Amateur athletic waiver and release of liability
If you have previously filled this waiver out in the past, you do not need to fill it out again.
In consideration of being allowed to participate in any way at ROCK & ROPE CLIMBING CENTRE, the undersigned acknowledge, appreciates and agrees that:
1.ASSUMPTION OF RISK: I hereby acknowledge, accept and agree that the sport of rock climbing and the use of ROCK & ROPE CLIMBING CENTRE'S climbing wall involves inherent risks, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist and:
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, assume full responsiblity for my participation and:
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove my self from participation, and bring such to the attention of the nearest official immediately.
4. I, for my self and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless ROCK & ROPE INDOOR CLIMBING CENTRE, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event ("releasees") with respect to any and all injury, disability, death, loss or damage to person or property, whether caused by the negligence of the releasees or otherwise.
I HAVE READ THIS RELEASE OF LIABIBLITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILTY WITHOUT INDUCEMENT.
| Name (please print)__________________________________________ | |
| Date of birth _______________________________________________ | |
| Address ___________________________________________________ | |
| Telephone _________________________________________________ | |
| Emergency Number _________________________________________ | |
| Email address ______________________________________________ | |
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Participants Signature |
Date Signed |
FOR PARTICIPANTS UNDER 18 YEARS OF AGE
This is to certify that I, as parent/guardian with legal responsibilty for this participant, so consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnity the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above.
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Parent/Guardian's Signature |
Date Signed |
HELMET WAIVER - MUST BE SIGNED IF YOU DO NOT WANT TO WEAR A HELMET
(NOTE: ALL CHILDREN AGES 10 AND BELOW, AND SCHOOL GROUPS MUST WEAR A HELMET)
I have been offered a CSA approved helmet, which could have prevented injury in case of an accident. Against the advice of the staff at ROCK & ROPE CLIMBING CENTRE, and the insurance company, I am refusing the critical safety precaution.
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Customer Signature |
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Parent/Guardian's Signature |
Date Signed |