Skate Molton CIC Mebership Sign up

Name *

Surname *

Date of Birth *

Address *

Postcode *

Parent\Guardian Name (if under 18)

Your Phone *

Your Email

Emergency Contact Name *

Emergency Contacts Number *

Any Medical Conditions?

Signed (Member) *

Signed (Parent\Guardian if under 18)

Photo Waiver - are you happy to have photos taken? *

Do you accept our Code of Conduct? *

View the Code of Conduct

Parent\Guardian accept Code of Conduct? (if member is under 18)

View the Parent Code of Conduct

Skate and Event waiver - Skate at your own risk! *

I hereby authorize the staff of Skate Molton CIC to act for me according to their reasonable judgment in any emergency requiring medical attention. I acknowledge that participation in athletics carries with it a risk of physical injury, I agree that Skate Molton CIC, its agents, employees, staff, or any of its assignees or other successors in interest, shall not be liable to me or the member for any injury or damage, whatsoever caused, resulting directly or indirectly from the member or my participation in Skate Molton CIC events and sessions at any time preceding, during, or after the event and\or sessions and I hereby discharge and shall indemnify Skate Molton CIC, its agents, employees, staff, or any of its assignees or other successors in interest, from all actions, claims, and demands the member or I may have for any such injury or damage. All medical expenses incurred will be the responsibility of the participant\member or the participant’s parent or guardian. I have no knowledge of any physical or mental impairment that would affect the student’s or my participation in the events and\or sessions.

No matter how careful the participants and the instructors\Skate Molton CIC Staff are, no matter what safety equipment is used and worn, and what precautions are taken, there is an inherent risk that cannot be eliminated. The risk of injury includes minor injuries such as bruises, scrapes, and more serious injuries such as broken bones, dislocations, sprains, and catastrophic injuries such as permanent paralysis or even death due to falls on the back, neck or head.

By completing this membership\waiver form you accept that no matter the precautions taken by Skate Molton CIC that taking part in any of our events, anywhere, is entirely at your own risk and if completing for children under 18 that they are your responsibilty.

Membership\Skate Waiver Signup