Name of Participant *

First Name

Last Name

Name of Parent of Guardian

Must be included if participant is under the age of 18.

First Name

Last Name

Emergency Contact Phone *

(###)

###

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Liability Release Agreement *

All boxes must be checked to be allowed to participate in our any GCSA event and failure to do so may result in ejection from any GCSA events present and future.

In consideration of my participation in the skateboarding event, I hereby agree that I, on behalf of myself or my child, heirs, distributees, guardians, legal representatives, and assigns will make no claim against, sue, attach the property of, or prosecute the Gulf Coast Skateparks Association or any of its officers, directors, agents, employees, contractor or affiliates of injury or damage resulting from negligence or any other acts, howsoever caused, by any volunteer, agent, or instructor of the skateboarding event, as a result of my participation, or the participation of my child, in the skateboarding event.

I have carefully read this agreement and fully understand and acknowledge its content. I know this is the release of liability and a contract between myself, the Gulf Coast Skateparks Association, and its affiliates.

I, the undersigned, hereby acknowledge that I have voluntarily applied to participate, or have elected to have my child or a minor for whom I am responsible (hereinafter “my child”), to participate in the skateboarding event directed and taught by the Gulf Coast Skateparks Association and their volunteers. By enrolling myself or my child, I represent that I, or my child, is physically fit and able to participate in such activities. I am aware that participation in the skateboarding event by my child or myself will involve my/my child’s participation in physical activities, and I hereby acknowledge that such activities can be dangerous. I hereby accept any and all risks of injury or death associated with such participation.

I also agree to adhere to the policies of the Gulf Coast Skateparks Association. 1. A parent must be present at all times if your child is at the skateboarding lesson. 2. The use of safety equipment is highly encouraged for participants under the age of 18. 3. I understand and give consent to allow the Gulf Coast Skateparks Association and its volunteers may take pictures of the skateboarding event and use them on social media websites and they may include myself or my child.

Digital Signature *

Parents and legal guardians, for participants under 18, please enter your digital signature. Participants 18 and older, please provide your digital signature below.

First Name

Last Name