Please read this document carefully This is a legal document and must be filled out by someone over 18. Only parents/legal guardians of children under 18 are able to fill out this form on behalf of a child.
Children under 18 are not allowed to fill out this form. RECITALS The individual named below desires: (a) to use or be granted access to one or more Latitude Climbing and Fitness facilities owned or operated by Latitude Climbing, LLC, Latitude Climbing Hampton, LLC, Latitude Hampton Properties, LLC, or Latitude Management, Inclocated at 1830 Lindsay Avenue, Norfolk, VA 23504 and/or 4554 Virginia Beach Blvd, Virginia Beach, VA 23462, and/or 2021 Executive Drive Hampton VA 23666 including, without limitation, all rooms, areas, and spaces on the interior of the Facility, the exterior of the Facility, and the parking lot of the Facility; (b) to participate in trips, competitions, camps, climbing courses, adventures, and/or other types of gatherings, activities or events which may take place at the Facilities or are otherwise organized, offered or sponsored by or in any way involve Latitude Climbing and Fitness (collectively, “Events”); and/or (c) to engage in wall climbing, bouldering, other climbing activities, sports, fitness activities, or any of the various other types of activities which may take place at the Facilities or are otherwise organized, offered or sponsored by or in any way involve Latitude Climbing and Fitness (collectively, “Activities”). WAIVER The above-stated Recitals are true and correct and are incorporated herein by this reference. I agree to the following Waiver on behalf of myself and on behalf of my heirs, executors, personal representatives and assigns: I FULLY ACCEPT AND ASSUME ALL RISK AND ALL RESPONSIBILITY FOR ANY AND ALL LOSSES, COSTS, AND DAMAGES I INCUR AS A RESULT OF MY ACCESS TO THE FACILITIES, PARTICIPATION IN EVENTS, AND/OR ENGAGEMENT IN ACTIVITIES. RELEASE OF LIABILITY The above-stated Recitals are true and correct and are incorporated herein by this reference. I agree to the following Release of Liability on behalf of myself and on behalf of my heirs, executors, personal representatives and assigns: For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledge, including me being permitted access to the Facility/Facilities, participation in Events, and/or engagement in Activities, I, for myself, and my heirs, executors, personal representatives and assigns, forever RELEASE AND DISCHARGE Latitude Climbing, LLC, Latitude Climbing Hampton, LLC, Latitude Hampton Properties, LLC, or Latitude Management, Inc and its past, present, and future agents, affiliates, subsidiaries, parents, stockholders, officers, directors, partners, members, owners, predecessors, successors-in-interest, assigns, employees, staff, subcontractors, attorneys, insurers, and all other persons, entities or corporations with whom any of the former have been, are now, or may hereafter be affiliated, separately or jointly (collectively, “Released Parties”), from any and all claims, causes of action, suits, costs, judgments, and responsibility from liability of any nature whatsoever for personal injuries, including death, and damage to or loss of property, caused by or arising out of my access to the Facility/Facilities, participation in Events, and/or engagement in Activities, whether or not caused in whole or in part by any act, omission or default of Released Parties. ASSUMPTION OF THE RISK The above-stated Recitals are true and correct and are incorporated herein by this reference. I agree to the following Assumption of the Risk on behalf of myself and on behalf of my heirs, executors, personal representatives and assigns: I understand and appreciate that there are significant elements of risk, even substantial risk, associated with my use of the Facility, participation in Events and engagement in Activities. I understand that the risks include, by way of example and not limitation: faulty gear; equipment failures; improper belays; improperly tied knots or tie-ins; improperly buckled harnesses; loose or falling equipment or gear; falling; acts of other participants; being hit by falling persons, equipment or debris; other dangerous property conditions; and negligence of others. I understand that I may be exposed to dangers and hazards, including, by way of example and not limitation: physical and emotional injuries; cuts; bruises; muscle and tendon strains/tears; twisted/sprained ankles; rope burn; dislocations; fractures; concussions; paralysis; death; overexertion, overheating, injuries from my lack of fitness or conditioning; damage to and loss of property; and that there are more dangers and hazards than listed here, including known and unknown dangers and hazards. All risks, dangers and hazards cannot be eliminated without destroying the unique character of the Facility, Events and Activities, regardless of whether I follow safety instructions or recommendations, such as those pertaining to the Facility’s rules and regulations, climbing, bouldering, instructional programs, or involving my choice of equipment to use or whether or not to wear a helmet or any other safety device. The same elements that contribute to the unique character of the Facility, Events and Activities can be causes of personal injury, death, and/or damage to or loss of property. I further warrant that I am in good health and have no mental or physical condition that would prevent my use of the Facility, participation in Events and engagement in Activities. I further agree that I will examine and inspect the Facility, Event and/or Activity which I take part in and that, if I observe any condition which I consider to be unacceptably hazardous or dangerous, I will notify staff immediately and will refuse to take part in the Event and/or Activity. I ACKNOWLEDGE THAT I FULLY UNDERSTAND AND APPRECIATE THE NATURE AND EXTENT OF THE ABOVE-MENTIONED KNOWN RISK AS WELL AS OTHER RISKS NOT LISTED THAT ARE PART OF USING THE FACILITY, PARTICIPATING IN EVENTS AND ENGAGING IN ACTIVITIES, INCLUDING ALL DANGERS, THE RISK OF PERSONAL INJURY, DEATH, AND/OR DAMAGE TO OR LOSS OF PROPERTY, AND I VOLUNTARILY EXPOSE MYSELF TO THOSE RISKS IN ORDER TO USE THE FACILITY, PARTICIPATE IN EVENTS AND ENGAGE IN ACTIVITIES AND ASSUME FULL RESPONSIBILITY FOR ANY RISK OF PERSONAL INJURY, INCLUDING DEATH, AND DAMAGE TO OR LOSS OF PROPERTY. I FURTHER ACKNOWLEDGE THAT ANY EQUIPMENT PROVIDED AT THE FACILITY, EVENTS AND/OR ACTIVITIES IS PROVIDED “AS IS” WITHOUT ANY WARRANTY, EXPRESS OR IMPLIED, ABOUT ITS CONDITION OR SUITABILITY AND THAT I USE ANY EQUIPMENT PROVIDED AT MY OWN RISK. IT IS FURTHER AGREED THAT ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING WITHOUT LIMITATION, WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, AND ANY WARRANTY ARISING FROM COURSE OF DEALING OR USAGE OF TRADE, OR ANY OTHER OBLIGATION OR LIABILITY ARE HEREBY DISCLAIMED. I AGREE TO USE THE FACILITY, PARTICIPATE IN EVENTS AND/OR ENGAGE IN ACTIVITIES, INCLUDING USE OF ANY EQUIPMENT PROVIDED, AT MY OWN RISK. INDEMNITY AGREEMENT The above-stated Recitals are true and correct and are incorporated herein by this reference. I agree to the following Indemnity Agreement on behalf of myself and on behalf of my heirs, executors, personal representatives and assigns: For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledge, including me being permitted access to the Facility, the participation in Events, and/or the engagement in Activities, I, for myself, and my heirs, executors, personal representatives and assigns, agree to INDEMNIFY, DEFEND AND HOLD HARMLESS RELEASED PARTIES FROM AND AGAINST ANY AND ALL CLAIMS, CAUSES OF ACTION, SUITS, AND RESPONSIBILITY FOR LIABILITY OF ANY NATURE WHATSOEVER CONNECTED IN ANY WAY WITH MY ACCESS TO THE FACILITY, PARTICIPATION IN EVENTS, AND/OR ENGAGEMENT IN ACTIVITIES, INCLUDING, BUT NOT LIMITED TO, ACTIONS BROUGHT BY MYSELF OR ON MY BEHALF OR MY ESTATE, OR OTHERS ON MY BEHALF, OR ACTIONS BROUGHT BY OTHERS DUE TO MY OWN CONDUCT, WHETHER INTENTIONAL, NEGLIGENT OR OTHERWISE, AT MY SOLE COST AND EXPENSE. ADDITIONAL TERMS AND CONDITIONS (CHOICE OF LAW, VENUE SELECTION, WAIVER OF JURY TRIAL, LIMITATION OF DAMAGES, CONTRACTUAL STATUTE OF LIMITATIONS, SEVERABILITY, AMENDMENTS) The above-stated Recitals are true and correct and are incorporated herein by this reference. I agree to the following terms and conditions on behalf of myself and on behalf of my heirs, executors, personal representatives and assigns: I agree that the laws of the Commonwealth of Virginia shall apply to issues involving the construction, interpretation, and validity of the Waiver, Release of Liability, Assumption of the Risk and Indemnity Agreement and that Virginia laws shall govern any dispute arising, either directly or indirectly, out of my use of the Facility, participation in Events, and/or engagement in Activities. I consent to the exclusive jurisdiction of state and federal courts of competent subject matter jurisdiction in the Commonwealth of Virginia for any dispute arising, either directly or indirectly, out of my use of the Facility, participation in Events, and/or engagement in Activities. Venue shall lie exclusively in such courts in the City of Norfolk, Virginia. I knowingly and voluntarily agree to WAIVE MY RIGHT TO TRIAL BY JURY in any action, suit, proceeding or counterclaim for any dispute arising, either directly or indirectly, out of my use of the Facility, participation in Events, and/or engagement in Activities. I acknowledge and agree that any action, suit, proceeding or counterclaim will be tried by a judge without a jury. I AGREE THAT IN NO EVENT SHALL THE RELEASED PARTIES’ LIABILITY EXCEED ONE HUNDRED DOLLARS ($100.00). I agree that any action, suit, proceeding or counterclaim for any dispute arising, either directly or indirectly, out of my use of the Facility, participation in Events, and/or engagement in Activities may NOT be brought more than one (1) year after the accrual date of the cause of action for the alleged claim. I agree that the terms and conditions of the Waiver, Release of Liability, Assumption of the Risk and Indemnity Agreement are intended to be as broad and inclusive as permitted by law. If any provision or portion is held invalid, the balance shall continue in full force and effect as if such stricken provision or portion had not been contained in the Waiver, Release of Liability, Assumption of the Risk and Indemnity Agreement. No amendment, modification, termination, or attempted waiver of the Waiver, Release of Liability, Assumption of the Risk and Indemnity Agreement, or any terms and conditions under this section, shall be valid unless in writing and signed by the party against whom the same is sought to be enforced. PERMISSION TO USE MY LIKENESS I hereby grant and release to Latitude Climbing, LLC, Latitude Climbing Hampton, LLC, Latitude Hampton Properties, LLC, or Latitude Management, Inc. the right to use, reproduce, distribute, display, and to license others to so use, my name, voice, photographs, video images, representation and likeness in any and all media, whether now known or hereafter discovered, to promote the Facility, Events and/or Activities and/or my participation therein, and other related purposes. I acknowledge and agree that Latitude Climbing, LLC, Latitude Climbing Hampton, LLC, Latitude Hampton Properties, LLC, or Latitude Management, Inc and its licensees, if any, shall own all right, title and interest in and to such uses, and that I shall not be entitled to compensation with respect to such uses. The rights granted herein will continue for so long as such rights are used in a lawful manner. This does not apply to private treatment rooms inside of Director Performance PT. THIS IS A BINDING LEGAL CONTRACT. PLEASE READ IT CAREFULLY BEFORE SIGNING. I have carefully read and understand the above Waiver, Release of Liability, Assumption of the Risk, Indemnity Agreement, Additional Terms and Conditions, Permission to Use My Likeness and Minor Participant Addendum, and I do further intend to be legally bound for myself and my heirs, executors, personal representatives and assigns. No oral representations, statements or other inducements to sign have been made apart from what is contained in this document. I understand that by signing below that I may be waiving valuable legal rights. PLEASE PRINT LEGIBLY November 21, 2024
LATITUDE CLIMBING AND FITNESS CENTER - BOULDERING ORIENTATION · I certify that I will watch the Orientation video, confirm that I watched it to a staff member, and ask any questions that I may have prior to participating in Latitude Climbing and Fitness activities. If the participant is a minor, and this agreement is signed by a parent or legal guardian, I as the parent or legal guardian understand that it is my responsibility to review the video and orientation materials and provide the information therein to my child. · Bouldering (un-roped climbing) is permitted at Latitude Climbing and Fitness in designated bouldering areas. · Bouldering involves increased risks because YOU WILL FALL, and all falls are ground falls which could result in injury or death. Padded floors and crash pads (where present) mitigate risks, but do not and cannot guarantee prevention of injury or death. Improper pad placement or improper pad use can also cause injury or death. Many injuries occur when you fall near or at the top of the wall and / or when you miss the crash pad or hit an edge of a crash pad. · To reduce your risk of injury: · o Down climb when possible instead of jumping off. · o Before each climb, ensure crash pads (where present) are positioned properly so that you land in the middle of the pad. · o Use a spotter to help position crash pads (where present) and ensure a clear landing zone. · o Keep Landing Zones Clear: Do not lounge on pads or walk under climbers. Remove all personal items (like water bottles) from landing zones. Be aware at all times because you could land on or be landed on by other participants. · Proper Falling Technique Can Reduce Injuries: · o First, upon falling from the wall, spot your landing. · o Second, stay relaxed and bend your knees and elbows. · o Next, pull in your arms. Avoid extending your arms to reach for the floor. · o Lastly, as you land, absorb the impact with your legs bent and roll to the ground. · Ratings: Latitude Climbing rates the difficulty of boulder problems with a circuit grading scale with red tag problem being the easiest. A key for the circuit grading scale can be found posted in the Facilities. · Top-Out Bouldering: Top out bouldering is not permitted. · New Climbers: Those who are new to bouldering should start with easier problems (red tagged problems) and avoid climbing the full height of the wall until they are more comfortable with climbing, down climbing, proper falling technique, and how to utilize crash pads (where present). · While Latitude Climbing takes substantial measures to mitigate the risks of Bouldering, it cannot eliminate all risks. Risks of injury and death are present even when you and Latitude Climbing take all available safety measures. LATITUDE CLIMBING AND FITNESS – FACILITY ORIENTATION · All climbers and observers must check in at the front desk before proceeding into Latitude Climbing. · Climbing is inherently dangerous. Participants must assume the risks of climbing. All climbers, facility participants, individuals operating a safety system at Latitude Climbing, and anyone walking on a padded surface must sign (or their parent/legal guardian must sign) Latitude Climbing’s Waiver and Release of Liability for any Injury or Death and Assumption of Risks form. · Double check your partner’s safety system (Knots / Harness / Carabiners / Belay Device) before every climb! · Latitude Climbing staff reserve the right to check safety systems at any time. · Individuals desiring to utilize the auto belay and/or top rope systems at Latitude Climbing must be pass the corresponding Belay Safety Check. Those individuals who do not pass or choose to not take the Auto Belay Safety Check may not utilize the auto belay, belay others or tie knots, and must wait a minimum of 24 hours before re-taking the Belay Safety Check. Latitude Climbing staff reserve the right to revoke belay privileges at any time. Any customer that does not pass the Safety Check twice, will only be permitted to take the Safety Check for a third time after taking a required belay instruction course. · All persons using Latitude Climbing are expected to respect other individuals at the Facility and conduct themselves in good order. Persons deemed by Latitude Climbing staff to be behaving in an unsafe or disorderly fashion will be asked to leave the facility. · Youth: Youth climbers under the age of 13 must be supervised by an adult (18 years or older) or by an Latitude Climbing staff member. Youth under the age of 14 are not permitted in fitness areas. Parents and caregivers are responsible for the supervision of their children. · Belay Devices – all persons that wish to lead climbing in the Facilities agree that they are only permitted to use an approved belay device as dictated by Latitude Climbing and Fitness. Under no circumstances will a non-approved device be used. ACKNOWLEDGEMENT I acknowledge, for myself and any minor child or children on whose behalf I have signed the Terms and Conditions for Access to Facility, Participation in Events and Engagement in Activities (“Agreement”), that: (a) I agree that nothing in the Bouldering Orientation and Facility Orientation unto which this Acknowledgment is attached shall be construed to alter, modify, or extinguish any element of the Agreement; (b) I understand that I or such minor child or children identified as the “Participant” are required to complete orientation and/or training before participating in climbing and bouldering activities; (c) I understand that if I or such minor child or children identified as the Participant need additional assistance, orientation, instruction, training or assessment during my or such Participant’s use of the Facility, participation in Events and/or engagement in Activities at any future time, then it is my responsibility to seek such assistance, orientation, instruction, training or assessment from the staff prior to participating in any activity for which I am not, or such Participant is not, trained or qualified; and (d) My signature indicates that I understand the information and acknowledgments set forth above. November 21, 2024 This waiver is valid for one year from the date signed, unless a more current version is available.
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