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In consideration for being allowed to participate in Power Skating 100 practice and related activities (collectively "Activities"), on behalf of myself and my next of kin, heirs and representatives, I release from all liability and promise not to sue Michelle Racimo, all Power Skating 100 employees, officers, directors, volunteers, coaches and agents (collectively "Power Skating 100") from any and all claims, including claims of the Power Skating 100's negligence, resulting in any physical or psychological injury (including paralysis and death), illness, damages, or economic or emotional loss I may suffer because of my participation in this Activity, including travel to, from and during the Activity.

I am voluntarily participating in this Activity. I am aware of the risks associated with traveling to/from and participating in this Activity, which include but are not limited to physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and/or death. I understand that these injuries or outcomes may arise from my own or other's actions, inaction, or negligence; conditions related to travel; or the condition of the Activity location(s). Nonetheless, I assume all related risks, both known or unknown to me, of my participation in this Activity, including travel to, from and during the Activity.

I agree to hold Power Skating 100 harmless from any and all claims, including attorney's fees or damage to my personal property, that may occur as a result of my participation in this Activity, including travel to, from and during the Activity. If Power Skating 100 incurs any of these types of expenses, I agree to reimburse Power Skating 100. If I need medical treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.

I am 18 years or older. I understand the legal consequences of agreeing to this document, including (a) releasing Power Skating 100 from all liability, (b) promising not to sue the Power Skating 100, (c) and assuming all risks of participating in this Activity, including travel to, from and during the Activity.

I grant permission to Power Skating 100, its agents, and its employees the irrevocable and unrestricted right to produce photographs and video taken of my child, myself, and members of my family while at a Power Skating 100 event for any lawful purpose including publication, promotion, illustration, advertising, trade, or historical archive in any manner or in any medium by Power Skating 100. I hereby release Power Skating 100 and its legal representatives from liability for any violation or claims relating to said images or video.

Furthermore, I grant permission to use the statements of my child, myself, or my family members given during an interview or evaluation with or without my name for the purpose of advertising and publicity without restriction to time limit or geographic area. I waive my right, my child’s rights, and my family’s rights to any and all compensation stemming from the use of these materials.

I understand that this document is written to be as broad and inclusive as legally permitted. I agree that if any portion is held invalid or unenforceable, I will continue to be bound by the remaining terms. I have read this document, and I am agreeing to it freely. No other representations concerning the legal effect of this document have been made to me.

If Participant is under 18 years of age:

I am the parent or legal guardian of the Participant. I understand the legal consequences of agreeing to this document, including (a) releasing Power Skating 100 from all liability on my and the Participant's behalf, (b) promising not to sue on my and the Participant's behalf, (c) and assuming all risks of the Participant's participation in this Activity, including travel to, from and during the Activity. I allow Participant to participate in this Activity. I understand that I am responsible for the obligations and acts of Participant as described in this document. I agree to be bound by the terms of this document. I have read this document, and I am agreeing to it freely. No other representations concerning the legal effect of this document have been made to me.