BOROUGH OF OLD TAPPAN BERGEN COUNTY NEW JERSEY Old Tappan Skate Park Participant Release of Liability Form We/I_________________________________residing at __________________________ ___________________________________________ Telephone No.:________________ In consideration of the benefits to be gained by myself/my child, ___________________ Participant’s Age: ________ and Participant’s Birthdates: ________/________/________ hereby Consent to my/my child’s participation in activities at the Old Tappan Skate Park located at Stone Point Park in Old Tappan under the control and the jurisdiction of the Borough of Old Tappan. We/I further agree that we/I shall not hold the Borough of Old Tappan, the Old Tappan Recreation Commission, and its agents, servants or employees liable in the event of an accident, other loss or damage that might be sustained by me or my child as a result of my/my child’s attendance and participation at the Old Tappan Skate Park. This document shall serve as a full and general release from any and all claims resulting from use of the skate park. We/I agree that I/my child am/is physically able and in normal health and have/has not been otherwise informed by a physician that I I/my child am/is incapable of participation in any leagues, clinics, classes, tournaments or activities at the Old Tappan Skate Park that may include strenuous physical activity. I fully understand that the risk of injury from the activities and programs provided at the Old Tappan Skate Park may be significant. The risk of injury includes, but is not limited to minor injury such as abrasions and bruises, and more serious injury such as broken bones, muscle pulls and dislocations. The risk of injury also includes catastrophic injury such as permanent paralysis or even death. With full knowledge of the potential risk for injury, I hereby give my consent to participate and/or give my child permission to participate and represent that I have full legal authority to provide such consent. In addition, I fully understand and will abide by all rules and regulations as stated below and posted at the Old Tappan Skate Park: • No one is allowed to participate in the activities of the Skate Park unless they are wearing ALL of the required protective gear which shall include: elbow and knee pads, gloves and wrist protection. In addition, users must have proper shoes satisfactory for participation in the activity. All equipment is to be worn in accordance with the manufacturer’s specifications. • The Skate Park is a skate at your own risk facility designed for skate boarding and inline skating only. The Skate Park will not be supervised. Users will skate at their own risk. • No one is allowed to participate in the activities of the Skate Park unless they have registered with the Old Tappan Recreation Commission and they have signed participant release of liability form on file and obtained a badge for the Borough of Old Tappan. • All participants must skate in a manner as to avoid collision with other participants. Fighting or other aggressive or disruptive behavior will result in ejection from the Skate Park and possible revocation of their badge. • No organized events or contests of any kind are allowed in the Skate Park unless organized and administered by the Old Tappan Recreation Department. • Bicycles and motorized vehicles are not permitted in the Skate Park at any time. • Only skaters are permitted inside the enclosed Skate Park. All spectators must remain outside the enclosed area. • Shirts must be worn inside the Skate Park. Proper shoes must be worn while skateboarding. • Skating is prohibited in the parking lot. • Use of the Skate Park and facility shall only be permitted in accordance with the dates and hours posted. The facility shall be closed during periods when the equipment or services are wet and/or icy. The facility shall also be closed to allow for reasonable inspection and maintenance. • Organized events involving participation of 7 or more people shall require the prior approval of the Recreation Department. • No food, drinks, drugs, smoking, profanity, abusive language, amplified music or pets shall be permitted. • The Skate Park will be open, weather permitting, during the posted hours only: Monday to Friday- 9:00 am to dusk Saturday- 9:00 am to dusk Sunday- 9:00pm to dusk • The participants are required to inspect the skating surfaces before use and to remove any trash, debris or objects. Participants are required to report any damage to the Skate Park to the Borough of Old Tappan Recreation Department or Borough of Old Tappan Public Works Department. • Signs shall be posted at the Skate Park setting forth the requirements to wear safety equipment and advising users of the rules and regulations for use of the Skate Park. • The Ordinance shall be enforced by representatives of the Borough of Old Tappan Police Department and the Borough of Old Tappan Recreation Department. I further authorize the Old Tappan Recreation Commission to use all photographs or video taken of me or my child while participating at the skate park for advertising and/or promotional material. I assume all risks and hazards incidental to such participation. In the case of any emergency, I authorize the Old Tappan Recreation Commission, Old Tappan Police Department and/or the Old Tappan Volunteer Ambulance Corps to administer first aid treatment, to secure the services of a physician, to transport me/my child to the nearest emergency facility for treatment in case of emergency, and to try to notify my contact person. I have read this release of liability and assumption of risk agreement, fully understand the rules and regulations for use of the skate park provided to me, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without my inducement. _____________________________________ ___________ Participant Signature date _________________________________________________ ____________ Parent/Guardian Signature (If participant is under age 18) date Emergency Contact Person: Name: _______________________________________ Telephone No.: ________________ Address: ___________________________________________________________________ Relationship to Participant: ____________________________________________________ Check participant’s form of skating: [ ] Skate boarding [ ] Inline-skating .