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Release of Liability Waiver

Required for participation in all Clintonville Roller Club events

RELEASE OF LIABILITY AND ASSUMPTION OF RISK

The individual named below (referred to as "I" or "me") desires to participate in roller skating and all related activities (the "Activity") at events organized and/or hosted by the Clintonville Roller Club, a community roller skating organization based in Columbus, Ohio (the "Club"), at various venues throughout Columbus, Ohio and surrounding areas. In consideration of being permitted by the Club to participate in the Activity and in recognition of the Club's reliance hereon, I agree to all the terms and conditions set forth in this instrument (this "Release").

I AM AWARE AND UNDERSTAND THAT THE ACTIVITY IS A POTENTIALLY DANGEROUS ACTIVITY AND INVOLVES THE RISK OF SERIOUS INJURY, DISABILITY, DEATH, AND/OR PROPERTY DAMAGE. I ACKNOWLEDGE THAT ANY INJURIES THAT I SUSTAIN MAY RESULT FROM OR BE COMPOUNDED BY THE ACTIONS, OMISSIONS, OR NEGLIGENCE OF THE CLUB, INCLUDING NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF THE CLUB. NOTWITHSTANDING THE RISK, I ACKNOWLEDGE THAT I AM VOLUNTARILY PARTICIPATING IN THE ACTIVITY WITH KNOWLEDGE OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS OF INJURY, DISABILITY, DEATH, AND/OR PROPERTY DAMAGE ARISING FROM MY PARTICIPATION IN THE ACTIVITY, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF THE CLUB OR OTHERWISE.

I hereby expressly waive and release any and all claims, now known or hereafter known, against the Club, and its officers, directors, managers, employees, agents, affiliates, members, successors, and assigns (collectively, "Releasees"), arising out of or attributable to my participation in the Activity, whether arising out of the ordinary negligence of the Club or any Releasees or otherwise. I covenant not to make or bring any such claim against the Club or any other Releasee, and forever release and discharge the Club and all other Releasees from liability under such claims.

I hereby consent to receive medical treatment deemed necessary if I am injured or require medical attention during my participation in the Activity. I understand and agree that I am solely responsible for all costs related to such medical treatment and any related medical transportation and/or evacuation. I hereby release, forever discharge, and hold harmless the Club from any claim based on such treatment or other medical services.

I hereby consent and agree that the Club may take photographs or digital recordings of me as a participant of the Activity and use such photographs or digital recordings for marketing and promotional purposes. I understand that there will be no financial or other remuneration for the Club's use of my image for marketing or promotional purposes.

I hereby consent and agree that the Club may use any contact information I provide to contact me for marketing, advertisement, and promotional purposes via text message, email, or other forms of communication. I acknowledge that I will be provided the opportunity to opt-out of such promotional communication.

This Release constitutes the sole and entire agreement of the Club and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter. If any term or provision of this Release is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Release or invalidate or render unenforceable such term or provision in any other jurisdiction. This Release is binding on and shall inure to the benefit of the Club and me and their respective successors and assigns. All matters arising out of or relating to this Release shall be governed by and construed in accordance with the internal laws of the State of Ohio without giving effect to any choice or conflict of law provision or rule (whether of the State of Ohio or any other jurisdiction). Any claim or cause of action arising under this Release may be brought only in the federal and state courts located in Franklin County, Ohio and I hereby consent to the exclusive jurisdiction of such courts.

GUEST INFORMATION

GUEST SIGNATURE

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ELECTRONIC SIGNATURE CONSENT

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