Untitled - LFCC Celebrity Skate Night

VENDOR WAIVER & DISCLAIMER
ph. 248.436.1158 | registration@jstallworthevents.com
Laborers for Christ Ministries, J. Stallworth Events, NT Design Solutions and Skateland West highly recommend
the use of personal protective equipment (which include but are not limited to: wristguards, helmets, knee & elbow pads, etc.) during skating activity. Wearing protective equipment will greatly reduce the chance of injury due
to a fall /collision. Laborers for Christ Ministries, J. Stallworth Events (DEJ), NT Design Solutions nor Skateland
West, accepts any responsibility for injury caused by a fall /collision which would have otherwise not occurred if
protective equipment had been worn.
Persons using their own skates, materials (such as banners, table clothes, signage etc.) and equipment are responsible for the maintenance and upkeep of such, and Laborers for Christ Ministries, J. Stallworth Events, NT Design
Solutions and Skateland West cannot be held responsible for any accidents, loss, damage or injury caused by such
skates, materials, and equipment to yourself or a third party. Laborers for Christ Ministries, J. Stallworth Events,
NT Design Solutions and Skateland West reserve the right of admission and to remove persons from the venue
for any reason including behaviour likely to cause damage, injury, nuisance or annoyance, or for failure to comply with the reasonable requests of Laborers for Christ Ministries, J. Stallworth Events, NT Design Solutions and
Skateland West representatives staffing the Event. Refunds will not be granted due removal from premises for
misconduct, or behaviour which endangers the livelihood of other persons.
People skating at this venue do so entirely at their own risk and Laborers for Christ Ministries, J. Stallworth
Events, NT Design Solutions and Skateland West can not be held responsible for any accidents caused by in house
structures, objects, or by the actions of other skaters. Laborers for Christ Ministries, J. Stallworth Events, NT Design Solutions and Skateland West are not responsible for any loss, injury or damage, howsoever caused, to yourself or third party, your property or clothing.
It is highly recommended that event attendees/participants do not take part in skating activity if they suffer from
high blood pressure, heart, back or neck problems, brittle bones, joint injuries or any other condition that could be
aggravated by this activity.
If you are, or suspect you are pregnant you should not take part in this activity.
WAIVER & RELEASE OF LIABILITY, ASSUMPTION OF RISK AND/OR PARENTAL CONSENT
AND INDEMNITY AGREEMENT
In consideration of being allowed to participate in the CELEBRITY SKATE Night/Skating Competition Saturday June 22, 2013 at
The Westland Skateland West arena, the undersigned agrees:
1. I, the undersigned, do affirm the registration information above is correct and truthful and hereby make application to the Laborers for
Christ CELEBRITY Skate Night and associated Skating Competition “Skate Off” for amateur registration with which to identify myself
at sanctioned competitions, exhibitions and other appropriate occasions.
I further agree to abide by the rules and regulations of CELEBRITY Skate Night and associated Skating Competition “Skate Off” during
the terms of this registration and agree to observe the Amateur Code of Conduct, in spirit as well as in letter, upholding the high ethics of
amateur roller skating.
2. I understand dangers may be caused by my own actions, or inactions, the actions or inactions of others participating in these activities.
I understand the nature of CELEBRITY Skate Night and associated Skating Competition “Skate Off”activities and believe that I (or my
minor child) am/are qualified and physically fit to participate in roller skating competitions and practices. I further acknowledge that I am
aware that the activity will be conducted in facilities open to the public. As a skater, coach, parent or legal guardian, I further agree and
warrant that prior to participating in any event I will inspect the facilities to be used and if believing conditions to be unsafe, I will immediately advise my coach or the meet director of this condition and refuse to participate unless corrected.
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VENDOR WAIVER & DISCLAIMER
ph. 248.436.1158 | registration@jstallworthevents.com
3. I fully understand that Laborers for Christ & CELEBRITY Skate Night and associated Skating Competition “Skate Off” activities
involve risks and dangers of serious bodily injury, including permanent disability, paralysis and death, and economic losses which might
result not only from a skater’s actions, inactions or negligence, but the action, inaction, or negligence of others, the rules of competition,
or the condition of the premises or any equipment in use. I fully accept and assume all such risks and responsibilities for losses and costs
and damages incurred as a result of my participation in CELEBRITY Skate Night and associated Skating Competition “Skate Off” activities or arising out of my traveling to or returning from such activities or practice sessions.
4. I hereby release, discharge, covenant not to sue, and agree to hold harmless Laborers for Christ/CELEBRITY Skate Night and
associated Skating Competition “Skate Off”, their administrators, directors, agents, officers, volunteers and employees, other
participants, any sponsors, advertisers, and where applicable, owners and lessors of premises and their employees on which the activity
takes place (collectively “Releasees”), from all liability, claims, demands, losses, or damages caused or alleged to be caused in whole or
in part by the Releasees. I further agree that if a claim is made against any of the Releasees that arises out of or in any way relates to my
participation or involvement in a Laborers for Christ/J.Stallworth Event/NTDS/Skateland West activity or event, I, AND THE PARENT
OR GUARDIAN SIGNING ON BEHALF OF A MINOR, AGREE TO INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF
THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY’S FEES, LOSS, LIABILITY, DAMAGE, OR ANY COSTS
INCURRED AS A RESULT OF ANY SUCH CLAIM. I have read this agreement and fully understand its terms, understand that I have
given up
substantial rights by signing it, and have signed it freely and without any inducement or assurance of any nature and intend it to be a
complete and unconditional release of all liability to the greatest extent allowed by the law and agree that if any portion of this agreement is held to be invalid that the balance, not withstanding, shall continue in full force and effect. We acknowledge our responsibility to
deliver this participation/eligibility form to Laboreres for Christ Ministries/J. Stallworth Events/NTDS/Skateland West and CELEBRITY
SKATE Night before insurance benefits associated with this are effected.
By signing this disclaimer you agree to waive all your rights to pursue any form of claim of compensation against Laborers for Christ
Ministries/J. Stallworth Events/NT Design Solutions and/or Skateland West.
Printed Name of Participant (team/league coach or authorized guardian):_____________________________________________
Signature of Participant Date: _______________________________________________________________________________
Printed Name of Parent or Legal Guardian: ____________________________________________________________________
(For Minor Child{ren} each minor child requires a signed and dated disclaimer and release)
Signature of Parent(s) or Legal Guardian: _____________________________________________________________________
Date: ____________________________________________
Laborers for Christ annual Family Skate Night, themed CELEBRITY SKATE
Saturday June 22, 2013
from 7:30pm - 11:30pm
Forward to: Laborers for Christ: CELEBRITY SKATE FAX to: 248.415.6302 (fx)
Subject Line: CELEBRITY SKATE NIGHT
19785 W. 12 Mile Rd. #493
Southfield, MI 48076 Subject Line: CELEBRITY SKATE NIGHT
EMAIL to: registration@jstallworthevents.com
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248.436.1158 registration@jstallworthevents.com
VENDOR COMMITMENT SHEET
Name___________________________________________________
Company ________________________________________________
Phone___________________________________________________
Email ____________________________________________________
Amount Enclosed: $________________________
PAY PAL OPTIONS AVAILABLE link: labourers4christ@gmail.com
Indicate which contributor option you would like your proceeds to be allocated toward on the online form.
Also indicate your company/business/organization name on the online form.
Yes, I/my organization would like to be a Sponsor/Contributor/Supporter of Laborers for Christ
annual Family Skate Night, themed CELEBRITY SKATE Saturday June 22, 2013 7pm-11pm
at Skateland WEST (37550 Cherry Hill Rd, Westland, Michigan 48185).
Please include us as a: (indicate by checking the box)
EVENT SPONSOR
$ 400
Vendor Booth Participant $ 150
Ticket Purchaser
o Adult Ticket $ 15 Qty. _______ Total: $ __________
o Child Ticket $ 15 Qty. _______ Total: $ __________
In-Kind Donator $ ______
List items to be donated & its retail value: (ie. Gift Certificates, children’s give a ways, etc.)
PAY PAL OPTIONS AVAILABLE
labourers4christ@gmail.com
Indicate which contributor option you would like your
proceeds to be allocated toward on the online form.
Also indicate your company/business/organization name
on the online form.
All Commitment Forms & Associated Payments
MUST be submitted in full by Monday June 17th.
Fax Form to: Celebrity Skate Night
(fax) 248.415.6302
Mail Form to: Laborers for Christ Celebrity Skate
19785 W. 12 Mile Rd. #493
Southfield, MI 48075
Make Checks Payable to: Labourers For Christ Church
Value: $_____________________________ Value: $ ___________________________
Indicate on Memo:
Family Skate Night