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Village Skatepark ATL
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Village Skatepark ATL
Family Ride Waiver
Parent / Guardian / Chaperone
First Name
Last Name
Email
Date of Birth
I am 18 years old or older.
Phone
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Zip Code
FAMILY/GROUP MEMBERS
First Name
Last Name
Grade
Date of Birth
Discipline
BMX
SKATEBOARD
SCOOTER
INLINE / ROLLER SKATES
VOLUNTEER
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Upload supported file (Max 15MB)
Please list any special needs, allergies, etc.
First Name
Last Name
Grade
Date of Birth
Discipline
BMX
SKATEBOARD
SCOOTER
INLINE / ROLLER SKATES
VOLUNTEER
Snap a Selfie for our records!
Upload File
Upload supported file (Max 15MB)
Please list any special needs, allergies, etc.
First Name
Last Name
Grade
Date of Birth
Discipline
BMX
SKATEBOARD
SCOOTER
INLINE / ROLLER SKATES
VOLUNTEER
Snap a Selfie for our records!
Upload File
Upload supported file (Max 15MB)
Please list any special needs, allergies, etc.
First Name
Last Name
Grade
Date of Birth
Discipline
BMX
SKATEBOARD
SCOOTER
INLINE / ROLLER SKATES
VOLUNTEER
Snap a Selfie for our records!
Upload File
Upload supported file (Max 15MB)
Please list any special needs, allergies, etc.
Initials
I declare that the info I’ve provided is accurate & complete.
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program. This release applies to Parcel 44, Bonfire ATL LLC, Atlanta Indie Market LLC, Tsohai Productions LLC and Tenth Street Ventures LLC, and Village Skatepark ATL
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