Aegir Boardworks LLC Waiver and Release Form

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I acknowledge that participation in skateboarding carries with it a risk of physical injury. I agree that Aegir and its agents, employees, staff, or any of its assignees or other successors in interest, shall not be liable to me or the student / participant for any injury or damage, whatsoever caused, resulting directly or indirectly from the student or my participation in Aegir's skateboarding lessons at any time preceding, during, or after the lesson is in session.

I hereby discharge and shall indemnify Aegir, its agents, employees, staff, or any of its assignees or other successors in interest, from all actions, claims, and demands the student or I may have for any such injury or damage. All medical expenses incurred will be the responsibility of the participant 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 skateboard lesson.

I authorize Aegir to use all photographs or videos taken of the student or myself during the lesson for advertising and promotional material.

Student's Birthdate
*

Student's Name
*

Parent(s) or Guardian(s) Name(s) *

Parent(s) or Guardian(s) Contact Number(s)
*

Parent(s) or Guardian(s) Email(s) *

Emergency Contact Name and Number
*

Parent(s) or Guardian(s) Signature(s)
*

Date
*

YYYY

How did you hear about our program?
*

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