BMX Registration

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Rider Information

First Name *

Last Name *

Date of Birth *

Address 1 *

Address 2

City *

Country *

Postal Code *

Phone *

Email *

Province / State *

Emergency Contact

First Name *

Last Name *

Phone *

Relation *

BMX Class

Due to our new location and associated space constraints, we will unfortunately be unable to feature a young guns BMX competition at Shake The Lake, this year. Please Be Aware: This straight-line format will happen outdoors and feature a roll in, two of our famous box jumps, and a giant quarter to finish the line off.

Statement of Risks

I am aware of the importance of wearing protective equipment such as elbow/forearm and knee/shim armor when Skateboarding, Inline Skating & BMX Riding. Wearing an approved helmet while Skateboarding, Inline Skating & BMX Riding may be mandatory under provincial law. *

I am aware that Skateboarding, Inline Skating & BMX Riding involved many risks, dangers and hazards. The risks, dangers and hazards, including but not limited to: loss of balance: difficulty or inability to control one's speed and direction; variation or steepness in terrain; rapid or uncontrolled acceleration on hills and inclines; mechanical failure of equipment; variation or changes in the riding surface including rocks, gravel, trees, and man-made structures such as ramps, rails, stairs, pyramids, manual pads, bowls and jumps; travel or transport to and from the sites used for Skateboarding, Inline Skating & BMX Riding; collision with pedestrians, motor vehicles, and cyclists; negligence of other participants; and NEGLIGENCE ON THE PART OF THE RELEASEES, INCLUDING THE FAILURE ON THE PART OF THE RISKS RELEASEES TO SAFEGUARD OR PRO TECT ME FROM THE RISKS, DANGERS, AND HAZARDS OF SKATEBOARDING, INLINE SKATING & BMX RIDING. *

I AM AWARE OF THE RISKS, DANGERS AND HAZARDS ASSOCIATED WITH SKATEBOARD, INLINE SKATING & BMX RIDING AND I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS AND THE POSSIBILITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE OR LOSS RESULTING THEREFROM. *

I hereby declare that I am physically fit. I do not, and have not, suffered from any of the following conditions, which I understand may lead to a dangerous situation with regard to other persons or myself during Skate Park Activities, including but not limited to Skateboarding, Inline Skating & BMX Riding: Epilepsy, fits, severe head injury, recurrent blackouts or giddiness, disease of the brain or nervous system, high blood pressure, lung or heart disease, recurrent weakness or dislocation of any limb, diabetes, mental illness, recent back injury, arthritis, and severe joint sprains, chronic bronchitis, asthma, rheumatic fever, thyroid adrenal or other glandular disorder, recent blood donation or any condition that requires the regular use of drugs. *

In entering into this Release Agreement I am not relying on any oral or written representations or statements made by the Releasees with respect to the safety of participating in Skateboard, Inline Skating & BMX Riding, other than what is set forth in this Release Agreement.I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES. *

Registration Fee

$ 40.00