Adult 18+ Waiver Form

Adult 18+ Waiver

  • Before my participation in Roller Skating, Inline Skating, Hockey, Roller Derby or other activities in which roller skates are worn by me or others (hereinafter “Roller Skating Activities”) at 1055 Auburn Street, Whitman, MA 02832 (the “Premises”), CR Conway Enterprises of Whitman, Inc., d/b/a Carousel Family Fun Center (hereinafter “Carousel Family Fun Center”), is requiring this Waiver And Release to be filled out, signed and returned. My ability to participate in Roller Skating Activities is valuable and sufficient consideration for this Waiver and Release.
  • Protective equipment is optional but always encouraged – helmet, knee pads, elbow pads and wrist guards can be worn by the skater if this makes the skater feel more comfortable.  Carousel Family Fun Center is under no obligation to and has no responsibility to provide or require the use of protective equipment.
  • I am 18 years of age or older.
  • I agree to abide by the Carousel Family Fun Center rules of conduct.  
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Roller Skating / Inline Skating Sports Waiver and Release

  • I acknowledge that Roller Skating Activities are strenuous and fast moving recreational and sports activities. By participating in Roller Skating Activities, I am personally assuming risk of an accident inherent in these activities.  It is the nature of Roller Skating Activities that participants may fall down, run into, collide with or strike other people or run into, collide with or strike objects, such as the floor, walls, barriers or dividers. I understand the risks and hazards inherent in Roller Skating Activities.
  • I acknowledge that I and others may suffer bodily injury arising from participating in Roller Skating Activities. These bodily injuries include, but are not limited to, soft tissue injury, bone fractures, concussion, nerve damage and even death.  I understand that bodily injury may result in damages such as temporary or permanent disability, economic loss, and medical expenses.  I understand that the acts and omissions of myself or others, whether intentional, negligent, grossly negligent or reckless, may cause or contribute to bodily injury of myself or others.
  • I acknowledge that I may be exposed to and infected by COVID-19 from participating in Roller Skating Activities. I understand that COVID-19 and other viral diseases are highly contagious and that contraction of COVID-19 or another viral disease may result in illness, permanent or temporary disability and/or death. I understand that the acts and omissions of myself or others may result in my exposure to or infection by COVID-19, and, by participating in Roller Skating Activities, I am fully and voluntarily assuming the risk of contracting COVID-19 or another viral disease.
  • I understand and consent to my being being filmed, photographed, video recorded or audio recorded while at the Premises (“Recordings”) and that such Recordings may contain my image, likeness and/or voice. I hereby irrevocably waive and release to Carousel Family Fun Center any ownership, copyright, possessory or other interest I may have in the Recordings.  I agree that such Recordings may be copied, edited, revised, retouched or changed and may be used in whole, in part or together with other Recordings non-commercially or commercially in social media, advertising, marketing, television shows or motion pictures by Carousel Family Fun Center or any other party as permitted by Carousel Family Fun Center.
  • I hereby waive any claims for and I release Carousel Family Fun Center and its shareholders, directors, officers, employees, agents, associates, staff and lessors of real property (together the “Releasees”) from any responsibility or liability for any injuries, bodily or otherwise, and any damages, economic or noneconomic, that may arise from any activities at the Premises, including, but not limited to: classes; private or public sessions; private lessons; club activities; practices; birthday parties; private events; inline skating; roller-derby; speed skating; hockey; Roller Skating Activities; or, Recordings. I RELEASE THE RELEASEES FROM LIABILITY FOR THEIR OWN NEGLIGENCE AND, TO THE FULLEST EXTENT POSSIBLE, THEIR OWN GROSS NEGLIGENCE OR RECKLESSNESS. 
  •  I have read this Waiver And Release; I represent that I am 18 years of age or older; and, I accept the terms hereof. I understand that I may decline to sign and accept this Waiver And Release, but, if I so decline, I may not participate in Roller Skating Activities at 1055 Auburn Street, Whitman, MA 02832. I further understand that, if I do not sign this Waiver and Release, and if I nonetheless participate in Roller Skating Activities, my participation is an acknowledgement and acceptance of the terms of this Waiver and Release. 
    Initial Here

 


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By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.