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The Rock Boxx Release of Liability and Assumption of Risk

RELEASE OF LIABILITY AND ASSUMPTION OF RISK

In consideration of the services provided by the Rock Boxx Climbing Gym, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as TRB). I hereby agree to release and dischare TRB on behalf of myself, my children, my parents, my heirs, assigns, personal representatives and estate as follows:

1. Acknowledge that the activities involved in the use of any TRB's services or facilities, both climbing and nonclimbing related, entail significant risks, both known and unknown, which could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. Such risks include, among others; equipment failure, falling climbers, and negligence of spotters and other participants.

2. I am familiar with the safety features of the facility I will be using and other equipment that I will use (whether or not such equipment is provided by TRB), and acknowledge that these safety features and precautions may not be all that is necessary to minimize the risk of injury or provide maximum protection from injury or death.

3. I expressly agree and promise to accept and assume all of the risks existing in these activites both known and unknown, whether caused or allegede to be caused by the negligent acts or omissions of TRB. My participation in this activity is purely voluntary, and I elect to particpate in spite of the risks.

4. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless TRB from any and all claims, demands, or causes of action, which in any way arise out of, or are connected with (a) TRB's equipment and facilities, (b) any alleged negligent acts or omissions of TRB, or (c) my participation in the services and activities provided by TRB.

5. Should TRB or anyone acting on their behalf be required to incur attorney fees and cost to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

6. 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. 

7. I agree that the validity and enforceability of this Release of Liability and Assumtion of Risk will be governed by the substantive law of Oregon, including the Recreation Safety Act, without regard to its conflict of law rules.

8.I agree to abide the rules of TRB's facility.

9. This agreement shall endure and remain effective for the life of the participant or until modified or replaced by TRB.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS.

Dated: March 21, 2019

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 or Guardian's 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*
Phone Numbers

Home *

Work

Cell *
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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