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Origin Climbing & Fitness:

Visitor Agreement

1. In consideration of the services of Origin Climbing and Fitness, their agents, owners, volunteers, participants, managers, officers, employees, and all other person or entities acting in any capacity on their behalf (hereinafter collectively referred to as “Origin”), I hereby agree to release and discharge Origin on behalf of myself, my heirs, executors, administrators, legal representatives, and assigns as follows:

2. I voluntarily accept and fully assume all risks for any injury, paralysis, or death to myself or others arising from or related to my use of Origin Climbing and Fitness property (the ‘Facility’). I understand that indoor rock climbing, bouldering, or any other activity in the Facility are inherently dangerous activities involving many risks, dangers and hazards. These risks, dangers, and hazards include, but are not in any way limited to: -Falls while using the climbing walls, bouldering areas, landing pads, floors, work-out room, or shower facilities -Injuries arising from falling and striking objects or individuals; or being struck by falling individuals or objects -Failure to climb or belay safely within my own ability -Misuse or failure of the facilities, climbing wall, landing pad or equipment, including loose or spinning climbing holds -Reliance upon other persons (including Origin) to spot or belay me or otherwise assist me in the preparation, inspection, or use of harnesses, ropes, knots, and other equipment. -Failure to wear or properly use safety equipment.

3. I hereby waive and release any and all claims that I or my heirs, executors, administrators, legal representatives and assigns have or may have in the future against Origin for any loss, damage, expense, injury, or death, suffered from or in connection with my use of these facilities or equipment, or participation in activities sponsored by Origin, or my physical presence on the premises of the Facility, due to any cause whatsoever, including but not limited to negligence on the part of Origin, as well as any product liability claims related to any equipment or structure used within the Facility. I further represent that any of my own equipment that I use at the Facility is safe and in no way shall Origin be liable for any damage caused to myself or others for any failure of any such equipment.

4. I hereby relieve, release and discharge Origin from any duty to protect me from harm, and agree that even if Origin chooses to implement safety procedures, such actions shall not alter the fact that Origin has no duty to protect me. I further agree that if I do suffer any type of damage or injury, I shall notify Origin immediately of any such occurrence or cause.

5. I hereby voluntarily waive and release, forever discharge, and agree to indemnify and hold harmless Origin from any and all claims, suits, actions, liability, cost and expenses, both present and future, known or unknown, whether at law or in equity, including injury, death, damage to myself or my property, or to any other person or property resulting from or arising in connection with my use of the Facility or equipment, my participation in activities sponsored by Origin, or my physical presence on the premises of the Facility.

6. I will hold harmless and indemnify Origin for attorney’s fees, costs or expenses it may incur in enforcing this agreement or that relate in any way to my activities at or with Origin. 

7. I authorize Origin to stabilize, obtain medical care for, or transport me to a medical facility or hospital if, in the opinion of Origin, medical attention is required and I am unable to make such decisions for myself. I agree to pay all costs associated with such medical care and related transportation and shall defend, indemnify, and hold harmless Origin of and from the consequences of such decisions and from any such cost incurred relating to the provision of medical care.

8. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while using the Facility or equipment, or, I agree to bear the costs of such injury or damage myself. I further certify that I have no medical or physical condition 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 whether or not I disclose that condition to Origin.

9. I agree that this liability waiver shall continue in effect in perpetuity or until it is cancelled or modified by written agreement, so that each time I use or am on the premises of this Facility or participate in any activity at the Facility, this waiver shall remain in force, and I shall be bound by the terms and conditions herein.

10. This agreement shall be governed by and interpreted under the laws of Nevada, without regard to its conflict of laws provisions. I agree not to sue or make claim against Origin. However, if any lawsuit or claim is brought that arises out of or relates to my use of, or physical presence at the Facility or arises out of or relates to the enforcement of this document, I agree that the jurisdiction and venue for any such suit shall be in the Eighth Judicial District Court, Clark County, Nevada and hereby irrevocably waive any other jurisdiction or venue to which I or my estate might otherwise be entitled. If any provision of this agreement is held to be invalid or unenforceable, in whole or in part, by any court of competent jurisdiction, such provision shall be amended to conform to the requirements of the law so as to be valid and enforceable, provided that such provision shall be curtailed, limited, or eliminated only to the minimum extent necessary to remove the invalidity, illegality, or unenforceability and the rest of this Agreement shall remain in full force and effect. This agreement supersedes all prior Agreements that I have signed relating to my use of the Facility (if any). I further agree that electronic signatures and initials shall be accepted as original signatures and initials.

11. I have read and understand the rules and regulations of Origin (posted in the Facility or available online at www.originclimb.com) and agree to comply with each of them. I also understand the provisions of this Agreement. I further understand that in the event I do not understand any provision of this Agreement, I may seek clarification of the provision from an employee or manager of Origin before signing this Agreement.

12. I have carefully read and understand this Agreement and am voluntarily signing below. I intend that this agreement be binding on me, my heirs, executors, administrators, and assignees. By signing this Agreement, I intend to waive legal rights against Origin on behalf of myself, my heirs, executors, administrators, and assignees.

13. If Participant is a Minor: I represent that I am the parent or legal guardian of the above individual and hereby consent to their use of the Facility and/or participation in activities. In consideration of Origin allowing the above individual to participate and/or use the Facility, I acknowledge I am familiar with and consent and agree to be bound by the terms and conditions of this Agreement. I, on behalf of myself and the above-named participant, hereby agree to waive and release, indemnify, hold harmless and forever discharge the Origin, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that said Minor ever had or may have, arising from or in any way related to such Minor’s participation in activities in connection with the Origin. I further agree to indemnify hold harmless and defend the Origin from and against any loss, damage, liability, expense, costs, and/ or attorneys fees, including any of those brought by or on behalf of, or otherwise related to or caused by the above-named participant.

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: September 21, 2019

First Visitor's Name

First Name*

Middle Name

Last Name*
First Visitor's Date of Birth*
First Visitor's Information
Gender *
First Visitor's Signature*
Second Visitor's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Visitor's Date of Birth*
Tenth Visitor's Information
Gender *
Visitor'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 Phone

Work Phone

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*
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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