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CLIMBING CAFÉ, LLC
RELEASE OF LIABILTIY, ASSUMPTION OF RISK, AND INDEMNIFICATION AGREEMENT

1. ACTIVITY AND ASSOCIATED RISKS: I have chosen to participate in the following activity:
(hereinafter referred to as “the Activity”), which is conducted and organized by Climbing Café, LLC. I understand that:
____________________________________________________________________

The Activity is inherently hazardous, and I may be exposed to dangers and hazards, including some of the following: falls, fractures, concussions,
overexertion, overheating, injuries from my lack of fitness or conditions, death, equipment failures, and negligence of others;
• As a consequence of these risks, I may be seriously hurt or disabled or may die from the resulting injuries, and my property may also be damaged;
• Hospital facilities, qualified medical care, and medical evacuation may be limited by local conditions; and
• Climbing Café, LLC, assumes no responsibility for providing medical care during the Activity, and I will have to pay for any medical care and/or evacuation that I incur.

In consideration of the permission to participate in the Activity, I agree to the terms contained in this document.

2. ASSUMPTION OF THE RISKS: I hereby freely assume the above-mentioned risks as well as other risks not listed that are part of this activity and any harm, injury, or loss that may occur to me or my property as a result of my participation in the Activity or
during any transportation to or from the Activity – including any injury or loss caused by the negligence of The Climbing Café, LLC, its employees, agents and officers, its contractors, and other Activity participants. I understand any equipment that I
provide or may borrow or rent from Climbing Café, LLC, or any other provider I use at my own risk and that any such equipment is provided without any warranty about its condition or suitability.

3. RELEASE OF LIABILITY: I hereby RELEASE CLIIMBING CAFÉ, LLC, its employees, agents officers, and contractors, the providers of any equipment used in the Activity, land owners, and their respective employees, officers,
directors (“the Release Parties”) FROM ALL LIABILITES, CAUSES OF ACTION, CLAIMS, AND DEMANDS that arise in any way from any injury, death, loss, or harm that occur to me or to any other person or to any property during
the Activity or in any way related to the Activity, including during transportation to or from the Activity. This RELEASE includes but is not limited to claims for the negligence of the Released Parties and claims for strict liability
for abnormally dangerous activities. I agree NOT TO SUE or make a claim against the Released Parties for death, injuries, loss or harm that occurs during the Activity or are related in any way to the Activity. 

4. INDEMNIFICATION, HOLD HARMLESS, AND DEFENSE: I promise to INDEMNIFY, HOLD HARMLESS, AND DEFEND the Released Parties (defined in Section 3) against any and all claims to which Section 3 of this agreement applies,
including claims for their own negligence. I promise to INDEMNIFY, HOLD HARMLES, AND DEFEND the Released Parties against any and all claims for my own negligence, and any other claim arising from my conduct during the
Activity. In accordance with these promises, I will reimburse the Released Parties for any damages, reasonable settlements, and defense costs, including attorney’s fees, that they incur because of any such claims made against
them. I agree that in the event of my death or disability, the terms of this agreement, including the indemnification obligation in the Section, will be binding on my estate, and my personal representative, executor, administrator or
guardian will be obligated to respect and enforce them.

5. AGREEMENT TO FOLLOW DIRECTIONS: I agree to follow the rules for the Activity provided to me and to follow directions given to me by the leaders of the Activity USING ALL OF THE PROTECTIVE GEAR that I am instructed to use.

6. INDEPENDENT CONTRACTORS: I acknowledge that Climbing Café, LLC, has no control over and assumes no responsibility for the actions of any independent contractors providing any services for the Activity.

7. USE OF MY LIKENESS: I understand that during the Activity I may be photographed or videotaped. To the fullest extent allowed by law, I waive all rights of publicity or privacy or pre-approval that I have for any such likeness of me or use of my name in connection with such likeness.

8. SEVERABILITY: I agree that the purpose of this Agreement is that it shall be enforceable RELEASE OF LIABILITY AND INDEMNITY as broad and inclusive as is permitted by Indiana law. I agree that if any portion or provision of this Agreement is found to be invalid or unenforceable, then
the remainder will continue in full force and effect. I agree that any invalid provision will be modified or partially enforced to the maximum extent permitted by law to carry out the purpose of the agreement.

9. APPLICABLE LAW, FORUM & ATTORNEY FEES: This agreement is governed by and shall be construed in accordance with the laws of the State of Indiana, without any reference to its choice of law rules. I agree that any dispute arising from this Agreement or in any way associated
with the Activity shall be brought only in the Superior Courts of Vigo County, Indiana, and I agree to the jurisdiction and venue of those courts for any such dispute. In any litigation in which the validity or enforceability of this agreement is contested, I agree that the prevailing party will
pay all attorney’s fees and costs of the parties seeking to uphold the agreement.

 

I HAVE FULLY INFORMED MYSELF OR THE CONTENTS OF THIS AGREEMENT BY READING IT BEFORE SIGNING IT.
NO ORAL REPRESENTATIONS, STATEMENTS OR OTHER INDUCEMENTS TO SIGN THIS RELEASE HAVE BEEN MADE
APART FROM WHAT IS CONTAINED IN THIS DOCUMENT. I UNDERSTAND THIS IS A CONTRACT THAT AFFECTS
MY LEGAL RIGHTS AND I SIGN IT OF MY OWN FREE WILL.

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*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
If a participant is a minor, signature of parent or responsible adult is required below: In consideration of the minor child being permitted to participate in the Activity, I accept and agree to the full contents of this agreement. I certify that I have the authority to sign on behalf of the minor child and to make decisions for the minor child regarding this Activity. I also agree to RELEASE, HOLD HARMLESS, INDEMNIFY AND DEFEND the Release Parties (defined in Section 3) from all liabilities and claims that arise in any way from any injury, death, loss or harm that occurs to the minor child during the Activity or in any way related to the Activity. This includes any claim of the minor and any claim arising from the negligence of the Released Parties. I understand that nothing in this agreement is intended to release claims for gross negligence, intentional, or reckless misconduct or any other liabilities that Indiana law does not permit to be excluded by agreement.
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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