GoGrind BMX Clinic Registration Form

GoGrind BMX Clinic Registration Form
Register for the Chicago Park District
GoGrind Clinics!

The Chicago Park District has teamed up with Chicago Action Sports to create GoGrind.

GoGrind is a series of BMX and skateboarding clinics at some of Chicago’s best skate parks.

The clinics give young people the opportunity to try action sports with the help of expert skateboarding coaches.

You Must Bring Your Own Bike and Safety Equipment.

If You are Enrolling More Than One Clinic Participant,

Each Pariticpant Must Be Enrolled Seperately

This is a bike/BMX clinic ONLY.
There is no skatboarding instruction at either clinic.
Register:*

Saturday, July 23, 3pm - 5pm; Wilson Ave. Skate Park, Wilson & Lake Shore Drive, Chicago, IL 60640Saturday, September 24, 1pm - 5pm Big Marsh Bike Park - 11559 S. Stony Island Ave. Chicago, IL 60633
Clinic Participant Information
Clinic Participant's Last Name*
Clinic Participant's First Name*
Middle Initial
Clinic Participant's Birth Date*

MonthDayYear
Date
Parent or Legal Guardian Information
Parent/Legal Guardian *

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Best Phone Number *

Area CodePhone Number
Other Phone

Area CodePhone Number
Email
example@example.com
Emergency Contact Information
Emergency Contact Name (if parent or guardian is not avaliable)*
Emergency Contact Phone*

Area CodePhone Number
2nd Emergency Contact Phone

Area CodePhone Number
Email Confirmation
Parent's Email (confirmation will be sent by email, if left blank it will be mailed)
Participant's Email

WAIVER FORM

By submitting this form electronically you are bound by the following agreement:
Parent/Legal Guardian*

First NameLast Name
THIS AGREEMENT CONSTITUTES AN EXPRESS CONTRACTUAL ASSUMPTION OF ALL RISKS, WAIVER AND RELEASE FROM ALL LIABILITY FOR ANY NEGLIGENCE AND INDEMNITY FOR ALL THIRD PARTY CLAIMS. PLEASE READ CAREFULLY!

I know that skateboarding is an inherently dangerous sport and activity in which I choose to voluntarily participate at my own risk. I am aware that the usual risks, hazards and dangers of personal injury, death and disability or property damage and loss (collectively, “damages”), necessarily increase when using rails, jumps, boxes, quarter pipes, inclines or declines, or any other structure and device. I know that the risks, hazards and dangers include, but are not limited to, uncontrollable boards, falling, jumping, landing, performing tricks, colliding with other users, staff, media personnel and spectators. I also understand that these risks, hazards and dangers are further increased when other persons, whether or not of the same level of experience or skill, are present at the same time and using the same facilities. (All of the above defined activities are collectively referred to throughout this Agreement as “the Hazardous Activities.”)

By this agreement, it is my intention to relieve Business Logistics Development [DBA Chicago Action Sports], Chicago Park District and all partners, venue operators and owners, and any managers, employees, officers, directors, agents, contractors, volunteers, vendors, or exhibitors or any other person, company or entity in any way associated with such entities (hereinafter, "Sponsors") of any duty to me and I DO ASSUME THE ENTIRE risk of any of the Damages that might occur during or as a result of my use of, or presence at the GO GRIND Clinics (hereinafter "Event") at the Chicago Park District Skateparks on June/September, 2018. By this agreement I also intend to RELEASE, DISCHARGE AND ABSOLVE Sponsors from any and all liability for any active or passive negligence whatsoever by Sponsors and to WAIVE AND RELINQUISH any claim or cause of action against Sponsors for any loss, claim, damage, personal injury, disability, death, medical and any other type of expense or property damage or loss caused by any negligence of Sponsors and promise not to sue or exercise any legal right to seek damages from Sponsors.

In consideration of participating in the Event at the Chicago Park District Skateparks, I agree as follows:

1. As to my participation in any activity, including, but not limited to, the Hazardous Activities and as to any and all liability for the Damages, which I may suffer or incur due to any cause whatsoever, I hereby agree:

a. To WAIVE any and all claims for Damages that I may have against Sponsors;

b. To RELEASE Sponsors from any and all liability for the Damages that I may suffer or incur, or that my next of kin may suffer as a result of participation in any activity, including but not limited to, Hazardous Activities while at Event.

c. To HOLD HARMLESS AND INDEMNIFY Sponsors from any and all liability for the Damages to any third party resulting from my participation in any activity, including but not limited to, the Hazardous Activities while at Event.

d. This waiver and release of liability and indemnification agreement (collectively, referred to hereafter as “Waiver and Release”) shall be effective and binding upon my heirs, next of kin, family, relatives, guardians, conservators, executors, administrators, trustees and assigns in the event of my injury, disability or death.

2. This event may be filmed and photographed. By attending the event, I consent to the recording/filming and the use of my likeness and image for the purpose of the filming/photography. I hereby grant Sponsors permission to utilize my name, and/or any photographs, videos, and likeness of me in any related advertising or promotional campaigns as Sponsors may deem appropriate from time to time, all without additional compensation to me. This assignment includes the transfer to Sponsors of all right, title and interest in any photographs, videos, and likenesses captured at this event.

3. This Agreement shall be governed by the laws of the state of Illinois. I agree that this Agreement is intended to be as broad and inclusive as is permitted by the law of the state of Illinois and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

THE UNDERSIGNED FURTHER CERTIFIES that he/she has no medical condition that would cause participation in Event to be potentially hazardous to his or her health. In addition, this agreement shall constitute authorization for Sponsors, to provide or cause to be provided such medical treatment to the undersigned as may be necessary or appropriate if an injury occurs while at Event.

THE UNDERSIGNED CERTIFY that I [We] am (are) the parent(s) or legal guardian(s) of
Name of Clinic Participant *

First NameLast Name
I [We] have completely read and understand this Agreement and its terms. Prior to signing this Agreement, I [we] have had the opportunity to ask any questions about this agreement. I [We] am(are) aware that, by signing this Agreement, I [we] ASSUME ALL RISKS, WAIVE AND RELEASE all rights against Sponsors, that I and my heirs, next of kin, family, relatives, guardians, executors, administrators, trustees and assigns may have against Sponsors and agree to INDEMNIFY AND HOLD HARMLESS Sponsors for any claims related to the event. I (We) give consent and permission to Sponsors to obtain on the behalf of myself or my minor child any emergency medical treatment in case of sickness, accident, or injury and to secure such medical attention at my expense.

THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THIS AGREEMENT, and further agrees that no oral representations, statements, or inducements apart from this Agreement have been made by Sponsors or anyone else with regard to the subject matter of this Agreement.
Name of Clinic Participant*

First NameLast Name
Birth Date*

MonthDayYear
Date
Today's Date*

MonthDayYear
Date
Clinic Participant's Email Address
example@example.com
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Drivers License or ID Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Parent/Guardian Signature (click and move mouse to sign or use touchpad)*

Clear
Today's Date*

MonthDayYear
Date
Should be Empty:

GoGrind BMX Clinic Registration Form

Clinic Participant Information

Parent or Legal Guardian Information

Emergency Contact Information

Email Confirmation