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Registration and Waiver for Climb North

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 (the ‘Agreement’)

The novel Coronavirus COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result of this pandemic, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

Climb North / Jewart’s Gymnastics have put in place preventative measures and used CDC guidelines to create best practices for our programs, in good faith to reduce the spread of COVID-19. However, Climb North / Jewart’s Gymnastics cannot guarantee that you or your child(ren) will not become infected with COVID-19 by your voluntary participation in any gymnastics or climbing practices, camps, classes or other events or activities. This Agreement is binding to and through the end August of the calendar year 2020 (hereafter Climb North).

Your voluntary participation in Climb North Events could increase your and your child(ren)’s risk of contracting COVID-19.

By signing this Agreement, I acknowledge the contagious nature of COVID-19 and VOLUNTARILY ASSUME ALL RISK that my family, child(ren) and I may be exposed to or infected by COVID-19 by attending Climb North and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at Climb North  may result from the actions, omissions, or negligence of myself and others, including, but not limited to (i) present and future Climb North directors, officers, coaching staff, members, volunteers, agents, Jewart’s Gymnastics, Steel City Ninja and representatives (the ‘Climb North Representatives’), and/or (ii) third parties over whom Climb North has no control. I HEREBY EXPRESSLY ASSUME ALL SUCH RISK ON MY BEHALF AND ON BEHALF OF MY CHILD(REN).                                   

Waiver of Claims, Release of Liability, Assumption of Risk, and Indemnity Agreement  

This form must be signed by a parent or legal guardian and the child if over 6 years of age.  

By signing this document, you will waive certain legal rights including the right to sue or claim compensation following an accident, injury, or death.  Please read carefully.  My child has permission to attend activities at Climb North, I feel my child is mentally and physically capable to follow directions and participate in a program that offers gymnastics, tumbling, or trampolines.  I understand that my child will use trampolines, rings, bars, and other apparatus involving height and motion, which might increase the inherent risk of these activities.  I understand that these activities could lead to catastrophic injuries or even death.  I hereby release Jewart’s Gymnastics and its owners, landlords, officers, employees, teachers and coaches from all liability for any and all damages, loss and injuries suffered by my child or me while in the facility as a student, participant or spectator.  I agree to waive any and all claims resulting from such damages, loss or injury, and this release shall be effective and binding.   The foregoing includes any CLAIMS relating to, by and/or on behalf of any person who may contract COVID-19, directly or indirectly, from me or my child(ren). I further understand and agree that the foregoing covenant not to sue and release waiver includes any CLAIMS based on the actions, omissions, or negligence of Climb North and the Climb North Representatives whether a COVID-19 infection occurs before, during, or after participation at Climb North.

I, ON MY BEHALF AND ON BEHALF OF MY CHILD(REN) HEREBY AGREES, REPRESENTS, AND WARRANTS that neither I nor my child(ren) shall (i) visit or utilize the facilities, services, and/or programs of Climb North or (ii) participate in any Climb North Activities if I or my child(ren) (a) experiences symptoms of COVID-19 including, without limitation, fever, cough or shortness of breath, or (b) has a suspected or diagnosed/confirmed case of COVID-19. I also represent and warrant, on my behalf and on behalf of my child(ren) that I (i) do not believe that we have been exposed to the COVID-19 virus within the past fourteen (14) days, (ii) have not been diagnosed with the COVID-19 virus to date and (iii) have not experienced any symptoms related to the COVID-19 virus within the past fourteen (14) days. I agree to notify Climb North immediately if any of the foregoing representations become incorrect.

 I have thoroughly read this acknowledgement of risk and liability.  I UNDERSTAND AND ACCEPT THE CONTENT and INTENT OF THIS DOCUMENT TO FULLY ASSUME ALL RISK and WE WILL NOT PURSUE LEGAL REMEDY FOR INJURY OR LOSS. 

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

  • NO food or drink is permitted in the climbing area.
  • 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.
  • All belays must be through the Gri-Gri and with CLIMB NORTH ropes.
  • 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.
  • No bouldering is permitted higher that the 8-foot line or at the discretion of the wall supervisor.
  • In consideration of the young people training in our facility, foul language, demonstration of poor sportsmanship or wandering into “gymnastics” area is prohibited.
  • 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.
  • All accidents, equipment damage, or loose holds must be reported immediately.
  • Climbing clothes must be appropriate for the gym. Loose fitting garments and “short- shorts” are not allowed.
  • We are not responsible for any lost or stolen items!
  • You must make a reservation before coming to Climb North. Max capacity is 20. The reservation link is below, and you will be allowed 2 hours of climbing. Download the Rock Gym Pro app
  • All previous and new customers must resign the online waiver that now includes Covid-19
  • There will be gymnastics camps in the parking lot. You are permitted to park in any open area not coned off or in the back gravel area. Enter through the upper lot only and exit only through back gravel lot.
  • All customers will have their temperature taken when entering the building. Customers with a reading of 100.4 or higher will be asked to leave.
  • No cash transactions
  • All staff are required to wear masks. Customers must wear a mask when entering the building but can remove when in the wall area. Masks will not be provided by Climb North.
  • All customers must wash their hands before entering the climbing gym and must wash their hands once they are finished with their session.
  • No bare feet in the rockwall. No climbing shoes permitted in the bathroom.
  • All customers must provide their own water and we will provide touchless refill stations.
  • No chalk bag rentals will be given
  • Belay instruction will no longer be offered until distance regulations are lifted.
  • Please follow all posted signs and make sure to treat all customers and staff with respect.
  • Enter the gym with only essentials, the locker room will be closed due to spacing.
  • Climb North staff has the right to ask you to leave if you are not following these new guidelines.

 

Today's Date: September 20, 2020

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.


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