SHADYSKATES

 
Online Ramp Club Application

7501 Penn avenue
 Pittsburgh Pa 15208
 tel: 412.731.5400 fax: 412.731.5408

  Yearly membership: $30.00 Six Month Membership: $20.00 Session with membership: $7.00 Session
                    without membership: $15.00 Ten day pass for members: $50.00

MEMBERS MUST BRING THEIR MEMBERSHIP CARD EVERY TIME THEY SKATE.

Safety Equipment Rental:$2.00 for helmet, $2.00 for knee pads, $2.00 for wrist guards, $2.00 for elbow pads

MEMBERS WHO REFUSE TO WEAR SAFETY EQUIPMENT WILL BE EJECTED FORM THE FACILITY.


PLEASE PRINT

Member Name_____________________________________________________________

Address__________________________________________________________________

City______________________________________State__________________Zip_______

Home Phone ( ____ ) _______________________ Day Phone ( ____ )________________

Birthday __________________________________

Today's Date ______________________________

PLEASE CIRCLE ONE : INLINE SKATEBOARD

RELEASE FORM
Due to the nature of skating, it is understood that I release ShadySkates, it's employees, agents, and servants, from all liability of any sort, and that they be held harmless and indemnitfied for any accident or injuries sustained by me/my child while skating at ShadySkates (Please intial)X___________________________________________________________________________

In the event of injury, all possible attempts will be made to notify the parent of guardian of minors. Signatures not executed on the premises are subject to verbal verification

Signature.X________________________________________________________________________
PARENT OR GUARDIAN NAME (PLEASE PRINT)

_________________________________________________________________