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AGREEMENT INCLUDING WAIVER AND RELEASE, ASSUMPTION OF RISKS & INDEMNIFICATION FOR


Lighthouse Skatepark LLC

THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS. YOU NEED TO READ IT CAREFULLY. NO ADMITTANCE WILL BE GRANTED WITHOUT PROPER REVIEW, COMPLETION AND EXECUTION OF THIS DOCUMENT.

UNDER 18 YEARS OF AGE, HELMETS MUST BE WORN TO PARTICIPATE AT LIGHTHOUSE SKATEPARK. LIGHTHOUSE SKATEPARK RECOMMENDS HELMETS BE WORN REGARDLESS OF AGE.


I, the above PARTICIPANT (or, if the Participant is younger than 18 years of age, the PARENT or LEGAL, GUARDIAN of the above named PARTICIPANT), agree to the following:


RELEASE, WAIVER AND INDEMNITY

In partial consideration for admission into THE LIGHTHOUSE SKATEPARK, viewing privileges and use of the facilities, I, on my own behalf and on behalf of the Participant, hereby agree to release, acquit, discharge, and covenant to hold harmless the LIGHTHOUSE SKATEPARK LLC, the owners of LIGHTHOUSE SKATEPARK LLC, and any retailer renting or selling equipment at LIGHTHOUSE SKATEPARK, and each of their shareholders or owners, agents, servants, employees, officers, directors, trustees and all other persons or entities acting on their behalf (the “covered parties”), from any and all claims, actions, damages, liability, costs or expenses and attorneys’ fees which are related to, arise out of, or are in any way connected to my participation or use or the Participant’s participation or use of LIGHTHOUSE SKATEPARK facilities (either in the interior or the exterior), use of equipment or property supplied by LIGHTHOUSE SKATEPARK, including protective gear, which may be rented, or my presence or the Participant’s presence at LIGHTHOUSE SKATEPARK, whether or not such claims, actions, damages, liability, costs or expenses are caused by negligence or omissions of LIGHTHOUSE SKATEPARK or any other covered parties. I understand that the covered parties are not responsible for any personal property that is lost, stolen or damaged at LIGHTHOUSE SKATEPARK. In the event that I do file a claim against LIGHTHOUSE SKATEPARK LLC, I agree on behalf of the Participant and me that any such claim shall be settled by binding arbitration. Judgment upon the award rendered by the arbitrator may be entered in any court having jurisdiction thereof. Such arbitration shall be conducted in Providence, Rhode Island before a single arbitrator, who shall be selected by mutual agreement. I further agree that the substantive law of Rhode Island shall apply in that action without regard to the conflict of law rules of Rhode Island. I understand and give permission that the possibility exists that I/the Participant may be photographed and or videotaped due to the various activities at LIGHTHOUSE SKATEPARK.

I agree, on my own behalf and on behalf of the Participant, to indemnify, hold harmless and defend LIGHTHOUSE SKATEPARK LLC, and any other covered party from any and all claims, actions, damages, liability, costs or expenses and attorney fees of any spectator, other participant or third party in connection with or arising out of my presence and/or involvement or participation in any activity at LIGHTHOUSE SKATEPARK. This includes acknowledging that an inherent risk of exposure to COVID-19 exists in any public space where people are present, and holding LIGHTHOUSE SKATEPARK LLC blameless for any exposure while on its premises. I give consent and permission to LIGHTHOUSE SKATEPARK or a covered party to obtain on the behalf of my minor child, the Participant, or me any emergency medical attention and treatment at my sole expense. I certify that I have adequate insurance to cover any injury or damage that I/the Participant may cause or suffer while participating, or else I agree to bear the costs of such injury or damage to the Participant or me. I further certify that I am willing to assume the risk of any medical or physical condition the Participant or I may have.

I agree that this Agreement is intended to be construed and interpreted as broadly as permitted by the laws of Rhode Island. If any portion of this Agreement is found or declared to be invalid or unenforceable, such invalidity shall not affect the remainder of this agreement not found to be invalid, and the remainder of this agreement shall remain in full force and effect.


ASSUMPTION OF RISK

I acknowledge and understand that roller-blading, in-line skating, skateboarding, biking, scootering and similar activities are hazardous and dangerous activities that involve strenuous exercise. I acknowledge the risk of injury from the activities involved can be significant, including the potential for permanent paralysis, death and serious bodily injury and damage to property. I acknowledge that my presence or the Participant’s presence and any participation in activities at LIGHTHOUSE SKATEPARK are strictly voluntary and that there is no one forcing me and or the Participant to participate in any activities at LIGHTHOUSE SKATEPARK. I hereby represent that no special relationship exists between me/the Participant and any of the covered parties and that I am not under any physical, economic or other compulsion to sign this Agreement. On my own behalf and on behalf of the Participant, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my/the Participant’s participation while on the premises of LIGHTHOUSE SKATEPARK. I am also aware that there is an inherent risk in simply being at LIGHTHOUSE SKATEPARK and/or observing, photographing or videotaping the activities. On my own behalf and on behalf of the Participant, I knowingly and voluntarily assume any and all of the foregoing risks of loss, damage and injury.


MEDICAL RELEASE

In the event that I cannot be reached in an emergency, I hereby give permission to any LIGHTHOUSE SKATEPARK employee and any licensed physician, surgeon, clinic or hospital to secure/seek proper treatment and to order anesthesia for the Participant or me as named above.

I HEREBY CERTIFY THAT I AM OVER 18 YEARS OF AGE OR I AM HAVING MY PARENT/LEGAL GUARDIAN SIGN THIS DOCUMENT. I HAVE CAREFULLY READ AND HEREBY AGREE TO THE ABOVE TERMS AND CONDITIONS. PRIOR TO SIGNING THIS AGREEMENT, I HAVE REVIEWED LIGHTHOUSE SKATEPARK’S SAFETY RULES AND REGULATIONS AND HAVE HAD THE OPPORTUNITY TO ASK ANY QUESTIONS ABOUT LIGHTHOUSE SKATEPARK, THE STAFF AND/OR THIS AGREEMENT. I AM AWARE THAT BY SIGNING THIS AGREEMENT, I, ON MY OWN BEHALF AND ON BEHALF OF THE PARTICIPANT, ASSUME ALL RISKS AND WAIVE AND RELEASE CERTAIN SUBSTANTIAL RIGHTS THAT I, MY HEIRS, NEXT OF KIN, FAMILY, RELATIVES, GUARDIANS, EXECUTORS, ADMINISTRATORS, TRUSTEES AND ASSIGNS OR THE PARTICIPANT MAY HAVE OR POSSESS AGAINST LIGHTHOUSE SKATEPARK LLC.

PERSON SIGNING THIS FORM ACCEPTS FULL RESPONSIBILITY FOR PARTICIPANT

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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