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Skater's Name __________________________ Card No. _____________________
Skater's Age ________
IN CONSIDERATION of receiving
permission from the Mayor and City Council of Ocean City, Maryland
(hereinafter sometimes called City), to enter upon the premises
known as the Ocean Bowl skateboard and inline skate facilities,
the receipt of such permission being hereby acknowledged, and in
the further consideration of receiving permission to participate
and utilize said skateboard and inline skate facilities, the receipt
of such permission being also acknowledged, the undersigned participant
and his/her parents, if he/she be under the age of 18 years, hereby
releases and released the Mayor and City Council of Ocean City,
Maryland, its agents, officers, servants and employees, of and from
any and all liability, claims, demands, actions and causes of action
whatsoever, arising out of or related to any loss, damage or injury,
including death, that may be sustained by the participant, or any
properly of participant's parents, while in, on, upon or near these
premises.
Both participant and participant's parents are
duly aware of the risks and hazards inherent upon entering said
premises and/or in participating in skateboarding and inline skate
activities at the subject premises, and hereby voluntarily elect
to enter—or have their children enter—upon said premises and participate
in skateboard or inline skate activities thereon, Knowing the present
condition of the facilities and knowing that said condition may
become hazardous or dangerous—or more dangerous during the time
that the participant is on the premises or continues to, from time
to time, use the facilities. The participant and/or his/her parents,
if participant is below the age of 18 years, hereby voluntarily
assumes all risks of loss, damage or injury, including death, that
may be sustained by the participant or participant's parents or
any property of either while in, on, near or upon the premises and/or
skateboard and inline skate facilities.
This waiver and release
shall be binding upon the participant, his/her parents, their distributees,
heirs, next of kin and personal representatives.
In signing the
foregoing Assumption of Risk, Waiver and Release each of the undersigned
hereby acknowledges and represents:
1. That the age as stated
above is his/her correct age, and that both participant and his/her
parents (if signed beiow by parents) are of sound mind.
2. That
he/she, or they, have read the foregoing Assumption of Risk, Waiver
and Release, and signs below voluntarily,
3. That he/she, or
they, know that by signing this Release, Assumption and Waiver,
he/she or they are giving up all rights to recover for any injury,
illness, disability or damage resulting from the use of the premises
and facilities which he/she or/and they haves have had or may in
the future have.
THE UNDERSIGNED HEREBY
UNDERSTANDS THAT THIS IS A RELEASE, and that the undersigned are
hereby GIVING UP EVERY RIGHT THEY, SHE OR HE HAS TO RECOVER FOR
ANY INJURY, DAMAGE OR DEATH occurring as a result of the use of
the facilities.
4. That the participant
and parents (if their signatures are affixed below), in consideration
of the Mayor and City Council of Ocean City granting the permission
hereinbefore described, do hereby expressly stipulate and agree
to indemnify and hold forever harmless the "City," its
successors and assigns, against any loss from any and all claims,
demands or action in law or equity that may hereafter at any time
be made or brought by the participant (be he or she a minor or not)
or brought by anyone on behalf of said participant for the purpose
of enforcing a claim for damages on account of any injuries received
or sustained in consequence of the participant's actions on the
premises or facilities.
WITNESS the hands and seal of
the participant (and his/her parents if the participant is a minor)
as of the
(date of signing) __________________ day,
Participant's/
Skater's Signature ________________________ Parent's Signature ____________________________
Address________________________________________City_______________State____Phone
____________
Proof of Age Exhibited ________________________________
Notary
Clause (To be notarized if not executed in the presence of
Recreation Department Personnel)
STATE OF_____________,
COUNTY OF____________ , TO WIT:
HEREBY CERTIFY, (that on
the)______________ day of 2005 before me, the subscriber,
a Notary Public in and for the State and County aforesaid, personally
appeared __________________________________________________
and
did acknowledge the a foregoing Assumption of Risk, Waiver and Release
to be his/her/their respective act._____________________________AS
WITNESS my hand and Notary Seal.
________________________________________________
Notary Public
I, __________________________________________________,
give permission to the Ocean City Recreation and Parks Department's
staff to act in my behalf in caring for my child should an emergency
arise. In addition, I give permission, in case of injury,
to take my child to a medical facility or hospital for treatment,
to include evaluation of injuries, x-rays, and other needed care.
I do understand that the Recreation and Parks Department will
make every effort to contact me prior to authorizing transportation
or medical attention on my behalf, and I hereby release the Town
of Ocean City and its agents or employees from any liability in
connection with the granted authorization.
____________________________________________
__________________
Signature
of parent or guardian. Date
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Ocean
City Maryland 
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