Loading...

Registration and Waiver for Climb North

UNDER 18: You must be 18 years of age to use the Climb North indoor climbing gym unless you have written permission from your parent or legal guardian. Signature of parent or legal guardian is required.

ASSUMPTION OF RISK AND WAIVER LIABILITY

Notice: This is a binding, legal agreement. By signing this agreement you give up your right to bring court action to recover compensation or obtain any other remedy for an injury to yourself, your property, or for your death, however caused, arising out of use of Climb North/Jewarts Gymnastics facilities now or in the future.

I understand that rock climbing and training in an indoor climbing gym are dangerous activities that carry significant risk that could lead to injuries including catastrophic injuries or even death. I also understand that participation in climbing activities at Climb North is in no way instruction for outdoor climbing and that I have been advised that proper instruction is necessary to climb outdoors.

I understand and agree that any equipment that I may rent or borrow from Climb North during the use of the facility, I use at my own risk. It is expressly understood and agreed that Climb North shall not be liable for any damage or injury resulting from such equipment.

I HAVE MY OWN HARNESS

I elect to use my own harness, and waive all rights to any liability claim, compensation, or any type of court action against Climb North/Jewart’s Gymnastics and employees should I suffer an injury or death due to faulty or unsafe equipment or if my personal harness is put on incorrectly.

PHOTOGRAPHY RELEASE WAIVER

I grant permission to Climb North and its employees to take photographs/videos of me during my time at Climb North. I agree these photographs/videos can be used for publicity, illustration, advertising, and Web purposes with or without my name. I understand Climb North will not use photographs/videos of me for any other purposes than those outlined in this waiver. 

CLIMB NORTH RESPONSIBILITY CODE

  1. NO food or drink is permitted in the climbing area.
  2. Climbers will tie the rope directly to their harness with a “figure-8” follow thru knot and finish with 1⁄2 of a double fishermen’s knot.
  3. All belays must be through the Gri-Gri and with CLIMB NORTH ropes.
  4. All belayers must be at least 14 years of age and must use the approved American Mountain Guide Standard and pass the CLIMB NORTH Competency Check Out.
  5. No bouldering is permitted higher that the 8-foot line or at the discretion of the wall supervisor.
  6. In consideration of the young people training in our facility, foul language, demonstration of poor sportsmanship or wandering into “gymnastics” area is prohibited.
  7. All climbers must inform CLIMB NORTH staff and other climbers of any situation seen as unsafe or not in accordance with safety policies. Do not play on any equipment belonging to the gymnastics program.
  8. All accidents, equipment damage, or loose holds must be reported immediately.
  9. Climbing clothes must be appropriate for the gym. Loose fitting garments and “short- shorts” are not allowed.
  10. We are not responsible for any lost or stolen items!

Today's Date: November 22, 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*
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*
Check to receive information, news, and discounts by e-mail.
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*

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 and  Rock Gym Pro