You must be 18 years or older to sign this form. If a participant is under 18 years old, this form must be signed
by a parent or guardian.

Please read this Form carefully. If you do not agree to it, then you cannot participate in the activities.

I confirm that participation in the activities provided by Skates and Ladders is on the terms set out in this Form.

I confirm that I understand that the activities provided by Skates and Ladders are not completely free from the
risk of personal injury and includes potential for permanent paralysis and death. While rules, equipment,
tuition and personal discipline may reduce the risk, the risk of serious injury still applies. I accept that while
Skates and Ladders will take the appropriate precautions and safeguards to prevent accidents from occurring,
this cannot be guaranteed, and I/we are also responsible for contributing to our own safety and the safety of
others.

I confirm that I/they are physically fit and healthy and able to take part in the activities and I will advise Skates and Ladders of any relevant learning disabilities, medical and physical conditions that may affect me/us, and
update Skates and Ladders before taking part in any activities if this position changes.

I confirm that I, my child/children will follow and comply with any rules and instructions provided by Skates
and Ladders at all times. I agree that failure to follow and comply with the rules and any instructions may
result in behaviour that is unsafe to me/my child/children or other participants. To ensure the health and
safety of everyone, this may result in having to cease participation in the activity on a temporary basis, or
complete exclusion from the activities.

In the absence of any negligence or other breach of duty by Skates and Ladders, participation in the activities is
entirely at my risk. In the absence of any negligence or other breach of duty by Skates and Ladders, Skates and
Ladders are not responsible for any theft, damage or destruction or loss of my property or belongings during
my participation of the activities.

By signing this Form, I agree that I accept the terms of this Risk Disclaimer Form for myself or on behalf of the
child/children named below.