Skate King Permission Form

SKATE KING PERMISSION FORM

2301 140th NE, Bellevue, WA 98005

Please join us for a fun evening of skating with family and friends at the Ben Rush Skate King Night scheduled for Thursday, October 16, 2008 from 6:00 p.m. to 8:00 p.m.

In order to ensure maximum safety for all students at this activity, your child is required to attend with: • A Parent or guardian (no teenage siblings please) OR • An Adult designated on permission form as chaperone

The person responsible for your child must stay on the premises during the entire event.

• Tickets will be available at the door for $5.00 per skater • Adults not skating get in free • Skate rentals are included in the price, no discounts for providing your own skates • Skate King coupons may not be used • Skate King will have a snack bar open

Please be aware that the Ben Rush PTA, which sponsors the Ben Rush Skate King activities, does NOT carry insurance for skating. Skate King's liability insurance applies only to injuries due to their negligence. It is important for you to know that Ben Rush families are SKATING AT THEIR OWN RISK during Ben Rush Skate King parties.

Please complete the form below (one per family) and bring it to Skate King You MUST have a permission form to get in!!!

I acknowledge that skating is a hazardous activity and that I have made a voluntary choice to participate in the activity despite its associated risks. I have read and understand the above and am willing to allow members of my family to skate at Skate King under the conditions stated.

List family members:

______has/have my permission to skate at Skate King on October 16, 2008, from 6:00 p.m.-8:00 p.m..

In my absence, my child will be chaperoned by ______.

______Parent/Guardian Signature