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WAIVER, RELEASE AND INDEMNITY
Rockit Climbing Gym Pty Ltd

Warranties

I warrant that:

  1. I am aged 18 years of age or over and have legal capacity to sign this agreement; OR I am under 18 years of age and my parent or legal guardian has legal capacity and signs this form on my behalf and consents to my participation at Rockit Climbing Gym.
  2. I do not suffer from any medical condition or know of any other reason that may affect my ability to participate safely in activities at Rockit Climbing Gym.

Acknowledgements and acceptance 

By signing this waiver, I acknowledge and agree:

  1. Indoor rock climbing is a “dangerous recreational activity” with “obvious risks” as defined by the Civil Liability Act 2003 (Qld) and the provisions regarding dangerous recreational activities with obvious risks apply to my participation and behaviour at Rockit Climbing Gym;
     
  2. Indoor rock climbing involves real risks which may cause various injuries and/or harm to health and safety and those injuries and/or harm may result in death or disability;
     
  3. Indoor rock climbing is physically and mentally demanding and may cause, among other things, panic, anxiety, hyperventilation or heart attack;
     
  4. To participate at my own risk and by doing so, fully appreciate and voluntarily assume the risk of injury and/or harm to my health and safety;
     
  5. that if, at any time I use my own equipment while participating in indoor rock climbing at Rockit Climbing Gym, my equipment is less than five (5) years old, is safe to use, and has been stored and maintained to the manufacturer’s specifications and standards;
     
  6. to comply with all instructions given to me by Rockit Climbing Gym Pty Ltd or its directors, staff, employees, servants or agents relating to my participation and behaviour at Rockit Climbing Gym;
     
  7. to indemnify, release and absolve from any liability whatsoever Rockit Climbing Gym Pty Ltd and its directors, servants, agents, employees, contractors, administrators or assigns from all liability, present and future, that may be incurred, including legal costs, arising from any demand, action or claim caused by any reason whatsoever, including without limitation negligence at common law, or failure to comply with instructions;
     
  8. Rockit Climbing Gym Pty Ltd may use any photographs, footage or other images of me taken by, for or on behalf of Rockit Climbing Gym Pty Ltd for promotional and advertising purposes only;
     
  9. This waiver is ongoing and will apply to all occasions, present and future, that I participate in indoor rock climbing at Rockit Climbing Gym or activities associated with Rockit Climbing Gym Pty Ltd;
     
  10. This document is contractual and signed by me in consideration for Rockit Climbing Gym Pty Ltd permitting me to participate in indoor rock climbing and issuing to me a belay licence upon satisfaction of compliance and competence with the required safety procedures and correct use of equipment;
     
  11. This document may be relied upon in any proceedings, shall be binding on my heirs, next of kin, executors, and administrators, and shall be governed in all respects by the law of Queensland;
     
  12. I have read and understand this document and the terms contained with it, and have been provided with an opportunity to receive clarification on any queries or concerns regarding its contents, my participation in activities at Rockit Climbing Gym or any other related matter;
     
  13. I am not relying on any oral, written or visual representations, statements, inducements, assurances or guarantees by Rockit Climbing Gym Pty Ltd or its directors, staff, employees servants or agents, and sign voluntarily and of my own free will with full knowledge of my rights being waived. 

Dated: April 19, 2021

First Participant's Name

First Name*

Last Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First 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*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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*

Last Name*

Relationship*

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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