Form Builder

children playing on splashpad

Adult Waiver for Minor Participant in Power Skating 

Acknowledgement and assumption of risk

I am the parent/guardian having full legal responsibility for decisions regarding my minor child/ward.

I am familiar with and accept, on behalf of myself and my minor child/ward that there is a potential risk for injury involved in the training and participation of any physical activity. I further understand and agree on behalf of myself and my minor child/ward that when participating in Power Skating Instruction Lessons and Programs there is a potential for injury. I freely accept and fully acknowledge all such risks, dangers and hazards, resulting from my minor child/ward participating in any event hosted or instructed by Karen Bulger.

I have read and understand the above statement of risk and on behalf of myself and my minor child/ward I assume responsibility for the safety of my minor child/ward, and I understand and accept the risks involved with his/her participation.

Protective equipment

I have been advised that my child/ward requires to wear all protective equipment, that being full hockey gear, while participating in the Power Skating Lessons/Programs.

Release, waiver and indemnity agreement

I confirm that I have read and understood this release agreement prior to signing it, and I am aware that by signing this Release Agreement I am waiving certain legal rights which my minor child/ward, his/her Heirs, Next of Kin, Executors, Administrators, Assigns and Representatives may have against the Releases.

Photo waiver

During the course of programs or activities photos, audio, or video may be taken by the City of facilities and participants. The City of Peterborough reserves the right to use all materials it captures for promotional purposes.

Completion of this waiver does not guarantee your space in the program. You must complete the online registration.