. I agree to pay attention to the skateboard equipment and to advise HTX SKATEBOARDING ACADEMY LLC staff if I inflict or notice any damage. I agree that the jobs of the HTX SKATEBOARDING ACADEMY LLC staff are difficult and that they seek to create a safe environment by giving adequate warnings and/or instructions, however it is entirely possible that the equipment being used might malfunction, be defective, and/or fail. In the event any claim, demand, or cause of action is made against HTX SKATEBOARDING ACADEMY LLC, its owners, volunteers, participants, employees, lessors, insurers and agents (hereinafter collectively called “Releasees”), by the undersigned or by the minor at the facilities of HTX SKATEBOARDING ACADEMY LLC, whether or not the undersigned is physically present at the time of the occurrence of any injury, damage or loss), I agree to indemnify, hold harmless, and defend the said Releasees, including the payment of reasonable attorneys fees, including indemnifying (with payment of costs and a reasonable attorneys fee) for any claim arising in whole or in part from any and all alleged negligent actions or inaction on the part of any Releasees. Should HTX SKATEBOARDING ACADEMY LLC or anyone on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold harmless that party for all such fees and costs. I expressly agree and promise on my behalf, and on behalf of the minor for whom I sign up, to accept and assume all of the risks, which exist by reason of the participation in this activity. Participation in this activity is purely voluntary and this is an election to participate in spite of the risks. I agree to assume all risk of personal injury, including paralysis and death, which may occur while on HTX SKATEBOARDING ACADEMY LLC premises. I personally, and on behalf of any minor I sign up, hereby voluntarily release, remise and forever discharge and covenant not to sue Releasees, from all liability for any such personal injury that may be incurred, and any and all claims, demands or causes of action, which are in any way connected with participation in this activity or use HTX SKATEBOARDING ACADEMY LLC’s equipment and/or facilities, including any such claims which allege negligent acts or omissions of HTX SKATEBOARDING ACADEMY LLC I understand that this Waiver of Liability includes claims for personal injury including death based in total or in part upon the negligent action or inaction of Releasees. I certify that I, or the minor I sign up, have adequate insurance to cover any injury or damage that may be suffered while participating, or else I agree to bear the costs of such injury or damage myself. I certify that I, nor any minor I sign up, have any medical, emotional and/or physical conditions that could interfere with the safety in this activity, or else I am willing to assume – and bear the cost of – all risks that may be created, directly or indirectly, by any such condition .By signing this document, I acknowledge that if anyone is hurt or property is damaged during participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against Releasees on the basis of any claim from which I release them .I am aware that skateboarding is a hazardous activity that includes certain risks and dangers and includes the risk of serious injury or death. I voluntarily accept full responsibility for myself and any minor for whom I sign for all risks involved, including risks inherent in skateboarding and in the skateboarding environment. I understand that I, or the minor for whom I sign this agreement, will supply our own equipment, but we also may rent or purchase equipment from HTX SKATEBOARDING ACADEMY LLC and/or other equipment suppliers. Such equipment may include, but is not limited to helmets, knee pads, elbow pads, skateboards, and hardware (hereafter referred to as “Equipment”). I agree that any Equipment I use, or the minor for whom I sign this agreement uses, while skateboarding or participating in lessons, is to be used entirely at our own risk. I, and on behalf of the minor for whom I sign, voluntarily acknowledge and assume all risks associated with the use of all Equipment. I further agree to return, in good condition, any Equipment that I rent. I understand that this release is a contract. I sign it digitally by accepting these term and conditions when signing up for Lessons on HTXskateboarding.com, and I do it of my own free will. I also understand that this contact is severable; that if any part of it is held by a court of law to be unenforceable, the rest shall survive.
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FALL Skateboarding Registration Form

July Payment*

Payment Methods

July Payment