Velocity Blade Registration

Parent Information

Student Information

Emergency Contact

Consent

I agree I agree

ACKNOWLEDGMENT OF RISK AND WAIVER AND RELEASE OF LIABILITY VELOCITY BLADE, ITS REPRESENTATIVES, TEACHERS OR VOLUNTEERS ARE NOT RESPONSIBLE FOR ANY INJURY (OR LOSS OF PROPERTY) TO ANY PERSON WHILE PRACTICING, TAKING CLASS, COMPETING, OR IN ANY OTHER WAY INVOLVED IN ANY ACTIVITY AT ANY LOCATION INCLUDING THE VELOCITY BLADE LOCATION FOR ANY REASON WHATSOEVER, INCLUDING ORDINARY NEGLIGENCE ON THE PART OF VELOCITY BLADE, ITS OWNERS, VOLUNTEERS, OFFICERS, DIRECTORS, AGENTS OR EMPLOYEES. 1. I understand and acknowledge that the purpose of this program is to teach rollerblading in a fun environment. I recognize that rollerblading is a dangerous sport that can result in severe injuries. Velocity Blade does not provide first aid or CPR services. In case of an emergency, the parents and/or the emergency contact person will be notified. 2. I acknowledge, agree and represent that I understand the nature of the activities and that my child is qualified, in good health, and in proper physical condition to participate in such activities. I further agree if at any time I believe conditions to be unsafe, I will have my child immediately discontinue further participation in the program. I assume full legal and financial responsibility for my child's participation in this program. 3. I voluntarily agree to assume all the inherent risks and accept sole responsibility for any injury to the participant (including, but not limited to, personal injury, disability, or death), illness, damage, loss, claim, liability, or expense of any kind that my child may experience or incur in connection with Velocity Blade programs. I hereby release, covenant not to sue, discharge, and hold harmless Velocity Blade, its employees, agents, and representatives from any and all claims, including all liabilities, actions, damages, costs, or expenses arising out of or relating to participation in the program. I understand that the risk of injury may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Velocity Blade employees, volunteers, and program participants and their families. I acknowledge that this release includes any claims based on the actions, omissions, or negligence of Velocity Blade, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after attending any Velocity Blade program or activity. I recognize that, like all sports activities, rollerblading may result in personal injury, disability, or death. I voluntarily agree to assume all the foregoing risks and accept sole responsibility for any injury to the participant. Additionally, I confirm that I have all required insurance (including medical insurance) to cover any treatment costs that may arise from activities within this program.   4. I understand that as the parent/ legal guardian of my child, it is my responsibility to be present with my child on the premises at all times.

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CLASS REGISTRATION

Parent Information

Student Information

Emergency Contact

Consent

Please Zelle or Venmo $180 to Muhammad Farooq (510) 216-2281.