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BEACHES ROCK GYM
ATLANTIC BOULDERING COMPANY, LLC
RELEASE OF LIABILITY AND ASSUMPTION OF RISK

THIS IS A LEGALLY BINDING AGREEMENT. Read it carefully before signing, and consult with an attorney if you are uncertain about its terms. This Agreement must be read and signed by all participants 14 years of age and older. If the participant is a minor (under 18), it must be signed also by the child’s natural legal guardian (the child’s mother or father, by birth or adoption, or, if the parents are divorced, the parent to whom custody is awarded). The natural guardian signs for himself or herself and on behalf of the child. A minor who signs this agreement does so to reflect his or her understanding of the activities and their risks.

READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT EVEN IF ATLANTIC BOULDERING COMPANY, LLC, ITS OWNERS, SUCCESSORS, AFFILIATES, EMPLOYEES AND AGENTS (IDENTIFIED AS “RELEASED PARTIES”, BELOW) USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM A RELEASED PARTY IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND RELEASED PARTIES HAVE THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

1. Activities and Risks

Climbing on artificial climbing walls, and related activities (including, but not limited to, bouldering, challenge type activities and fitness or exercise classes) exposes participants to numerous risks which might result in physical and emotional injury, death or property loss or damage. These risks include, among others, the following: falling to the floor or pads; falling or swinging into the climbing wall and other structures and objects; being struck by falling climbers, hardware, tools, broken or dropped holds and other objects; entanglement in ropes; abrasions and/other injuries from contact with climbing walls, ropes, holds, loose holds, dropped holds, broken holds, pads, or the floor. Climbing and belaying equipment (if used) and structures may malfunction, be defective, or fail; and absorbing materials, including pads below the wall may not prevent all injuries from falls. Participants may participate out of control or beyond their limits or otherwise act in a negligent or intentional manner which contributes to the injury or death of themselves or another participant. Staff, visitors, belayers (when present) and other persons present may act negligently or engage in other wrongful conduct. Atlantic Bouldering Company may fail to warn participants or the natural guardians of certain inherent risks. These risks are inherent in a participant’s enrollment and climbing and related activities and they cannot be eliminated without altering the nature of the experience. Other risks may be encountered. If I am the natural guardian of a minor participant, I have explained the risks and possible outcomes to the child. I, and the child, understand them. I choose to participate nonetheless. If signing on behalf of the child, we both choose for the child to participate nevertheless. My, or the child’s, participation is voluntary.

2. Assumption of Risks

I, the participant or, if the participant is a minor, natural guardian, for myself and on behalf of the child, to the maximum extent allowed by law, understand, acknowledge and assume any and all risks of Atlantic Bouldering Company activities and the use of its facilities and equipment, inherent or not, and whether or not described in this document.

3. Release and Indemnity (Adult participant)

I, an adult participant, hereby release and covenant not to sue Atlantic Bouldering Company, LLC, its owners, members, managers, successors, affiliates, directors, employees and agents (hereinafter each a “Released Party”, or collectively “Released Parties”), with respect to liability for any personal injury, including death, property loss or damage, and all other claims, demands or causes of action which accrue to me, which are in any way related to my enrollment or participation in an activity of Atlantic Bouldering Company or the use of its facilities or equipment. In addition, I agree to protect, defend, hold harmless and indemnify (including the payment of reasonable attorneys’ fees, costs and insurance deductibles) Released Parties and each of them with respect to any claim of loss suffered or caused by me, by whomever it may be brought, which relates in any way to my enrollment in an activity of Atlantic Bouldering Company or the use of its facilities or equipment. These agreements of release and indemnity include claims of negligent (including, to the extent allowed by law, grossly negligent) acts or omissions of a Released Party, but not intentionally wrongful conduct.

4. Release and Indemnity (Natural guardian for himself or herself and on behalf of a minor participant)

As the natural guardian of the minor participant I, for myself and on behalf of my minor child, hereby release and covenant not to sue Atlantic Bouldering Company, LLC, its owners, members, managers, successors, affiliates, directors, employees and agents (hereinafter each a “Released Party”, or collectively “Released Parties”), with respect to liability for any personal injury, including death, property loss or damage, and any and all other claims, demands or causes of action which accrue to me or to my child which are in any way related to the child’s enrollment or participation in an activity of Atlantic Bouldering Company or the use of its facilities or equipment. The claims which I hereby release for myself include claims of negligent (including, to the extent allowed by law, grossly negligent) acts or omissions of a Released Party, but not intentionally wrongful conduct. The claims which I release on behalf of my child are those which accrue to the child resulting from an inherent risk of the child’s enrollment or participation in an activity of Atlantic Bouldering Company or the use of its facilities or equipment. (IMPORTANT: for purposes of this Release by the natural guardian on behalf of the minor child “inherent risk” is defined as those dangers or conditions, known or unknown, which are characteristic of, intrinsic to, or an integral part of the activity and which are not eliminated even if the activity provider acts with due care in a reasonable manner. The term includes, among other acts or omissions, the failure of the activity provider to warn the natural guardian or child of an inherent risk, and the negligent or intentional acts of the child or another participant which may contribute to the injury or death of the minor participant.) In addition, I agree to protect, defend, hold harmless and indemnify (including the payment of reasonable attorneys’ fees, costs and insurance deductibles) Released Parties and each of them, with respect to any claim of loss suffered or caused by the child, by whomever it may be brought, in any way related to my minor child’s enrollment in an activity of Atlantic Bouldering Company or the use of its facilities or equipment. This agreement of indemnity include claims of negligent (including, to the extent allowed by law, grossly negligent) acts or omissions of a Released Party, but not intentionally wrongful conduct.

5. Other

I, an adult participant or natural guardian, agree that if any part of this Agreement is held by a court of law to be unenforceable, the remainder shall survive.

It is my intent to comply fully with Florida law, including with respect to a natural guardian’s authority to release certain claims on behalf of his or her child or ward.

The venue of any legal action arising out of, concerning or involving this document or my participation in activities at Atlantic Bouldering Company, or a claim of any sort against a Released Party, will be Duval County, Florida, and I agree that the courts of Florida have personal jurisdiction over me for these purposes. I agree also that the laws of the State of Florida will be applied to an interpretation of this Agreement and any dispute which arises between me, or the child or any person acting on behalf of the child, and a Released Party.  

I agree that this agreement will remain in full force and effect, and apply to subsequent visits to Atlantic Bouldering Company by me, or the minor child, until revoked in writing, with notice to the other party. Future participation and use of Atlantic Bouldering Company is evidence of my, or the child’s, continuing agreement with the terms of this document.

I understand that photographs and video recordings which include me or the child may be taken at Atlantic Bouldering Company’s facilities. I agree that Atlantic Bouldering Company may use my or the child’s likeness in any and all of its publications and advertisements without payment or any other consideration.

Atlantic Bouldering Company wants to provide a fun environment for all participants and spectators. I, and the child, understand and agree that Atlantic Bouldering Company reserves the right to deny or revoke access to anyone for any act deemed inappropriate.

I, or the child and I, have read, understand and agree to obey the posted Safety Rules which are printed and available at Atlantic Bouldering Company.

I represent that I have complete and absolute authority to bind, contract for and legally act on behalf of myself and, if applicable, the minor participant. I understand and agree that RELEASED PARTIES rely to their detriment upon this representation and would not allow me or, if applicable, the minor child to participate without this representation. I have had sufficient opportunity to read and understand this document and intend for it to be binding on me, the minor child who is a participant, and members of my, and the child’s, respective families, estates and personal representatives.

Natural Guardian(s) must sign below for the minor child to participate and agree that they and the minor child are subject to all the terms of this document, as set forth above.

Date: December 10, 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*
Second Participant's Signature*
Third Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Signature*
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*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION): This is to certify that I, as parent/guardian with legal responsibility for minor(s), do consent and agree to his/her release as provided above of all the Releasees, and for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.
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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