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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.

1. ACTIVITY AND ASSOCIATED RISKS: I have voluntarily chosen to participate in climbing and non-climbing related activities including the use of fitness and conditioning equipment (hereinafter referred to as the “Activity”) occurring at the Source Climbing Center, LLC’s facility in Vancouver, Washington. Source Climbing Center, LLC, a Washington limited liability company, shall be hereinafter referred to as “SOURCE.”

I understand that:

  • the Activity is inherently hazardous, and I may be exposed to dangers and hazards, including but not limited to the following: falls, fractures, concussions, overexertion, injuries from my lack of fitness or conditioning, paralysis, death, equipment failures, and negligence of others;
  • 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.

In consideration of the SOURCE's permission to participate in the Activity, I agree to the terms contained in this document.
 
2. ASSUMPTION OF THE RISKS: I hereby freely assume the above-mentioned risks as well as any other risks not listed that are part of the Activity, and the risk of any harm, injury or loss that may occur to me or my property as a result of my participation in the Activity, including any injury or loss caused by the negligence of SOURCE, its employees, agents, officers, managers, members, directors, contractors, its landlord, and/or other Activity participants. I also understand that I use at my own risk any equipment that I provide, or may borrow from SOURCE or any other provider, and that any such equipment is provided without any warranty about its condition or suitability. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I have no medical or physical conditions which could interfere with my safety in this Activity, or else I am willing to assume, and bear the costs of, all risks that may be created, directly or indirectly, by any such condition.
 
3. RELEASE OF LIABILITY: I HEREBY RELEASE SOURCE, its landlord, the providers of any equipment used in the Activity, and their respective employees, agents, officers, managers, members, directors, and/or contractors (“the Released Parties”) FROM ALL LIABILITIES, CAUSES OF ACTION, CLAIMS AND DEMANDS that arise in any way from any injury, death, loss or harm that occurs to me or to any other person or to any property during the Activity or which is in any way related to the Activity. This release includes claims for the negligence of the Released Parties and claims for strict liability for abnormally dangerous activities. This RELEASE does not extend to claims for gross negligence, intentional or reckless misconduct, or any other liabilities that Washington law does not permit to be excluded by agreement. I ALSO AGREE NOT TO SUE or make a claim against the Released Parties for death, injury, loss, or harm that occurs during or results from the Activity or is in any way related to the Activity.
 
4. INDEMNIFICATION, HOLD HARMLESS, AND DEFENSE: I PROMISE TO INDEMNIFY, HOLD HARMLESS, AND DEFEND the Released Parties (defined in Section 3) against any and all claims to which Section 3 of this agreement applies, including claims for their own negligence. I ALSO PROMISE TO INDEMNIFY, HOLD HARMLESS, AND DEFEND the Released Parties against any and all claims for my own negligence, and any other claim arising from my conduct during the Activity. In accordance with these promises, I will reimburse the Released Parties for any damages, reasonable settlements and defense costs, including attorneys' fees, that they incur because of any such claims made against them. 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.
 
5. RULES AND TRAINING: I agree to abide by the rules of the facility. 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.
 
6. USE OF MY LIKENESS:  I understand that I may be photographed and/or audio and video recorded during the Activity.  To the fullest extent allowed by law, I assign all rights of property, publicity, privacy, or pre-approval that I have for any such likeness of me or use of my name, voice, signature, photograph, or likeness in connection with such photograph or recording, and I grant to SOURCE and its assigns permission to copyright, use, and publish (including by electronic means) such likeness of me, whether in whole or part, in any form, without restrictions, and for any purpose.

7. SEVERABILITY: I agree that the purpose of this agreement is that it shall be an enforceable RELEASE OF LIABILITY AND INDEMNITY as broad and inclusive as is 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 to carry out the purpose of the agreement. 
 
8. 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 AFFECTS 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/Responsible Adult Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's 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.
Parent/Responsible Adult Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent/Responsible Adult Date of Birth*
Parent/Responsible Adult 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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