RedPoint Indoor Climbing, Inc.
REQUIRED ASSUMPTION OF RISK, RELEASE OF
LIABILITY, WAIVER OF
PARTICIPANT INFORMATION FOR 2008
Participant’s Full Name
(please print) ________________________________________ Phone Number
________________________ Date of
Birth: _____/_____/______
Mailing
Address_______________________________ City, State, Zip____________________________________
Email address___________________________________
In consideration of being
given the opportunity to participate in climbing activities including but not
limited to climbing, bouldering, belaying, lowering on ropes, and rescue
systems (hereafter referred to as "Climbing Activities") at RedPoint
Indoor Climbing, Inc. (hereafter referred to as “RedPoint”), the right to
engage in technical rock climbing, rock climbing classes, rappelling, other
activities related to rock climbing, which I participate in or any other
activity or service provided to me by RedPoint, under the auspices and
sponsorship of RedPoint as a participant and/or volunteer, and the rate charged
for those services, I for myself, my personal representatives, assigns, heirs
and next of kin:
ASSUMPTION AND ACKNOWLEDGMENT OF RISK
I acknowledge, agree and
represent that I understand the nature of Climbing Activities and that I am
qualified, in good health, and in proper physical condition to participate in
such activities. I acknowledge that
Climbing Activities entail both known and unanticipated risks, seen and unseen,
which could result in emotional or physical injury, paralysis, death, or damage
to property, or to third parties. I understand that such risks cannot be
eliminated without jeopardizing the essential qualities of the activity. These
inherent risks include but in no way are limited to all manner of injury
resulting from participation during Climbing Activities.
I agree to bear full
responsibility for any injury or damage I may suffer while participating in
Climbing Activities. I have no physical or mental limitations which would
preclude my safe use of the climbing walls, climbing equipment, or exercise
equipment, or being in the landing zones (these areas hereafter referred to as
the "Walls") and/or I assume all risks that may be created by such
limitations. I further certify that I am not currently mentally impaired or
under the influence of drugs or alcohol and am otherwise legally competent to
understand and sign this document. I,
the undersigned, recognize the dangers inherent with Climbing Activities. I am
assuming the hazard of this risk upon myself since I wish to climb. I realize I
am subject to injury from this activity and that risks and dangers may arise
from foreseeable or unforeseeable causes to which I am exposing myself or my
minor child. The risks outlined in this document are not exhaustive and I
acknowledge that there may be other risks, hazards, and dangers that, based on
the circumstances, are integral to Climbing Activities.
Initial _______
(If participant is under 18, Parent/Legal Guardian must
initial)
RELEASE,
INDEMNIFICATION AND PROMISE NOT TO SUE
I hereby release, discharge
and covenant not to sue RedPoint Indoor Climbing Inc., its owners,
shareholders, agents, employees, attorneys, legal representatives, successors,
and assigns; and its directors, officers, contractors, representatives,
divisions, subsidiaries, affiliates, other participants in the Climbing Activities,
and all persons and entities acting by, through, under, or in concert with
them, (collectively "Releasees") from all
liability, claims, demands, losses or damages caused or alleged to be caused in
whole or in part by the negligence of any of the Releasees
or otherwise, and I further agree that if despite this release, waiver of
liability, assumption of risk, and indemnity agreement, I, or anyone on my
behalf makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS
each of the Releasees from any litigation expenses,
attorney fees, loss, liability, damage or cost which may incur as a result of
such claim. This release is binding on my heirs, assigns and agents. In the
event that I file a lawsuit against RedPoint Indoor Climbing, Inc., I agree to
do so solely in the state courts located in
Initial _______
(If participant is under 18, Parent/Legal Guardian must
initial)
FACILITY
RULES AND AGREEMENTS
I will comply with ALL
RedPoint rules, both written and as stated to me by RedPoint staff, during my
participation in Climbing Activities. I will obey the RedPoint gym's staff in
regards to those rules as they affect my safety, other participants and
observers, the property of RedPoint, and all resources used in conjunction with
Climbing Activities. I agree and warrant
that I will inspect each portion of the Climbing Activities in which I take
part and that if I find any condition which I consider to be unacceptable,
hazardous or dangerous, I will notify the RedPoint staff and will refuse to
take part in the Climbing Activities until the condition has been corrected to
my satisfaction. I understand that use
of the Walls and/or any instruction I receive at RedPoint Indoor Climbing Inc.
is not sufficient to prepare me for the risks and hazards of outdoor climbing.
Furthermore, I understand that the teaching of rock climbing safety procedures
is not allowed in the facility except by RedPoint staff members. I understand that RedPoint reserves the right
to refuse or terminate service for any reason not discriminatory, at any time.
Furthermore, I hereby give
permission to the physician selected by RedPoint Indoor Climbing, Inc. to
hospitalize, secure proper treatment for, and to order injections, anesthesia
and surgery as needed for me or my child named as "Participant." I do
hereby give consent to RedPoint Indoor Climbing, Inc. to treat an injury
occurring during climbing activities and seek definitive care in it is deemed
necessary. It is my intention to exempt, relieve, and hold harmless RedPoint
Indoor Climbing, Inc. and each of the other released parties from liability for
personal injury, illness, property damage or wrongful death while I am engaged
in this event, even if caused by negligence or any other cause, to the fullest
extent permitted by law. My signature
below indicates that I have read this entire document, understand it
completely, and agree to be bound by all its terms and conditions. Additionally, I give RedPoint Indoor Climbing,
Inc. permission to use in its catalog, brochure, or on its website any picture
in which the likeness of myself and/or my child appears and agree to notify
RedPoint in writing if I contest this practice immediately.
Initial _______
(If participant is under 18, Parent/Legal Guardian must
initial)
I have read this entire
document, fully understand its terms, understand that I have given up
substantial rights by signing it and have signed it freely and without any
inducement or assurance of any nature and intend it to be a complete and
unconditional release of all liability to the greatest extent allowed by law. I
also agree that if any portion of this agreement is held to be invalid,
illegal, or unenforceable, said portion of this agreement shall be deemed
separate, distinct and independent, and shall be ineffective to the extent it (i) invalidates the remaining provisions of the Agreement in
that jurisdiction or (ii) affects the legality, validity or enforceability of
such provision in any other jurisdiction.
By signing this document, I
certify that I am at least 18 years of age and that no other
representations have been made to me that change, alter, or modify anything
within this written agreement. I understand that Climbing Activities are
dangerous. I agree to be bound by its terms. In addition, if the participant
listed in "Participant Information" is under age 18, I state that I
am the parent or legal
guardian of said participant and I agree to each of the above terms on
his or her behalf, and I understand that said participant must sign his or her
own waiver upon turning age 18. I do give permission for my child to
participate in Climbing Activities and I have full and sole responsibility for
the safety and well-being for all minors whom I have invited to the climbing
gym for as long as they are on the premises.
MY PARTICIPATION IS PURELY VOLUNTARY,
AND I CHOOSE TO PARTICIPATE IN FULL VIEW OF THE RISKS.
____________________________________________ _______________________________________________________________ _______________
Printed Name of Participant or
Parent/Legal Guardian Signature
of Participant or Parent/Legal Guardian if Participant is Under
age 18 Today’s
Date
Emergency Contact –
Name________________________________________ Phone #_________________________Relationship
to climber____________________
Received
by ________Emp ___________ date