Disclaimer Form

To use the park we require all participants to fill in a disclaimer form – To save time this can be done electronically.
We recommend completing the form before attending the park to ensure a speedy entrance.

I HAVE READ AND FULLY UNDERSTOOD THE TERMS AND CONDITIONS OF ENTRANCE TO THE SKATE PARK AND AGREE TO ABIDE BY THEM.

( online disclaimer form to be filled in by Parent or Guardian if under 18 years of age )

* indicates required field

Subject:*

Name:*

(The name of the person using the park)

Sex:*

Ethnicity:*

Date of Birth:*

(Rider must be 5 years of age or over*)

Address*

Post Code*

Tel no:*

Emergency Contact Number*

(In the event of a serious incident)

Email:*

Are there any reasons why you should not participate in physical exercise?*

Yes No

Do you or have you ever suffered from any medical condition that our staff should be aware of? i.e. Asthma, Epilepsy, Diabetes, heart problems etc*

(you must enter something in this box even if its just to say 'none')

Disability:*

Additional Info

Parent or Guardian Name:*

(To be filled in by Parent or Guardian if under 18 years of age)

By ticking this box I confirm to be age 18 or over and the parent/guardian. I give consent to the named applicant above.

DISCLAIMER FORM SUBMISSION AGREEMENT:*

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