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WARNING: All activities or sports associated with an indoor bouldering facility and with training equipment and training programs (herein referred to as « activity ») present elements of considerable risk. Although we have taken serious measures to provide you with appropriate instructions for you to practice an activity with which you might not be completely familiar, we wish to remind you that this activity is not risk-free. Indeed, some risks cannot be eliminated without destroying the unique character of the activity. Elements that contribute to making this activity unique could cause loss or damage to your material, accidental injury, sickness or in extreme cases, permanent trauma or death. We do not wish to scare you or reduce your enthusiasm towards the activity but we believe it important that you know beforehand what is involved and make you aware of inherent risks. 


RISK ACKNOWLEDGMENT 

I UNDERSTAND THAT THE FOLLOWING ELEMENTS DESCRIBE SOME AND NOT ALL THE RISKS OF INDOOR CLIMBING, AND OF PHYSICAL TRAINING: 

  1. Sliding, tripping, falling or collapsing painfully while using the installations, material, climbing walls, floors, training area, change rooms or stairs; 
  2. Incorrect usage of the material, installations, or equipment failure;
  3. Suprise falls due to an incorrect position, incorrect spotting or an unsuspected loss of control!; 
  4. My health, my physical strength, my coordination, my balance and my ability to follow or to give directions while climbing or performing physical training might not be enough to safely practice indoor climbing; 
  5. Fatigue, shivers, and drowsiness that can reduce reaction time and increase potential risk; 
  6. Scratches caused by equipment or the structures; 
  7. Presence, actions or falls of other participants; ​


I UNDERSTAND THAT THIS IS NOT AN EXTENSIVE DESCRIPTION AND THAT OTHER UNKNOWN RISKS COULD CAUSE INJURY, SICKNESS OR DEATH. 

I AGREE TO PLAY AN ACTIVE ROLE IN RISK MANAGEMENT BY HAVING A PREVENTIVE ATTITUDE TOWARDS MYSELF AND TOWARDS OTHERS AROUND ME. 


HEALTH AND PHYSICAL CONDITION 

I hereby state that I am in good physical condition and that I have no personal health problem preventing me from participating in the activities offered at Klimat. I agree to disclose any physical or mental condition that could have an impact on my safety or the safety of others. 


RISK AGREEMENT 

I accept all risk of physical injury, accidents or sickness, including sprains, tears, fractures, eye problems, cuts, scratches, contusions, dehydration, lack of oxygen, vertigo, head, neck or spinal trauma, lung problems, nervous breakdown, paralysis and-or death. 


I TAKE FULL RESPONSIBILITY FOR CHOOSING MY SPOTTING PARTNER. 


RULES AND REGULATIONS AGREEMENT 

I hereby agree to have understood and accept to respect and follow the Klimat rules and regulations. A copy is posted in the facility. I have read it and understand it. Klimat and its representatives reserve the right to refuse or withdraw access to its facility to anyone displaying dangerous conduct regarding indoor climbing safety or any participant who refuses to abide by the Klimat rules and regulations. 


HELMET 

Helmets are not required in bouldering facilities , but I hereby assume all responsibility for any or all head injuries that may occur during my visit.


CHILDREN CLIMBERS AND VISITORS 

I hereby state that the child for which I am signing is truly my own biological child, or that I am truly the legal guardian. I agree to follow the rules and regulation that I have read and understood when I am in presences of children at Klimat as a climber and as a host. 


FALLING AND SAFETY ORIENTATION 

I UNDERSTAND THAT FOR EVERYONE'S SAFETY, I MUST PARTICIPATE IN A SAFETY ORIENTATION BEFORE MY CLIMBING ACTIVITY. 


I UNDERSTAND THAT I MUST RESPECT MY OWN BODY AND ABILITIES WHEN CHOOSING A CLIMBING HEIGHT. 



GENERAL AGREEMENT 

I hereby state that I have read and understood the risk acknowledgment form presented. OF MY OWN FREE WILL, I ACCEPT ALL THE RISKS AND DANGERS PREVIOUSLY MENTIONED. And I accept to respect the rules and regulations of Klimat. 

DATE: November 21, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Gender*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Gender*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Gender*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Gender*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Gender*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Gender*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Gender*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Gender*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Gender*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Gender*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive news and updates.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Please complete the following with "Yes I understand":

that in order to increase my safety, I must practice falling by increasing fall height progressively. *

that for my safety, I must participate in a short orientation with a Klimat staff before climbing. *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Gender*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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