Time & Location
Feb 13, 2021, 3:00 PM – 6:00 PM EST
Skate Luvers Roller Palace, 1684 Adirondack St, Rochester, NY 14606, USA
About the Event
Come Roll with Skate Luvers Roller Palace
Limited Capacity | Temperature Taken | Masks must be worn
ACKNOWLEDGE OF RISKS
I understand and acknowledge that by participating in the activity of “Skate Luvers” roller skating activities
and by using the equipment supplied by SKATE LUVERS ROLLER PALACE, I am exposing myself to
certain and unanticipated risks that could result in injury or death to myself, to my personal property, or to
spectators, or other third parties. I understand that those risks may result in personal claims against SKATE
LUVERS ROLLER PALACE or claims against me by spectators or other third parties.
ACCEPTANCE OF RESPONSIBILITY
Being aware of the risks involved in participating in “Skate Luvers” roller skating activities and in using
the facilities and equipment supplied by SKATE LUVERS ROLLER PALACE, I expressly agree,
covenant and promise to accept responsibility for any and all risk of injury or death to myself or to my
property or to spectators or other parties, suffered as a result of my participation in this activity. My
participation in this activity is purely voluntary and I elect to participate in spite of the risks.
INSURANCE AND REPRESENTATION OF PHYSICAL CONDITION
I understand that no medical insurance benefits are provided to participants or spectators during this
activity. I acknowledge that I will have to pay for any and all medical attention required for any injury I
may suffer during this event. I certify that I am in good physical condition at the time I began this activity
and that I am not suffering from any physical or mental condition nor am I under medical care for any such
RELEASE AND DISCHARGE
I have read and I fully understand this entire agreement. By signing below, I, in consideration of the
services of SKATE LUVERS ROLLER PALACE, and the right to engage in this event, hereby voluntarily
release and discharge SKATE LUVERS ROLLER PALACE, it's owners, agents, and employees, from any
and all liability and claims, including any negligent act or omission of SKATE LUVERS ROLLER
PALACE, it's agents or employees for any injury or death to myself or my property arising from or incident
to my participation in this activity and equipment supplied by SKATE LUVERS ROLLER PALACE or
from any claim asserted against me by any third party.
PHOTOGRAPHY/ VIDEO RELEASE
I grant to “Skate Luvers”, its representatives and employees the right to take photographs of me and my
property in connection with the identified subject. I authorize “Skate Luvers”, its assigns and transferees to
copyright, use and publish the same in print and/or electronically.
ASSUMPTION OF THE RISK. I acknowledge and understand the following:
1. Participation includes possible exposure to and illness from infectious diseases including but not limited to COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist;
2. I knowingly and freely assume all such risks related to illness and infectious diseases, such as COVID-19, even if arising from the negligence or fault of the Released Parties; and
3. I hereby knowingly assume the risk of injury, harm and loss associated with the Activity, including any injury, harm and loss caused by the negligence, fault or conduct of any kind on the part of the Released Parties.
By submitting this submission, I agree to all of the terms and conditions outlined within this waiver.
Joanna's Birthday Party
Saturday, February 13, 2021 @ 7pm