Town Date Fee Schedule for each event:!

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1 A new contest series developed by 2nd Nature and local recreation departments to bring the skateboarding communities together to have a good time and get free stuff. There will be three skill levels; 13 & under (beginner),14-18 (intermediate) and 18 & over (advanced). Younger skaters may challenge themselves by entering a more advanced level. Contests will consist of two heats; each heat will have up to three skaters at a time for 2 minutes. Skaters will be judged based on style, consistency and difficulty on a scale of Every skater will represent the town they are from or live nearest to. Each skater gains one point just for showing up and the town with the most points at the end of the competition receives a trophy. Prizes include: decks, shoes, wheels, t-shirts, gift certificates, and more. To Register: Step 1 Complete the registration form below. Be sure to include town, date & fee of the contest for which you are registering. Be sure to include work, home and cell phone numbers where you can be reached if necessary. Step 2 Write a check or money order payable to 2 nd Nature. If paying by credit card, please make sure all the credit card information is filled out completely including date of expiration and security code. Step 3 Mail or stop in with the completed form to any of the participating recreation departments, a 2 ND Nature store or the form to doug@2ntr.com (cc only) Please Print Participant s First Name Participant s Last Name Age Address City / Town State Zip Home Phone Work Cell Town Date Fee Schedule for each event:! Ardsley April 21 st $15 (_) Registration and Warm up 3:00 PM Rye May 5 th $15 (_) Beginner Contest 4:00 PM New Rochelle May 19 th $15 (_) Intermediate Contest 4:30 PM New Castle / Pleasantville June 2 nd $15 (_) Advanced Contest 5:00 PM Yorktown June 16 th $15 (_) Announcements 5:30 PM Peekskill July 14 th $15 (_) Product Toss 5:45 PM Total: $ *** Rain dates will be one week after each date. If they are rained out twice, they will not happen. Refunds will not be given but you will get an admission credit to 2 nd Nature Peekskill in exchange. ****Participants must abide by the rules of each skate park and have a waiver on file at each park. Method of Payment: Please make check payable to "2 nd Nature. Mail with registration form to: 1 Highland Industrial Park Peekskill, NY or any of the participating recreation departments. Charge my Credit Card (circle one): (You can this form to doug@2ntr.com) MasterCard Visa CC Billing Address: Credit Card number Expiration Date: / Month / Year PRINT Card Holder Name CVC (3 digits on back) Card Holder Signature

2 Page 1 of 2 2nd Nature Skate Park 1 Highland Industrial Park Peekskill, NY Phone: (914) WAIVER - PHOTO ID IS REQUIRED 17 AND UNDER, SIGNATURE MUST BE NOTARIZED UNLESS WITNESSED BY A PARK STAFF MEMBER. THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS. YOU NEED TO READ ALL OF IT CAREFULLY. NO ADMITTANCE WILL BE GRANTED WITHOUT PROPER REVIEW, COMPLETION AND EXECUTION OF THIS DOCUMENT. In consideration of being allowed to participate and use, on this date or any future date, the property, facilities and services of 2NTR Inc, 2ND NATURE SKATE PARK, related activities, events and contests, I (the undersigned) acknowledge, appreciate, and agree that: (please print) 1. THE RISK OF INJURY FROM THE ACTIVITIES INVOLVED AT 2NTR, Inc. 2ND NATURE SKATE PARK IS SIGNIFICANT, INCLUDING THE POTENTIAL FOR PERMANENT DISABILITY AND DEATH, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury to me does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation. If I observe any unusual significant concern in my readiness for participation at 2NTR, Inc. 2ND NATURE SKATE PARK itself, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4. I, for myself and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS 2NTR Inc, 2ND NATURE SKATE PARK, its officers, officials, agents, and/or employees, other participants, sanctioned events, sanctioned parks, sanctioned organizations, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ( Releasees ), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH or loss or damage to person or property incident to my involvement or participation at 2NTR Inc, 2ND NATURE SKATE PARK, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. 5. I UNDERSTAND THAT RAMPS ARE HAZARDOUS BY DESIGN. I will not hold the owners liable for any injury, mishap or death resulting from riding ramps; from skate park design; from skate park construction; from skate park maintenance; spectatorship, or presence at or near 2NTR Inc, 2ND NATURE SKATE PARK. This includes but is not limited to slipping, tripping, falling, collision with another person or object, impalement or falling objects. 6. I, for myself and on behalf of my /our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation at 2NTR Inc, 2ND NATURE SKATE PARK, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent of the law. 7. I ACKNOWLEDGE AND AGREE TO ALL POSTED RULES AT 2NTR Inc, 2ND NATURE SKATE PARK AND I AM AWARE THAT MYSELF OR MY SON / DAUGHTER MAY SKATEBOARD WITHOUT A HELMET AND / OR PADS AND I AGREE TO ASSUME ANY ADDITIONAL RISKS THAT MYSELF OR MY SON / DAUGHTER MAY INCUR BY NOT WEARING A HELMET OR PADS. ASSUMPTION OF RISK I acknowledge and understand that skateboarding and similar activities are hazardous and dangerous activities that involve strenuous exercise. I acknowledge the risk of injury from the activities involved can be significant, including the potential for permanent paralysis, death and serious bodily injury and damage to property. I acknowledge that my presence or the Participant s presence and any participation in activities at 2NTR Inc, 2ND NATURE SKATE PARK are strictly voluntary and that there is no one forcing me and or the Participant to participate in any activities at 2NTR Inc, 2ND NATURE SKATE PARK I hereby represent that no special relationship exists between me/the Participant and any of the covered parties and that I am not under any physical, economic or other compulsion to sign this Agreement. On my own behalf and on behalf of the Participant, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my/the Participant s participation while on the premises of 2NTR Inc, 2ND NATURE SKATE PARK I am also aware that there is an inherent risk in simply being at 2NTR Inc, 2ND NATURE SKATE PARK and/or observing, photographing or videotaping the activities. On my own behalf and on behalf of the Participant, I knowingly and voluntarily assume any and all of the foregoing risks of loss, damage and injury. 2NTR Inc, 2ND NATURE SKATE PARK RULES No alcohol or illegal substances. No Glass containers anywhere on site. Please dispose of your trash properly. No fighting or shoving. Helmets and pads are recommended. No skating in the shop, lounge or parking lot. Stay alert of your surroundings. To avoid collisions, make sure the skating path is clear. Pay attention to other skaters in the park. Do not skate where others are. Take turns. Violation of establishment rules will result in ejection. Have fun, be safe and respect your fellow skaters.

3 Page 2 of 2 I HAVE READ THIS RELEASE OF LIABILITY, THE ASSUMPTION OF RISK AGREEMENT, AND THE SKATE PARK RULES, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I attest that I am physically fit and ready for this activity. I also waive and release the use of my photograph or likeness for any reason or purpose. I WANT TO PARTICIPATE IN THIS HAZARDOUS SPORT! I AGREE TO ASSUME FULL RESPONSIBILITY FOR ALL INJURIES, PERMANENT DISABILITY OR DEATH AND MEDICAL EXPENSES IN CURRED at 2NTR Inc, 2ND NATURE SKATE PARK I ACKNOWLEDGE AND AGREE TO ALL RULES AT 2NTR Inc, 2ND NATURE SKATE PARK AND I AM AWARE THAT MYSELF OR MY SON / DAUGHTER MAY SKATEBOARD WITHOUT A HELMET AND / OR PADS AND I AGREE TO ASSUME ANY ADDITIONAL RISKS THAT MYSELF OR MY SON / DAUGHTER MAY INCUR BY NOT WEARING A HELMET OR PADS. X PARTICIPANT SIGNATURE DATE PRINT NAME DATE OF BIRTH Circle One: Male Female Address: Apt # City: State: Zip: Phone: ( ) Emergency Contact: Emerg Phone # ( ) If participant is under 18: X PARENT/ LEGAL GUARDIAN SIGNATURE DATE SIGNED NAME (Please Print): MEDICAL RELEASE: In the event that I cannot be reached in an emergency, I hereby give permission to any licensed physician, surgeon, clinic, or hospital to secure proper treatment, and to order anesthesia, for my child/ myself as named above. My child/i am allergic to the following medications: List allergies, notes here Signature DOCTOR to be notified in case of emergency: 17 AND UNDER, SIGNATURE MUST BE NOTARIZED UNLESS WITNESSED BY A SANCTIONED: PARK, EVENT OR ORGANIZATIONS OFFICIAL OR DIRECTOR. WITNESS SIGNATURE:

4 Rye Recreation Skate Park Waiver Participants Name: Parent or Guardians Name: Address: Address: City: Date of Birth: Grade: (current grade school year) Home Phone: Emergency Contact Name: Insurance Company & Card #: Cell Phone: Phone: SKATER MUST READ AND SIGN BELOW! Let s work together to make the Skate Park fun and safe for all participants! I will respect ALL Skate Park visitors, users and staff at ALL times. I will NOT do drugs or alcohol at the Skate Park. I will assist the Skate Park Staff in keeping our Park clean, safe and fun for all people. I will NOT use offensive language or gestures while at the Park. I will NOT use graffiti or damage any property at the Skate Park. I will use the required safety gear at ALL times. Helmet, both elbow pads and both kneepads. My skates/skate board will be kept in good condition at ALL times. SKATER SIGNATURE: DATE: I acknowledge that in-line skating and skateboarding require strenuous physical activity and endurance. I also understand the risks and dangers associated with participation in these activities, which include, but are not limited to, falls, muscle strains, cuts, bruises and broken bones. The risk of injury from these activities is significant, including the potential for permanent paralysis and death, and while the particular rules equipment and personal discipline may reduce this risk; the risk of serious injury does exit. I certify that I, to the best of my knowledge have no physical, mental or emotional condition which might be aggravated by this activity, which might in any way inconvenience or endanger staff or participants, or which might impair my ability to participate in and withstand all possible in-line and skateboarding activity. I will obey all rules, regulations and directives but forth by the Rye Recreation Department and the person in charge, and will assist by informing and/or calling to the attention of the person in charge, any situation which might result in injury. I acknowledge the rigors of these activities connected with in-line skating and skateboarding, and in consideration for being accepted as a participant in this program, I hereby accept ALL responsibility for taking care of myself while participating in this program. I agree that Rye Recreation, their agents, employees and volunteers will not be liable for any damages or injuries directly or approximately caused by any act, happening or event. I understand that the City of Rye does not provide medical coverage for participants in any programs and that my child or I participate at our own risk. Signature of Participant if over 18: Date: For participants under the age of 18: I (we) the parents/legal guardian of have read, understand and agree to the above statements and hereby consent to him/her participating in the designated program. I have signed this document signifying my agreement and consent. Signature of Parent/Guardian: Date:

5 Rules of the Skateboard/In-Line Skating Facility - Rye Recreation All participants must register and fill out required paperwork. (If under 18, a parent waiver is required.) All skaters must wear a helmet (buckled), elbow pads and kneepads while skating. Hand guards are recommended All skaters are expected to act in an orderly, safe and considerate manner while in the Skate Park. No snaking. Reckless or dangerous skaters will be requested to leave the premises. Those who have more than once offense can have their registration temporarily or permanently revoked. All injuries, whether major or minor, are to be reported to the supervisor immediately. In case of serious injury, do not move the injured person; notify the supervisor immediately. Any persons caught skating before or after hours will have their privileges revoked and any monies paid will not be refunded. Daily participants and guests of permit holders are permitted as long as a parent/guardian is on hand to sign the waiver and pay associated fees. The playing of a radio is not permitted. Shirts must be worn at all times. NO smoking, NO profanity and NO loitering in the skate park at anytime Minimum age for participants in 8 years old unless accompanied by an adult. Park Dismissal Any participant not following the rules of the skate park will be asked to leave the park immediately First time offenders will receive a verbal warning; second violation will result in suspension of park use A written report for each violation will be submitted to the Recreation Department If a suspension occurs, a refund WILL NOT be given, and will be reviewed prior to the start of the next season. If any member of the skate park club is found in the park when the park is not open, will have their privileges revoked. Park Hours The Rye Recreation Department will schedule hours of operation Rye Recreation reserves the right to close the skate park for any reason The park will be closed during inclement weather. Please call Rye Recreation s hot line for park closures after 5 p.m. when the park is open. (914) mailbox #1.

6 City of New Rochelle William V. Zimmermann Parks & Recreation Commissioner City Hall 515 North Avenue New Rochelle, NY Phone: (914) Fax: (914) Skate Park Registration Form Participant Name Date of Birth Home Phone address Street Address City State Zip Code Participant is (please check all that apply): in-line skater skateboarder FEE $ Please Print: Parent/Legal Guardian Home Phone Cell Phone Street Address City State Zip Code 1 Emergency Information: If Parent/Legal Guardian cannot be reached, please notify: Name Relationship: Phone: Please list any special medications, allergies or medical restrictions Insurance Company (Medical) (optional) Policy/Group Number (optional) PLEASE TURN OVER AND COMPLETE THE WAIVER INFORMATION! City of New Rochelle Parks & Recreation Doc: Word/OfficeMgr/Skatepark

7 City of New Rochelle Department of Parks and Recreation Sidney E. Frank Skate Park Release, Waiver, and Hold Harmless Agreement In consideration of the willingness of the City of New Rochelle, Department of Parks and Recreation (the Department ) to provide access to the Sidney E. Frank Skate Park, I hereby waive for myself and on behalf of my child or ward, and any persons claiming by, through or under me or the, any and all claims or causes of action which I or my child or ward now or hereafter may have against the Department, City of New Rochelle, its officers, agents, servants, and employees, for all injuries and damages suffered arising from use of the Skate Park or while at the Skate Park for any other reason. I acknowledge that in-line skating and skateboarding and other physical activities at the Skate Park involve the risk of serious bodily injury and I fully accept and assume all risks and responsibilities for all losses and damages incurred as a result of my participation, and the participation by my child or ward, in these activities. I acknowledge that all persons using the Skate Park pursuant to this Agreement are in good health and good physical condition. I have read the Rules of the Skate Park and understand that full gear is required including but not limited to helmet, elbow and kneepads, and wrist guards, and I will abide by them in full. I have explained the Rules to my child and/or ward and agree that the staff of the Department may deny further use of the Skate Park to any person who violates the Rules. I agree to indemnify, defend and save harmless the Department, and The City of New Rochelle, and its officers, agents, employees, and servants from and against all claims, suits, judgments liabilities and expenses, including attorney s fees, arising out of the use of the Skate Park as contemplated by this Agreement. I have read and understand the above agreement Signature of Parent/Legal Guardian or Participant if 18 or older Date Signed Home Phone Please print: Participant s Full Name

8 City of New Rochelle Parks & Recreation City Hall 515 North Avenue New Rochelle, NY Phone: (914) Fax: (914) William V. Zimmermann Commissioner SKATE PARK RULES Skaters are expected to follow the rules listed below plus any directions given by the Skate Park staff. Failure to do so may result in the loss of skating privileges, and NO REFUNDS will be given. 1. All skaters must sign in with attendant. 2. All skaters must sign Waiver/Release forms. Minors must have a parent or guardian sign. 3. All skaters assume risk of injury. The City of New Rochelle and its agents are not responsible for any injuries. 4. Skaters must wear proper safety equipment, including but not limited to, helmets, knee and elbow pads, and wrist guards. 5. No trespassing after park hours. 6. Skate Park can only be used when a monitor is on site. 7. No bicycles, roller skates or scooters are permitted inside this facility. 8. No littering. Please use trash containers. 9. Do not use ramps or obstacles that are beyond your ability level. 10. No food or beverages in the skating area. 11. Skaters under 10 years of age must be accompanied by someone 18 years of age or older. 12. No climbing on the fence. 13. No alcohol, smoking, drugs, foul language, inappropriate behavior, glass containers, or loud music. 14. Shirts are required at all times. 15. No headsets or stereo s allowed in the park.

9 City of New Rochelle Parks & Recreation City Hall 515 North Avenue New Rochelle, NY Phone: (914) Fax: (914) William V. Zimmermann Commissioner Hours of Operation: SIDNEY E. FRANK SKATE PARK At City Park (Fifth Avenue & Potter Avenue) Entrance and available parking in the main City Park parking lot Peak Hours May 1st October 22 nd School Year Weekdays Open 3:30pm to 7:30 pm Summer Weekdays, Weekends and Holidays Open 12:00 noon to 7:00 pm Off Peak Hours October 23 rd April 30 th January/February Closed Weekends, and Holidays Open 12:00 noon to 4:00 pm weather permitting CLOSED ON SCHOOL DAYS, and when the temperature is below 32 degrees For exact days and times monthly, please go to our website For weather closing information Call ½ hour before scheduled opening Please remember even if the weather clears, the park may not be opened due to the dampness of the ramps and/or asphalt. Fees: Day Pass $5.00 Annual Memberships : Residents $50.00 Non-Residents $75.00 Skate Park Policy NO REFUNDS

10 VILLAGE OF ARDSLEY DEPARTMENT OF PARKS AND RECREATION 18 CENTER STREET ARDSLEY NY HOLD HARMLESS RELEASE PARENTAL PERMISSION ARDSLEY VILLAGE SKATEPARK MEMBER #: SKATER/SKATEBOARDER/BIKER NAME: DATE OF BIRTH: AGE: SCHOOL: GRADE: ADDRESS: PHONE #: (street address / village, town or city /state/ zipcode) EMERGENCY CONTACT: PHONE #: We are pleased that your child has decided to participate in the Skatepark Programs. It is required by the Village of Ardsley that each skater/biker s parent or legal guardian complete the Hold Harmless Release. The mandatory understanding concerning participation is listed in three parts as follows: Part You give your child, identified in the top of this form, permission to participate at Ardsley Village Skatepark listed above. 2. You, on behalf of yourself, your child, your assigns, executors, and heirs, agree to release, indemnify, and hold harmless the Village of Ardsley, and its officials, officers, agents and employees from any and all liability, damage, injuries and/or claim of any nature arising out of or in any way related to your child s participation at this skate park including those things caused by the sole negligence of the Village of Ardsley. 3. You state that you are aware of all the inherent dangers and risks involved in skate park participation including but not limited to: bodily injury, sprains, fractures, dislocations, lacerations, concussions, skin disease, eye, head, neck or back injuries, paralysis, or death. Some specific risks include, but are not limited to: a. Being hit or struck by sports equipment (skateboard, skates, bike) b. Being hit, struck, physically challenged or colliding with other skate park participants c. Collision with skate park facilities (structures, ground, rink, obstacles, fence, fence posts) 4. You understand that the Village of Ardsley does not provide any Accident or Medical Insurance and you are required to provide this for your child. You agree that you are financially responsible for all medical expenses whatsoever.

11 5. You understand that the terms of this agreement are legally binding and certify that you are signing this agreement of your own free will after carefully reading it. Part 2. Medical Authorization In the event of serious illness or injury, I authorize the facility staff and/or the Village of Ardsley Police Department to transport (as deemed necessary) my child to a hospital emergency facility for treatment. All reasonable attempts to contact a parent or guardian will be made. I accept responsibility for all costs involved in the transport and treatment of my child. My hospital insurance carrier is:. Part 3. Facility Rules and Regulations 1. Biking may be permitted in separate sessions only. Absolutely no biking will be permitted during skateboarding/in-line skating sessions. 2. All skaters/bikers must have a seasonal permit or purchase daily admission and must be at least 9 years of age. Under 9 years of age must be accompanied by parent or guardian. 3. All skaters/bikers must wear protective gear and equipment, which includes helmet, knee and elbow pads, and proper shoes. Wrist guards or protective gloves are strongly recommended. 4. All protective gear and equipment must be designed for skateboarding/in-line skating/biking and be in good condition. Village of Ardsley reserves the right to refuse to allow anyone to skate/bike if their. protective gear and equipment are not adequate 5. All skaters/bikers agree to act in an orderly, safe and considerate manner while on the premises. 7. No snaking. Everyone is to wait his or her turn. Reckless or dangerous skaters/bikers will be requested to leave the skate park immediately. 8. All injuries, whether major or minor in nature, are to be reported to the management immediately. In the case of a serious injury, no skater/biker shall move the injured person and all skateboarding/in-line skating/biking shall cease immediately. In witness whereof, this instrument is duly executed: Date X X Parent or Guardian Witness THIS FORM MUST BE TURNED IN TO THE PARKS & RECREATION DEPARTMENT BEFORE THE SKATER/BIKER MAY PARTICIPATE.

12 Town of New Castle Department of Recreation & Parks and Village of Pleasantville Recreation Department 2012 SKATE PARK Participant Agreement, Agreement to Indemnify, & Risk Acknowledgment In consideration of the joint services of the Village of Pleasantville, the Pleasantville Recreation Department, the Town of New Castle and the New Castle Department of Recreation and Parks and their respective agents, officers, participants, consultants, employees, and all persons or entities acting in any capacity on their behalf (hereinafter jointly and severally referred to as the Town/Village ), I now agree to release & discharge the Town/Village, on behalf of myself, my children, my parents, my heirs, assigns, personal representatives and estate as follow: 1. I acknowledge that inline skating and skateboarding entail known & unanticipated risks, which could result in physical or emotional injury, paralysis, death or damage to myself, to property or to third parties. I understand that such risks cannot be eliminated without jeopardizing the essential qualities of the activity. In an effort to minimize those risks I agree to wear a protective helmet, knee pads, elbow pads and in addition, if I am in-line skating, wrist guards, at all times that I am in the Skate Park. THE RISKS INCLUDE, BUT ARE NOT LIMITED TO: (1) Nature of activity (2) Latent or apparent defects or conditions in equipment or property supplied by the Town/Village, or other persons or entity. (3) Use of property by myself, others or equipment supplied by the Town/Village, or other persons or entity. (4) Acts of other participants in this activity, employees or agents of the Town/Village. (5) My own physical condition, or own acts or omissions. (6) Conditions of the Town/Village facility & surrounding grounds or terrain and accidents connected with their use. (7) First Aid emergency treatment or other services. 2. I expressly agree and promise to accept and assume all the risks existing in this activity. My participating in this activity is purely voluntary and I elect to participate in spite of the risks. 3. I voluntarily release, forever discharge, and agree to indemnify and hold harmless the Town/Village, from any and all claims, demands or causes of action which are in any way connected with my participation in this activity or my use of the Town/Village equipment or facilities, including any such claims which allege negligent acts or omissions of the Town/Village, except if such claims, demands, or causes of action arise out of the gross negligence or willful misconduct of the Town/Village. 4. Should the Town/Village, or anyone acting on their behalf be required to incur attorney s fees and costs to enforce this agreement to indemnify and hold them harmless of all such fees and costs. 5. I hereby certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating or else I agree to bear the costs of such injury or damage myself. I further certify that I have no medical or physical conditions which could interfere with my safety in this activity, or else I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition. By signing this document, I acknowledge that if anyone is hurt, or property damaged during my participation in this activity a court of law may find me to have waived my right to maintain a lawsuit against either or both the Town/Village, on the basis of any claim from which I have released them herein. I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THE ENTIRE DOCUMENT. I HAVE READ AND I UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS. Signature of Participant: Print Name: Address: Phone: Date: RESIDENCY STATUS: New Castle Resident Village of Pleasantville Resident Other (name of town)

13 Town of New Castle Department of Recreation & Parks and Village of Pleasantville Recreation Department SKATE PARK PARENT S & GUARDIAN S ADDITIONAL INDEMNIFICATION (Parent or legal guardian of participants, under the age of 18, must complete this section) In consideration of (print minor s name) ( Minor ) being permitted by the Town/Village to participate in its activities and use its equipment and facilities, I further agree to indemnify and hold the Town/Village harmless such use or participation by Minor. By signing this document, I acknowledge that if anyone is hurt, or property is damaged during the Minor s participation in this activity, a court of law may find me to have waived my right to maintain a lawsuit against either or both the Town/Village, on the basis of any claim from which I have released them herein. I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THE ENTIRE PARTICIPANT AGREEMENT, AGREEMENT TO INDEMNIFY, & RISK ACKNOWLEDGMENT DOCUMENT ON THE FRONT OF THIS SHEET. I HAVE READ AND UNDERSTOOD, AND I AGREE TO BE BOUND BY ITS TERMS. Signature of Parent or Guardian: Print Name: Emergency Phone Number or Cell Phone: Date:

14 TOWN OF NEW CASTLE/VILLAGE OF PLEASANTVILLE Skateboard/In-Line Skating Facility Medical Information Form Skater s Name: Phone: Age: Sex: [ ] M [ ] F Address: City: Name of Emergency Contact Phone or Cell Phone of Emergency Contact Hospital Preferred Phone # Physician to be called in case of emergency Phone # Allergies Chronic Illnesses Regular Medication Medical Problems Recent Injuries (within last year), contact lenses worn? Past injuries, illnesses or sports limitations the Town/Village should be aware of: PARENT RELEASE As a parent or legal guardian, I authorize a licensed physician to exam the above named minor and in the event of injury to render such emergency care as he or she deems necessary for the treatment of such injury, including consultation and treatment by a specialist including a surgeon. As a parent or guardian, I authorize the Town of New Castle, The Village of Pleasantville or their agents or employees to send the minor to the hospital or doctor most accessible. Parent of Legal Guardian Signature: X Date:

15 TOWN OF NEW CASTLE AND VILLAGE OF PLEASANTVILLE 2012 SKATE PARK RULES Last initial 1. All participants must have read the rules of conduct. 2. This facility is for skateboarders and in-line skaters only. NO WAX PERMITTED! 3. All participants must wear the admission bracelet. 4. Participants must be at least five (5) years old. Participants ten years old and younger must be accompanied by an adult over 21 years old. NO EXCEPTIONS! 5. In the event of rain, thunder or lightening, the facility must be closed. 6. All skaters must wear protective safety equipment at all times. This includes: helmet, kneepads, elbow pads, proper shoes and wrist guards for in-line skaters. 7. All skaters must provide their own skateboard and safety equipment. All protective gear and equipment must be designed for skateboard/in-line skating and be in good condition and fitted properly. The Town of New Castle reserves the right to refuse to allow anyone to skate if his or her protective gear and equipment are not adequate. 8. Park hours and dates are subject to change depending on weather, staff availability and repairs. 9. Wait until an obstacle is not in use before attempting to use it! Be considerate of others and wait one s turn. Reckless or dangerous skaters will be requested to leave the skating area and the premises immediately. 10. All skaters must act in an orderly, safe and considerate manner while on the premises and in the skating area. Any behavior that the staff deems inappropriate will not be tolerated. 11. No food, beverages, chewing gum or smoking are allowed inside the skateboard area. No spectators are allowed inside the skateboard area. 12. The use of profanity, tobacco, alcohol, drugs or glass containers are not permitted anywhere within the park boundaries. Skating is restricted to the skate park area during the hours of operation and only when an attendant is on duty. Infractions of the above rules may result in loss of skateboard permit and all skating privileges with no consideration for a refund. I,, have read the rules of skateboarding/inline skating. I understand them and agree to follow them. Signature: Date: Parent/Guardian Signature: (if above participant is ten years old or younger) Residency Status: New Castle Resident Village of Pleasantville Resident Other (name of town)

16 Participants Name: Parent or Guardians Name: Address: Yorktown Parks and Recreation Department Patriot Skate Park Waiver Address: Date of Birth: Grade: (current grade) Age: Home Phone: Emergency Contact Name: Insurance Company & Card #: City: Cell Phone: Phone: SKATER / BIKER MUST READ AND SIGN BELOW! Let s work together to make the Skate Park fun and safe for all participants! I will respect ALL Skate Park visitors, users and staff at ALL times. I will NOT use drugs or alcohol at the Skate Park. I will assist the Skate Park Staff in keeping our Park clean, safe and fun for all users. I will NOT use offensive language or gestures while at the Park. I will NOT do graffiti or damage any property at the Skate Park. I will use the required safety gear at ALL times. Helmet, both elbow pads and both kneepads. I have read and will obey all rules and regulations as listed on reverse side. My skates/skate board/bike will be kept in good condition at ALL times. I will yield to the dedicated activity (Bike vs. Skate). Specified bike/skate hours will be posted. SKATER / BIKER SIGNATURE: DATE: I acknowledge that in-line skating and skateboarding and biking involve risks which could result in physical or emotional injury, paralysis, disability, death to myself or to third parties, as well as property damage. Some of the risks arise from the: (1) nature of the activity; (2) latent or apparent defects in or the condition of equipment or property; (3) use of property or equipment by myself or others; (4) my own acts or omissions or the acts or omissions of other participants; (5) acts or omissions of the Town; (6) my physical condition or the physical condition of others; (7) conditions of the Town facility and surrounding grounds or terrain; and (8) first aid, emergency medical treatment or emergency transportation. I accept and assume all of the risks associated with skate park activities. Note: Attendants are not certified in first aid. I hereby voluntarily release, forever discharge and covenant not to sue the Town of Yorktown, its departments officers, boards, employees and volunteers ( Town ) on behalf of myself, my heirs, assigns, personal representatives and estate with respect to any and all claims, liabilities, demands or causes of action which may arise in connection with my participation in skate park activities, including any claim etc. alleging negligence by the Town. I agree to abide by the Town s Skate Park Rules and Regulations including, but not limited to, the requirement that participants wear specified safety equipment while engaged in skate park activities. I am in good health and have no medical or physical condition which could interfere with my safety in participating in skate park activities. I agree to indemnify and hold the Town of Yorktown, its departments, officers, boards, employees and volunteers harmless from any and all claims, demands, liabilities, damages, causes of action or lawsuits arising from my acts or omissions in participating in skate park activities at Town facilities. I understand that the Town of Yorktown does not provide medical coverage for participants in any programs and that my child or I participate at our own risk. Signature of Participant if over 18: Date: For participants under the age of 18: I (we) the parents/legal guardian of have read, understand and agree to the above statements and hereby consent to him/her participating in the designated program. I have signed this document signifying my agreement and consent. Signature of Parent/Guardian: Date:

17 Patriot Skate Park Rules of the Patriot Skate Park All participants must register and fill out required paperwork. (If under 18, a parent waiver is required.) Users and spectators of this facility assume all risk of personal injury or damage to personal property. The skate park ramps and rails are for use of skateboards, in-line skates and bikes only. All other activities are prohibited. All skaters / bikers must wear a helmet (buckled), elbow pads and kneepads while skating or biking. Hand guards are recommended Additional objects or other material (ramps/jumps) may not be used in the skate park. Abide by staff instructions and park regulations at all times. All skaters / bikers are expected to act in an orderly, safe and considerate manner while in the Skate Park. No snaking. Reckless or dangerous skaters / bikers will be requested to leave the premises. Those who have more than one offense can have their registration temporarily or permanently revoked. All injuries, whether major or minor, are to be reported to the supervisor immediately. In case of serious injury, do not move the injured person; notify the supervisor immediately. Any persons caught skating before or after hours will have their privileges revoked and any monies paid will not be refunded. Daily participants are permitted as long as a parent/guardian is on hand to sign the waiver (if necessary) and pay associated fees. The playing of a radio is not permitted. No tobacco, food, beverage or gum allowed inside the skate park. Alcohol is prohibited. Please keep the surrounding area clean. Throw away your trash in the proper receptacles. Respect others. Share the space. Be respectful of other riders. Ride within your own ability. NO profanity and NO loitering in the skate park at anytime Minimum age for participants is 8 years old unless accompanied by an adult. Shirts must be worn at all times. Participants must provide their own equipment. Park Dismissal Any participant not following the rules of the skate park will be asked to leave the park immediately. First time offenders will receive a verbal warning; second violation will result in suspension of park use. A written report for each violation will be submitted to the Recreation Department. If a suspension occurs, a refund WILL NOT be given, and will be reviewed prior to the start of the next season. Any skate park permit holder found in the park when the park is not open, will have their privileges revoked. Park Hours The Yorktown Parks and Recreation Department will schedule hours of operation. The Yorktown Parks and Recreation Department reserves the right to close the skate park for any reason. The park will be closed during inclement weather. Please call Yorktown Parks and Recreation Department at option #3 regarding park closures.