Ollie World LLC – An Extreme Skate Park

ASSUMPTION OF RISK

WAIVER AND RELEASE OF LIABILITY

* Read Carefully *

* YOU ARE WAIVING IMPORTANT RIGHTS BY SIGNING THIS FORM *

By affixing your signature below you are relinquishing Ollie World, LLC, Tees Golf Center, LLC, Plymouth Industrial Center, Inc. and all of their respective employees, officers, directors, and/or members/shareholders (collectively referred to as “The Companies”) from liability for your (or your child’s) use of the facilities of Ollie World Extreme Sports Park (the “Facilities”). The undersigned has requested permission from “The Companies” to enter upon and use the “Facilities” and in consideration for the Companies’ grant of permission to enter upon and use the “Facilities”, the receipt of such permission is hereby acknowledged, the undersigned participant (or his/her parent or legal guardian if he/she is under the age of 18 years), does hereby release “The Companies”, its agents, successors, and assigns of and from any and all liability, claims, demands, actions, and courses of action whatsoever, arising out of or related to any loss, damages or injury, including death, that may be sustained by the participant, or any property of the participant’s parents or legal guardian, while in, on, upon or near the “Facilities”. Further, the participant or his/her parent or legal guardian agrees to defend, indemnify and hold forever harmless “The Companies”, its successors and assigns against any loss from any and all claims, demands, or actions in law or equity that may hereafter at anytime be made or brought by the participant (be he or she a minor or not) or brought by anyone on behalf of said participant for the purpose of entering a claim for damages on account of any injuries received or sustained in consequence of the participant’s actions or presence at, on or near the “Facilities”.

Skateboarding, rollerblading, biking, skating, spectating or even being present at extreme sports parks; such as Ollie World (the “Facilities”) are inherently dangerous activities including intentional and unintentional contact from other participants. Risk of severe and permanent injury, disfigurement and/or death exists and is beyond the ability of “the Companies” to control. IF YOU DO NOT FULLY UNDERSTAND THE RISKS YOU (OR ON BEHALF OF YOUR CHILD) ARE ASSUMING, DO NOT SIGN THIS FORM, DO NOT ENGAGE IN THIS ACTIVITY AND YOU WILL BE GIVEN A FULL REFUND OF ANY MONIES PAID. IF YOU DO NOT UNDERSTAND ANY OF THE LANGUAGE IN THIS WAIVER, DO NOT SIGN THIS FORM, DO NOT ENGAGE IN THESE ACTIVITIES AND YOU WILL BE GIVEN A FULL REFUND OF ANY MONIES PAID. WE RECOMMEND THAT YOU HAVE AN ATTORNEY ADVISE YOU OF THE IMPORTANT RIGHTS THAT YOU ARE WAIVING.

By signing this waiver you are agreeing that you are fully aware of the risks and hazards involved and inherent in the activities taking place at the “Facilities”, and voluntarily elect to enter (and/or have your child enter) and participate in said activities. You agree that prior to engaging in any activity at the “Facilities” that you have inspected the present conditions of the “Facilities”. For purposes of this waiver, “participating” and/or “engaging in” shall include but not be limited to spectating and/or just being present at the “Facilities”.

This waiver and release shall be binding upon the participant, his/her parents, distributes, heirs, next of kin, successors, assigns and personal representatives. By signing this Assumption of Risk, Waiver and Release form each of the undersigned hereby acknowledge and represents: (1) That the age as stated herein is the participant’s correct age, (2) That both participant and his/her parent/legal guardian are of sound mind; (3) That the participant and his/her parent/legal guardian have read, understand all parts of this form; (4) That the parent/legal guardian is in fact the parent/legal guardian of the participant if under 18 years of age; (5) That the participant or parent/legal guardian has received, read and understands and agrees to be bound by the Rules and Regulations page.

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(Signature) (Date)

(PLEASE PRINT LEGIBLY)

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Participant’s Name

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Parent Or Legal Guardian’s Name COPY VALID DRIVER’S LICENSE HERE

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Street Address, City, State, Zip Code

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Emergency Phone Number

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Email Address