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Rock Box Bouldering

Participation Agreement

In consideration of the right to participate in Activities as hereinafter described, which is hereby acknowledged to be good and sufficient consideration, this Participation Agreement is entered into this March 29, 2020 by or on behalf of Participant.

Acceptance of Risk

1. I understand that rock climbing, bouldering, and other activities now available or that may become available at the Facility in their various forms, as well as preparation for such activities, and spectating, coaching, spotting, belaying, and all other aspects involved with these activities (collectively referred to hereinafter as “Activities”) are inherently dangerous and involve many RISKS, DANGERS, AND HAZARDS.

2. These risks, dangers and hazards include, but are not limited to: falling; being struck by people or equipment that are themselves falling; collisions with objects, people or equipment; equipment failure; the actions of other participants including negligence or inexperience; overuse injuries; the aggravation of preexisting conditions.

3. I understand that INJURIES OF ALL TYPES ARE A COMMON AND ORDINARY OCCURANCE during the Activities. I know that the risk of SEVERE INJURY and even DEATH exists in the participation of the Activities.

4. I hereby represent that I am fit and suffer from no adverse health condition that would limit my ability to participate in any Activities offered by Rock Box. I hereby represent that any of my own equipment that I use at the Facility is in safe condition and good repair.

5. I hereby represent that I have conducted a thorough visual inspection of the Facility and equipment I will be using and I am aware of and understand any potential hazards associated with the Facility and/or such equipment. With full knowledge and understanding of the RISK OF SEVERE INJURY AND DEATH involved in the Activities and the Associated Activities, I FREELY AND VOLUNTARILY ACCEPT AND FULLY ASSUME THE RISK THAT I MAY SUFFER TEMPORARY, PERMANENT, OR EVEN FATAL INJURIES, even if I follow the instructions or advice of Rock Box.

 

Release and Indemnity

6. I hereby unconditionally WAIVE AND RELEASE ANY AND ALL CLAIMS AND CAUSES OF ACTION OF ANY KIND OR NATURE AGAINST ROCK BOX, AND ANY MANUFACTURERS OR DISTRIBUTORS OF EQUIPMENT USED BY ROCK BOX, RELATED IN ANY WAY TO THE ACTIVITIES OR ARISING FROM, ARISING DURING, OR AS A RESULT OF PARTICIPATION IN THE ACTIVITIES. THIS WAIVER AND RELEASE INCLUDES BUT IS NOT LIMITED TO ANY SUCH CLAIMS OR CAUSES OF ACTION, present or future, related to injury or damage to Participant, his/her property, for any loss, damage, expense or injury (including DEATH) suffered by any person from or in connection with Participant engaging in any Activities, due to any cause whatsoever, INCLUDING NEGLIGENCE and/or breach of express or implied warranty on the part of ROCK BOX. 

7. Participant agrees to hold harmless, defend and indemnify Rock Box from any claim or action, present or future, related to injury or damage to any other person or property, for any loss, damage, expense or injury (including DEATH) suffered by any person from or in connection with Participant’s participation in any Activities due to any cause whatsoever including negligence and/or breach of express or implied warranty on the part of Rock Box.

8. Participant hereby RELIEVES ROCK BOX OF ANY DUTY TO PROTECT PARTICIPANT FROM HARM in connection with any Activities, Outside Activities in which Rock Box is involved in any way.

9. In the event Participant does suffer any type of damages or injury, Participant shall notify Rock Box immediately of any such occurrence and the cause thereof.

10. Participant authorizes Rock Box to obtain medical care for, or transport him/her to a medical facility or hospital if, in the opinion of Rock Box medical attention is required and Participant is unable to make such decisions for himself/herself. Participant agrees to pay all costs associated with such medical care and related transportation and shall DEFEND, INDEMNIFY AND HOLD HARMLESS Rock Box of and from the consequences of such decision and from any such costs incurred relating to the provision of medical care. Participant also authorizes disclosure of any protected medical information in the possession of Rock Box that is necessary to provide, coordinate or manage members healthcare consistent with the dictates of HIPAA and to the extent that such use or disclosure is required by law.

11. This Agreement shall continue in effect in perpetuity so that each time Participant uses the Facility or participates in any Outside Activities from the date this waiver is signed forward he/she shall be bound by the terms and conditions herein.

12. If any provision of this Agreement or the application of any such provision to any person or circumstance is held invalid, the remainder of this Agreement, and the application of such provision other than to the extent it is held invalid, will not be invalidated or affected thereby.

13. This Agreement shall be governed by North Carolina law, without regard to conflict s of laws principles. In addition, Participant agrees that jurisdiction and venue for any action or claims arising out of or relating to this Agreement shall be in a court of competent jurisdiction in Forsyth County, NC. 

Terms of Use

14. Rock Box Bouldering, LLC and any of its employees, directors, officers, agents, representatives, or assigns (hereinafter Rock Box ) reserves the right in its sole discretion to refuse entry, or to remove the participant named above below, including his/her Guest (“Participant”) from Rock Box’s property (the “Facility”) or from participation in any activity organized by Rock Box outside of the Facility, including but not limited to instruction at off site locations by Rock Box staff (hereinafter “Outside Activities”) for any reason whatsoever. Any such refusal of entry or removal by Rock Box shall be in its sole discretion.

15. Rock Box shall not be responsible for the loss, theft, or damage of any Participant’s property or the property of any Guest of Participant that is brought into the Facility or brought to any Outside Activity.

16. Participant shall comply with and observe all rules and regulations of Rock Box and the terms and conditions of this Agreement at all times and shall assure that his/her Guest(s) complies with and observes the same.

17. Should Participant damage or break any of Rock Box ’s equipment or property, Participant shall be reimburse Rock Box for the reasonable cost of repairs or replacements to such equipment or property.

18. Rock Box is authorized by the Participant to use, store or transfer, as Rock Box may consider necessary, the Participant’s personal information, for any and all purposes in connection with the Facility and services provided by Rock Box and/or for the purpose of promoting, improving and furthering the interests of Rock Box. Participant acknowledges this may include posting their photos and/or names online, and/or in publications.

19. Any delay or failure by Rock Box to exercise its rights and/or remedies under this Agreement does not constitute a waiver of any of such right or remedy.

20. This constitutes the entire agreement between the Participant and Rock Box regarding the Participant’s use of the Facility and supersedes all previous agreements, understandings and arrangements, written or oral, between the Participant and Rock Box in relation to such matters. 

Date: March 29, 2020

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Zip code of home address *
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Zip code of home address *
Third Participant's Name

First Name*

Middle Name

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

Zip code of home address *
Fourth Participant's Name

First Name*

Middle Name

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

Zip code of home address *
Fifth Participant's Name

First Name*

Middle Name

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

Zip code of home address *
Sixth Participant's Name

First Name*

Middle Name

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

Zip code of home address *
Seventh Participant's Name

First Name*

Middle Name

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

Zip code of home address *
Eighth Participant's Name

First Name*

Middle Name

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

Zip code of home address *
Ninth Participant's Name

First Name*

Middle Name

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

Zip code of home address *
Tenth Participant's Name

First Name*

Middle Name

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

Zip code of home address *
Parent or Guardian's Email Address

Email
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A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Consent of Legal Guardian for Participant under 18 years of age. As the parent or legal guardian of the minor child Participant named above, I hereby make and enter into each and every agreement, representation, waiver and release described above on behalf of myself, Participant, and any other parent or legal guardian of the Participant, intending that they be binding on me, the Participant, and our respective heirs, executors, personal representatives, administrators and assigns.By affixing my signature below I represent that I have full rights and authority to enter into this Agreement. I further agree to hold harmless, defend, and indemnify Rock Box of and from any claims made on behalf of Participant, or arising from or related to Participants participation in any Activities.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Zip code of home address *
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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