By submitting this form, the undersigned acknowledges that participation in the Pawtucket & Providence FSC Learn to Skate USA Program involves risks that may include permanent injury. While caution on the part of the skater and use of protective gear may reduce this risk, the chance of serious injury is within the realm of possibility. PPFSC reserves the right to refuse admission to or dismiss from its program any skater whose conduct is disruptive or poses a danger to the safety of others. The undersigned acknowledges and accepts these risks and agrees to hold harmless the Pawtucket & Providence Figure Skating Club as well as its directors, officers, agents and rink employees in so far as the laws of the State of Rhode Island permit.  By checking the box, you accept the stated risks and limitations and must be at least 18 years of age. For minors under the age of 18, a parent or guardian must accept the risks and limitations for their child. The act of checking the box below represents a binding legal contract.

I, by checking the box below, as parent/guardian of the skater named in this registration, hereby grant the Pawtucket & Providence Figure Skating Club and all persons acting with its permission, the right to take and use Model’s photograph/performance for advertising, promotion or any lawful purposes.