Loading...

RELEASE OF LIABILITY, ASSUMPTION OF RISK, WAIVER OF CLAIMS, INDEMNIFICATION & BINDING ARBITRATION AGREEMENT (hereinafter, the "Agreement")

Notice – by signing this Agreement, you hereby agree to waive certain legal rights, including the right to sue.

I am voluntarily enrolling all individuals listed below under “Name(s)” (hereinafter, the “Participant Party”) to participate at AdventurePlex, a youth health and fitness center which includes activities, the AdventurePlex facilities, equipment, and/or transportation, whether on-site or off-site(the “Program”). The term “Activities” includes, but is not limited to, Guided Ropes Course & Climbing Wall, camps, classes, receiving instruction and/or training, as well as participation or observation.  The term “Host” shall mean Beach Cities Health District dba AdventurePlex, its employees, owners, clients, guests, affiliates, subsidiaries, operators, agents, and/or officers.

I am aware that the AdventurePlex  Program, Activities, strength training, stretching, aerobic exercise and the use of equipment are inherently potentially hazardous.  I understand that I should consult with a physician about myself or my child’s ability to engage in physical activity, exercise, and use of exercise training equipment before me or my child participates in the Activities and/or Program.

I declare myself and my child to be physically sound and suffering from no condition, impairment, disease, infirmity, or other preexisting illness that would prevent me or my child’s participation in the Program or the Activities. If there is a change in myself or my child’s health status, I am  obligated to inform AdventurePlex and provide a medical release from mine or his/her physician prior to returning to AdventurePlex.

I represent that by signing below, I am the parent and/or legal guardian of the minor child referenced above and have full legal authority to enter into this Agreement with the Host and to bind the Participant Party, their agents, representatives, heirs and assigns, to all terms and conditions discussed herein.

Release and Waiver of Claims; Assumption of the Risk; Indemnification Agreement

In consideration of being allowed to use the facilities and participate in Activities, provided by the Host the Participant Party, does hereby agree, to the fullest extent permitted by law, as follows:

1) TO KNOWINGLY AND VOLUNTARILY WAIVE ALL CLAIMS that the Participant Party has or may have against the Host arising out of the Participant Party’s participation in the Program and/or Activities;

2) TO EXPRESSLY ASSUME AND ACCEPT ALL RISKS of participating in the Program and/or Activities, even those caused by the negligent acts or conduct of the Host. The Participant Party understands and accepts that there are inherent risks of participating in the Program and/or Activities, which may be both foreseen and unforeseen and include potential illness, serious physical injury and/or death;

3) TO FOREVER RELEASE the Host from all liability for any loss, damage, injury, death, or expense that the Participant Party or their guests may suffer, arising out of his/her participation in the Program and/or Activities. The Participant Party specifically understands that they are releasing any and all claims that arise or may arise from any negligent acts or conduct of the Host to the fullest extent permitted by law; and

4) TO DEFEND AND INDEMNIFY the Host from all liability for any loss, damage, injury, death, or expense that the Participant Party or their guests may suffer, arising out of Participant Party’s, or their guest(s)’participation in the Program and/or Activities.

Inflatable Obstacle Course Liability Release

The Participant Party hereby acknowledges and agrees that the inflatable obstacle course/slide and toddler inflatable (collectively, the “Inflatables) of the Host, have inherent risks. The Participant Party has full knowledge of the nature and extent of all the risks associated with the Inflatables and hereby acknowledges that any of Participant Party’s questions about the Inflatables have been answered, including but not limited to:

  1. All manner of injury resulting from falling off the Inflatables and hitting floor or hard surfaces, other participants and projections whether permanently or temporarily in place or on the floor.
  2. Injuries resulting from collisions with other participants or falling off the Inflatables.
  3. Cuts and abrasions resulting from skin contact with the Inflatables.
  4. Failure of the Inflatables, mechanical blowers, tarps, nets, anchor points, or any part of the inflatable obstacle course structure or the inflatable slide structure.
  5. I hereby acknowledge that the obstacle course/slide can accommodate up to 2 children at a time, varying in ages from 3 to 16, and may result in body contact with other participants (which includes, but is not limited to, touching, grabbing, pulling, pushing, knocking) and the toddler inflatable can accommodate up to 2 children at a time from ages 0 to 5.

The Participant Party further acknowledges that the above list is not inclusive of all possible risks associated with the use of AdventurePlex Inflatables, hereby accepts said unknown risks and that the above list in no way limits this Agreement. The Participant Party voluntarily chooses to use the Inflatables and agrees as follows:

To waive and forever release any and all claims that Participant Party has or may have in the future against the Host, as well as the designers, manufacturers or installers of the Inflatables.

, on behalf of the Participant Party.

In consideration of the Participant Party’s use of the Inflatables I, the undersigned, agree to use the Inflatables in accordance with its established safety policies and procedures and agree to FOREVER DEFEND, INDEMNIFY AND HOLD HARMLESS the Host from any and all causes of action, claim, demands, losses or costs of any nature whatsoever arising out of or in any way relating to the Participant Party’s, or their guest(s)’ use of the Inflatables. 

Personal Responsibility

The undersigned hereby certifies that no member of Participant Party has a physical or mental condition that precludes him/her from participating in the Activities and/or Program and that he/she is not participating against medical advice.

The undersigned understands that the Participant Party’s participation in the Activities is entirely voluntary and further certifies that they have had the opportunity to inspect the Host’s equipment and facilities before any participation by the Participant Party.

The undersigned hereby acknowledges that Participant Party is obligated to follow the rules of the Program and/or the Activities and that he/she can minimize his/her risk of injury by being aware of his/her surroundings and by observing activities of and courtesy to other AdventurePlex users. 

If the Host determines the Participant Party has violated any rules and jeopardized the safety of the Participant Party or any other individual, that will result in immediate termination from the Activities and potentially expulsion from AdventurePlex.

If, while participating in the Activities, the Participant Party observes any unusual hazard or condition,  Participant Party will immediately remove themselves from participation in the Activities and immediately bring said hazard or condition to the attention of the Host.

Emergencies or Injuries

I acknowledge and hereby agree that the Host does not provide medical personnel during the Activities. In the event of an injury or emergency, I understand the Host will make a reasonable attempt to contact me if I am onsite, or by phone if off-site. I further acknowledge and agree that the Host is granted permission (but not required) to provide basic first aid for minor injuries to the Participant Party and/or their guest(s).  I hereby authorize the Host to contact 911 for emergency medical treatment beyond first aid if necessary.

Binding Arbitration

The undersigned hereby agrees to submit any dispute, claim, or controversy, relating to and/or arising from (a) this Agreement, (b) Participant Party’s participation in the Activities and/or the Program, and/or (c) any other interaction between the Participant Party and the Host, including the determination of the scope or applicability of this agreement to arbitrate, to binding arbitration. For such disputes, there shall be a three-member arbitration panel (the “Panel”), consisting of two party-appointed arbitrators (one arbitrator to be appointed by each party) and one neutral arbitrator (collectively, the “Panel”), to be chosen by the party-appointed arbitrators. In the event that the two party-appointed arbitrators are not able to agree on a third, neutral arbitrator, the neutral arbitrator shall be appointed by the United States District Court, for the district in which the Activities and/or the Program occurred.

Each party shall bear its own costs, including the costs associated with the party-appointed arbitrators, and the parties shall share equally the costs associated with the neutral arbitrator. The arbitration proceedings shall proceed in the State and County where the Activities occurred, and shall be governed by the Federal Rules of Evidence. The Panel shall establish a reasonable and appropriate discovery schedule to expeditiously resolve this matter. Judgment on the Award may be entered in any court having jurisdiction over the parties and controversy. Participant and the Host specifically intend this Binding Arbitration provision to survive in the event that any other portion of this Agreement is held invalid. NOTICE TO PARTICIPANT PARTY: By signing this Agreement, you are giving up your right to commence litigation against the Host in a court of law, and you are giving up your right to a trial by jury.

To the extent that any portion of this Agreement is deemed to be invalid under the law of the applicable jurisdiction, the remaining portions of the Agreement shall remain binding.

This Agreement shall remain in effect indefinitely for the Participant Party’s current and future use of AdventurePlex, unless and until revoked by either party, mutually amended, or until the Participant Party (if a minor child at time of signing) reaches age of adulthood.

I HAVE READ AND UNDERSTAND THIS AGREEMENT. I AM AWARE THAT BY VOLUNTARILY SIGNING THIS AGREEMENT, I HEREBY AGREE TO BE BOUND BY ITS TERMS AND CONDITIONS WHICH INCLUDES THE WAIVER OF CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.

Today's Date: March 20, 2019

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*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

Phone*
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*
Photography/Video Release
Participant hereby grants to the Host, the right to take photographs and videos ("media") of Participant Party in connection with Participant Party's participation in the Activities and/or Program. Participant Party hereby authorizes the Host to copyright, use, and publish all the media in print and/or electronically. Participant Party hereby agrees that the Host may use such media for any lawful purpose, including but not limited to publicity, illustration, advertising, and Web content.*
Yes
No
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver