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Participation, Release of Liability, Assumption of Risk, and Indemnification Agreement

THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS.

READ ENTIRE DOCUMENT BEFORE SIGNING.

EVERYONE entering facility must complete this form.

In consideration of the services, activities, and equipment (collectively, the “Facilities”) provided by the Source Climbing Center, LLC, its agents, owners, landlord, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (collectively, “SOURCE”), I hereby agree and acknowledge as follows, on behalf of myself and my children, parents, spouse or partner, heirs, assigns, personal representative, and estate:

1. VOLUNTARY PARTICIPATION:  I have voluntarily chosen to participate in climbing and non-climbing activities including the use of fitness and conditioning equipment (collectively, the “Activity”) occurring at the SOURCE’s facility in Vancouver, Washington.  I understand the Facilities are private and recreational in nature, and I have chosen voluntarily to use the Facilities over other recreational opportunities available to me.  

2. RISKS and ASSUMPTION OF RISKS:

  • the Activity is inherently dangerous, and I may be exposed to dangers and hazards that are both apparent and not apparent, including but not limited to: falls; twists; fractures; concussions; overexertion; injuries from my lack of fitness or conditioning; paralysis; death; equipment failures; emotional injury; damage to me, to property, or to others; and negligence of others including SOURCE;
  • as a consequence of these risks, I may be seriously hurt or disabled or may die from the resulting injuries, and my property may also be damaged; and
  • SOURCE assumes no responsibility for providing medical care at their facility or during any Activity, and I will have to pay for any medical care that I may require.
  • I hereby freely assume responsibility for my voluntary use of the Facilities even though there are risks, and the risk of any harm, injury, or loss that may occur to me, my property, others, and the property of others as a result of my participation in the Activity, including any injury or loss caused by the ordinary negligence of SOURCE.  I also understand that I use at my own risk any equipment that I provide, or may borrow or rent from SOURCE or any other provider, and that any such equipment is provided without any warranty about its condition or suitability.  

3. MEDICAL INSURANCE AND CONDITIONS:  I certify that I have adequate insurance to cover any injury ‎or damage I may cause or suffer while using the Facilities and that I have no medical or physical ‎conditions which could limit or interfere with my use of the Facilities.  I agree to assume and bear the ‎costs of any injury or damage if not covered by insurance and of all consequences and risks that may be ‎created, directly or indirectly, by any personal medical or physical condition that could limit or interfere ‎with my use of the Facilities.‎

4. RELEASE OF LIABILITY:  For any and all claims, demands, or causes of action (“Claims”) that in any way arise out of or are ‎connected with the Facilities, my use of the Facilities, and any alleged ordinary negligence of SOURCE, I—on ‎behalf of myself and my children, parents, spouse or partner, heirs, assigns, personal representative, and ‎estate—to the extent permitted by law, hereby: (a) voluntarily release SOURCE from such Claims; and (b) ‎covenant not to sue or make any Claims against SOURCE (whether in court or in arbitration). The terms of ‎this Section do not extend to Claims based on gross negligence or reckless or intentional misconduct.‎

5. INDEMNIFICATION, HOLD HARMLESS, AND DEFENSE:  I AGREE TO INDEMNIFY, HOLD HARMLESS, AND DEFEND SOURCE against: (a) any and all claims that in any way arise out of or are connected to the Facilities, my use of the Facilities, and any alleged ordinary negligence of SOURCE; (b) against any and all claims for my own negligence; and (c) any other claim arising from my use of the Facilities.  I will reimburse SOURCE for any damages, reasonable settlements, and defense costs, including attorneys’ ‎fees, that it incurs because of any such claims made against it.  ‎I agree that in the event of my death or disability, the terms of this agreement, including the indemnification obligation in this Section, will be binding on my estate and my personal representative, executor, administrator, or guardian will be obligated to respect and enforce them.

6. RULES AND TRAINING:  I agree to abide by SOURCE’s rules and directions while using the Facilities.  I recognize that it is my responsibility to learn how to use correctly the gear, anchors, ropes, autobelay systems, and all other equipment used during the Activity.  I will demonstrate proper use of this equipment, and my ability to tie a “figure-of-eight knot,” to a SOURCE employee before participating in belaying another climber.  I agree that people who use equipment incorrectly are menaces to themselves and others.  I AGREE TO USE ALL OF THE PROTECTIVE GEAR that I am instructed to use.  I understand that using the Facilities may require strength, endurance, and agility, and I will refrain from ‎or stop any activity that I believe is beyond my abilities.  I acknowledge that climbing while impaired—‎either from alcohol, controlled substances, or anything else that could affect my ability to climb safely—is ‎strictly prohibited and I agree to not climb while impaired.‎

7. USE OF MY LIKENESS: I understand that I may be photographed and/or audio and video recorded during the Activity. I irrevocably grant SOURCE and its assigns permission to use and publish (including by electronic means) such likeness of me, in whole or part, in any form, and I assign all rights of copyright, property, publicity, privacy or pre-approval that I have for any such likeness of me and to use my name, voice, photograph or likeness for any lawful purpose..

8. DISEASES:  I am aware of the contagious nature of bacterial and viral diseases including but not limited to the 2019 novel ‎coronavirus disease (also known as COVID-19) (collectively, “Diseases”) and the risk that I may be ‎exposed to or contract such Diseases by using the Facilities.  I understand and acknowledge that such ‎exposure or infection may result in serious illness, personal injury, permanent disability, death, or ‎property damage.  I acknowledge that this risk may result from or be compounded by the actions, ‎omissions, or negligence of others, including SOURCE.  I understand that while SOURCE may take measures to ‎reduce the spread of the Disease, it cannot guarantee that I will not become infected while using the ‎Facilities and that using the Facilities may increase my risk of contracting such Diseases.  I understand ‎that if requested, SOURCE will cooperate with governmental agencies to provide them (or their agents) with ‎information about such Diseases, which may include providing my name and contact information to such ‎authorities, and I agree to SOURCE sharing such information. ‎

NOTWITHSTANDING THE RISKS ASSOCIATED WITH SUCH DISEASES, I ACKNOWLEDGE THAT I ‎AM VOLUNTARILY USING THE FACILITIES WITH KNOWLEDGE OF THE DANGER INVOLVED AND ‎THAT THE RELEASE OF LIABILITY AND INDEMNIFICATION PROVISIONS IN SECTION 4 AND 5 ‎ABOVE WILL APPLY TO ANY CLAIM THAT I CONTRACTED A DISEASE WHILE USING THE ‎FACILITIES OR WHILE INTERACTING WITH ANYONE ELSE USING THE FACILITIES.‎

9. SEVERABILITY:  I agree this agreement shall be an enforceable RELEASE OF LIABILITY AND INDEMNITY as broad and inclusive as permitted by Washington law.  I agree that if any portion or provision of this agreement is found to be invalid or unenforceable, then the remainder will continue in full force and effect.  I also agree that any invalid provision will be modified or partially enforced to the maximum extent permitted by law.

10. CHOICE OF LAW, FORUM, AND ATTORNEYS’ FEES:  This agreement is governed by and shall be construed in accordance with the laws of the State of Washington, without any reference to its choice of law rules.  I agree that any dispute arising from this agreement or in any way associated with the Activity shall be brought only in the Superior Court of Clark County, Washington, or in the U.S. District Court for the Western District of Washington, and I agree to the jurisdiction and venue of those courts for any such dispute.  In any litigation in which the validity or enforceability of this agreement is contested, I agree that the non-prevailing party will pay all attorneys’ fees and costs of the parties seeking to uphold the agreement. 

I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS AGREEMENT BY READING ALL OF IT BEFORE SIGNING IT.  NO ORAL STATEMENTS HAVE BEEN MADE TO ME WHICH PURPORT TO MODIFY THE TERMS OF THIS AGREEMENT.  NO PROMISES OR OTHER INDUCEMENT TO SIGN THIS RELEASE HAVE BEEN MADE APART FROM WHAT IS CONTAINED IN THIS DOCUMENT.  I UNDERSTAND THIS IS A CONTRACT THAT AFECTS MY LEGAL RIGHTS AND I SIGN IT OF MY OWN FREE WILL AND AGREE TO BE BOUND BY ALL OF ITS TERMS. 

I Agree

First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent/Court-Appointed Legal Guardian Email Address

Email*

Confirm Email*
Check to receive monthly information and news by e-mail. If unchecked, customer will still receive critical account related notifications.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
In consideration of the minor child being permitted to participate in the Activity, I accept and agree to the full contents of this agreement. I ALSO AGREE TO RELEASE, HOLD HARMLESS, INDEMNIFY, AND DEFEND the Released Parties (defined in Section 3) from all liabilities and claims that arise in any way from any injury, death, loss, or harm that occurs to the minor child during the Activity or in any way related to the Activity. This includes any claim of the minor and any claim arising from the negligence of the Released Parties. I understand that nothing in this agreement is intended to release claims for gross negligence, intentional, or reckless misconduct, or any other liabilities that Washington law does not permit to be excluded by agreement.


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/Court-Appointed Legal Guardian Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent/Court-Appointed Legal Guardian Date of Birth*
Parent/Court-Appointed Legal Guardian 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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