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GHETTO WAIVER MEMEBERSHIP .pdf


Original filename: GHETTO WAIVER MEMEBERSHIP.pdf
Title: Microsoft Word - GHETTO WAIVER MEMEBERSHIP
Author: gramps

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For Staff Use:
Membership No.
Membership Start
Membership Expires
MEMBERSHIP/WAIVER AND RELEASE OF LIABILITY FORM
Annual Membership costs £15.00
Benefits include, reduced session prices . Discount on repairs & accessories
from the bike shop on site

PERSONAL DETAILS
NAME:

EMAIL:

ADDRESS:
TEL NO.
DATE OF BIRTH
EMERGENCY CONTACT:

NAME
CONTACT NO.

MEDICAL INFORMATION:

YES/NO

Do you have or have you ever suffered from any medical conditions that our
staff should be aware of Eg: asthma, epilepsy, diabetes, heart problems
or allergies

If yes please list

STATEMENT OF CONSENT / ACKNOWLEDGEMENT OF RISK
TO BE FILLED OUT BY USER OVER 16 YEARS
(name of participant) acknowledge, appreciate and agree that:

• All sports carried out in the Skatepark can be extremely dangerous and contain a HIGH DEGREE of RISK and
SIGINIFICANT INJURY

• I knowingly and freely accept all such risks and assume full responsibility for my participation
• I will comply with the terms of conditions for participation and I agree to follow all instructions given to me by 'Ghettopark' staff
• I hereby give my permission to be photographed or filmed when partaking in Skatepark activities or events and agree that
any material obtained can be used for marketing and promotion purposes

• I hereby release GHETTOPARK SKATEPARK and will NOT hold them responsible for any injuries, accidents, loss or damages to
person or property

• Completion of this form indicates permanent consent to use the facility and release of liability which will be kept on file for
future visits. If you wish to revoke this consent you must contact GHETTOPARK Skatepark.

• EQUIPMENT HIRE
Participants hiring equipment do so at their own risk. We cannot guarantee the equipment is in exactly the same condition as
first purchased but make every effort to record and
maintain equipment before and after every hire purchase. Therefore participants must understand they accept the hire
equipment in its current state. If you require a specific check on any equipment before hire please contact the Duty Manager
on arrival

...................................................USER SIGNATURE

......................................DATE

TO BE FILLED OUT BY PARENT/GUARDIAN IF UNDER 16 YEARS
I am the parent / guardian of the above and I give my full permission for them to use Ghettopark skatepark. I understand that they are
doing so at their own risk and I also understand the risks involved in these sports. I hereby release Ghettopark skatepark and will
NOT hold them responsible for any injuries, accidents, loss or damages to person or property whilst they are on the premises.

..................................................PARENT/GUARDIAN SIGNATURE ............................DATE

TERMS AND CONDITIONS OF PARTICIPATION
1. Prior to using any ramps, equipment or structure in the park you should check it for your safety and
suitability for your purpose and skill level. If you find any temporary defect in the equipment you should
immediately inform a member of staff who will rectify the fault.
2. The risk of injury from the activities involved in this facility is significant, including the potential for
permanent disability or death, and while particular rules, equipment and self-discipline may reduce the risk,
the risk of injury does exist.
3. All members knowingly and freely assume such risks, both known and unknown, and assume full
responsibility for their participation and for using appropriate safety equipment.
4. We do not accept any responsibility for member's failure to comply with these rules other than due to
negligence.
5. We do not accept any responsibility for loss, theft or damage to any personal property. 6.
Any accident must be reported to a member of staff immediately.
7. Members willingly agree to comply with the stated customary terms and conditions for participation. If a
member observes any unusual significant concern in readiness for participation they should remove
themselves from participation and bring it to the attention of the nearest member of staff immediately. 8.
Should any member of staff decide at any time and for any reason that a member is not behaving in a
suitable manner, they may remove the member immediately from the park and a note will be placed on the
members file. In this instance no refund will be given. 9. We reserve the right to refuse admission.
10. No graffiti will be tolerated anywhere in the park except in the designated areas. Any member wishing
to carry out proper graffiti art should register their interest with the manager.
11. No food or drink is to be brought into the premises (unless in the allocated areas). 12.
Smoking is not permitted anywhere within the building.
13. No alcohol or drugs will be allowed on the premises. Any evidence of use or trade in either will result in
an immediate removal from the park, a lifetime ban and the authorities will be advised.
14. Any abusive, dangerous, discourteous or anti social behaviour will not be tolerated and may lead the
member(s) being removed from the park. In this instance no refund will be given.
15. Anyone under 16 years wishing to use the park must have parental consent. Separate parental consent
may be required if wishing to use the park during school hours.
16. All BMX riders and Roller Bladers and scooter riders have to wear helmets at all times no matter what
age or ability. Skate boarders under the age of 16 years of age must wear helmets at all times, however
any skate boarders over the age of 16 are encouraged to wear helmets. All helmets must be properly
fastened at all times, all participants are encouraged to wear wrist, knee and elbow guards to minimise the
risk of injury.
17. Children under the age of 10 must not be left unattended by a parent or the responsible adult who
brought them at any time.
18. BMX bikes must have fully functional brakes to allow all options to be available in the event of a
possible collision.
19. Members should allow other users free and easy access to all ramps.
20. Do not attempt any manoeuvres you feel is beyond your skill level. If you require help please ask a
member of staff.
21. Make clear your intentions to other members before starting a manoeuvre if it is likely to obstruct them.
22. Avoid cutting across, in front of or behind other riders, boarders or bladers.


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GHETTO WAIVER MEMEBERSHIP.pdf - page 2/2

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