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<br />Informed Consent/Liability Waiver Form <br />For the City/Town of <br /> <br />In consideration for being permitted to use the City/Town of <br />'s skate park, the undersigned, on behalf <br />of himself/herself and his/her heirs, successors, representatives, and assigns, <br />hereby expressly exempts and releases, and agrees to indemnify and hold <br />harmless, the City/Town, its officers, employees, insurers, and self-insurance <br />pool, from and against all liability, claims and demands, which are incurred, <br />made, or brought by him/herself or any other person or entity, on account of <br />damage, loss, or injury, including without limitation, claims arising from property <br />loss or damage, bodily injury, personal injury, sickness, disease, death, or any <br />other loss of any kind whatsoever, which arises out of, or in any manner <br />connected with, the use of the skate park. <br /> <br />Signature: <br /> <br />Date: <br /> <br />Signature or Parent or Guardian (if you are under 18 years old): <br /> <br />Date: <br /> <br />Parks & Ree 2001 <br /> <br />-135- <br />