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Adult Waiver Form - Skateboarding, Bmx Biking Or Inline Skating - Dekalb County Parks And Recreation Department Page 2

4. This Consent Form will remain in effect until the suspension or termination of privileges by the DeKalb

County Parks and Recreation Department for violation of rules and regulations, or until it is revoked in

writing by the undersigned, whichever shall occur first.

5. In the event that I should be injured, I authorize the DeKalb County Parks and Recreation Department

and its officers and employees to take whatever steps may be indicated in their judgment and discretion

to provide first aid and to seek medical attention for me wherein their judgment such is needed, and in

exchange I agree to indemnify them and hold them harmless from any good faith decisions on their part.

6. DeKalb County reserves the right to close the facility or limit the number of persons admitted at any

given time, without refund of any user fee which may be charged.

7. Skate Park Rules and Responsibility Code:

All patrons must complete a signed waiver in order to enter and skate in the park. All patrons

under the age of 18 years of age must have the waiver signed by a parent or legal guardian. All

(youth) waivers must be signed in the presence of the Skate Park staff.

CHILDREN 11 AND UNDER MUST BE ACCOMPANIED BY AN ADULT.

Stay in control. Maintain proper awareness and control of speed. Do not impede or collide

with others. Always skate with the flow of other skaters. Be courteous to others.

Wear safety gear.

HELMETS ARE

MANDATORY. Elbow and knee pads are

recommended. Shirts and shoes are required.

Do not place, drop or throw any object in the path of a patron or on the surface of the Skate

Park.

Alcohol, tobacco and drug use is prohibited in the Skate Park.

No Scooters or Heelies ™.

Food and beverages are allowed only in the concession area. No glass containers.

NO BOOM BOXES.

No pass out.

No metal pegs are allowed on BMX bikes.

No weapons or animals are allowed in the park.

I, the undersigned, acknowledge that I understand and agree to be bound by the above provisions.

____________________________________

___________________________

Adult Participant Signature

Date

Official Use Only

Received by ________________

Adult Waiver Form

07/05/07

Form of ID Verification

Page 2 of 2

_____ State Driver’s License

____ Other (specify)________________

Adult Waiver Form - Skateboarding, Bmx Biking Or Inline Skating - Dekalb County Parks And Recreation Department Page 2