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Leon Toppin Skateboard Lessons

New York City · Westchester County

Participant Waiver

Assumption of Risk, Waiver of Liability, and Indemnification Agreement

Acknowledgment of Risks: I understand that skateboarding is a physically demanding activity that involves inherent risks, including but not limited to falls, collisions, sprains, fractures, head injuries, and other bodily harm. I acknowledge that these risks exist regardless of the care, caution, and expertise provided by the instructor.

Assumption of Risk: I voluntarily assume all risks associated with participating in skateboard instruction provided by Leon Toppin, including risks that may arise from the condition of the premises, the actions of other participants, or unforeseen circumstances.

Release and Waiver of Liability: In consideration of being permitted to participate in skateboard instruction, I hereby release, waive, and discharge Leon Toppin, his agents, employees, and affiliates from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, or injury, including death, that may be sustained while participating in skateboard instruction or any related activities.

Indemnification: I agree to indemnify and hold harmless Leon Toppin from any loss, liability, damage, or costs, including court costs and attorney fees, that may be incurred due to my participation in skateboard instruction.

Medical Authorization: In the event of an emergency, I authorize Leon Toppin to seek emergency medical treatment for the participant. I understand that I am responsible for any medical costs incurred.

Safety Requirements: I understand that helmets are required for all participants under 18 and strongly recommended for adults. I agree to wear appropriate footwear (closed-toe, flat-soled shoes) and clothing suitable for physical activity.

Photo and Video: Unless I indicate otherwise below, I grant Leon Toppin permission to use photographs and videos taken during instruction for promotional and educational purposes, including on his website and social media accounts.

Participant Information

Participant Full Name

Date of Birth

Email

Phone

Emergency Contact

Emergency Contact Name

Emergency Contact Phone

Medical Conditions or Allergies

Parent / Legal Guardian Name (if minor)

Signature

Participant / Guardian Signature

Printed Name

Date