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Release of Liability and Assumption of Risk Agreement

Introduction
Please read this Assumption of Risk, Release of Liability and Indemnity Agreement (hereafter referred to as the “Document”) carefully and completely before signing. This Document informs you about your responsibilities and assumption of risks, and includes a release of liability, indemnification and surrender of certain legal rights.

If there is anything you do not understand in this document, PLEASE ASK US.

Parent(s) or Legal Guardian(s) (hereafter referred to as “parent(s)”) of any participating minor shall read and sign this agreement. Participating minors (those under the age of 18) shall also read and sign this agreement. First person references such as “I” or “me” shall include both the adult(s) and minor. All participants shall initial where noted as acknowledgement of understanding where applicable. In consideration of the services of Ascension Rock Club, its owners, employees, agents, representatives and all other entities associated with it (collectively referred to hereafter as “ARC”), I agree to the following:

Acknowledgment and Assumption of Risk

CLIMBING IS DANGEROUS

Participating in or spectating climbing activities at ARC’s facilities involves serious risks. These activities can include but are not limited to bouldering, climbing, belaying, rappelling, and slack-lining on ARC’s climbing walls with or without supervision by ARC staff. I acknowledge participating in these activities involves inherent risks and dangers, both predictable and unpredictable. Some of these risks and dangers cannot be eliminated or reduced. Risks can cause injury, property damage, illness, mental or emotional trauma, paralysis, disability or death to the participant or others. The following describes some, but not all, of the possible risks and dangers (please initial):

  • Risks associated with physical activity: activities vary but include climbing, lifting, and sustained physical exertion.
  • Risks associated with decision making: participants will constantly be making decisions and judgments and these will be subject to error, including but not limited to misjudging abilities and distances. ARC Staff is not responsible for making decisions or judgments regarding the fitness and skill level of participants on behalf of participants.
  • Equipment failure or misuse: equipment used includes, without limitation, climbing holds, anchor points, ropes, slings, harnesses, climbing shoes and climbing hardware which may be misused, or which can break, fail or malfunction. This includes participant’s personal equipment or equipment rented or borrowed from ARC.
  • Risks regarding conduct: the possibility I or other third parties may carelessly, recklessly or generally fail to act with care and awareness.
  • Risks associated with dynamic movement: climbing involves movement and falls are frequent. There exists the potential to fall short distances and to the floor, colliding with fixed objects, unfixed objects and people including but not limited to climbing holds, terrain features and anchors.
  • These risks may result in: property damage, sprains, cuts or abrasions, friction burns, bruises, fractures, or other injury including paralysis or death.
  • I understand the above list is not exhaustive and the activities may include other unknown or unanticipated risks or dangers. These unknown risks could result in property damage, injury, paralysis, death or other loss.

I acknowledge I AM RESPONSIBLE FOR MY OWN WELL-BEING AND SAFETY. I have no mental or physical problems or limitations that might compromise or affect my ability to participate in climbing activities which have not been disclosed to ARC. I am fully capable of participating in these activities without causing harm to myself or others and I agree to follow all ARC rules and regulations. I acknowledge ARC staff are, and have been, available should I have further questions about the nature or physical demands of these activities and the risks associated with these activities. I understand the presence of ARC staff or representatives is absolutely no assurance of my safety or the lessening of any of these risks. My participation in these activities is entirely voluntary, and I choose to participate in spite of and with knowledge of the risks.

Release and Indemnity
Read carefully: this section contains a Release and Indemnity Agreement and surrender of certain legal rights. I, and parent(s) if the participant is a minor:

  • agree to release ARC, with respect to any and all claims, liabilities, suits or expenses (including attorneys fees & legal costs), arising out of any injury, damage, death or other loss to me or my child in any way connected with my/my child’s enrollment or participation in ARC activities, or use of ARC’s climbing wall or other equipment and facilities. I understand and agree to waive all claims I may have against ARC, and agree that neither I nor anyone acting on my behalf will make a claim or file a lawsuit of any kind against ARC, as a result of any injury, damage, death or other loss suffered by me or my child.
  • agree to defend, hold harmless and indemnify (“indemnify” means to protect by reimbursement or payment) ARC with respect to all claims, liabilities, suits or expenses (including attorneys fees & legal costs):
    • brought by or on behalf of me, my child, or a family member arising out of any injury, damage, death or other loss to me or my child in any way connected with my/my child’s participation in ARC activities or use of ARC’s climbing walls or other equipment and facilities.
      OR
    • brought by a co-participant or any other person, arising out of any injury, damage, death or other loss claimed to be caused, in whole or in part, by my/my child’s conduct in the course of participating in ARC activities or using ARC’s climbing walls or other equipment and facilities.

Conclusion
I agree this Document and other aspects of my relationship are governed by Alaska state law. Furthermore, the venue for any mediation, suit, or other proceeding arising out of or relating to my participation in ARC activities, shall be in Fairbanks, Alaska and Alaska state law shall apply. I agree to attempt to settle any dispute (which cannot be settled by discussion alone) through mediation with a mutually acceptable mediator.

I authorize ARC staff to obtain medical care for me/my minor child. I authorize medical personnel to administer treatment as they deem necessary for my/my minor child’s health. I acknowledge ARC has no responsibility for any medical care provided to me/my minor child and agree to reimburse all cost associated with such care.

Any portion of this Document deemed unlawful or unenforceable shall not affect the enforceability of the remaining provisions of this Document and the remaining provisions shall continue in full force and effect.

I have carefully read, understood and voluntarily sign this Document and acknowledge that it shall be effective and binding upon myself, my family, my heirs, executors, representatives and estate.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT.
I HAVE READ AND UNDERSTOOD IT AND I AGREE TO BE BOUND BY ITS TERMS.

Date: November 13, 2019

First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle 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*
How did you hear about us?:

How did you hear about us?: *
Parents and Guardians of minors must sign below for minor(s) 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*

Middle 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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