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Waiver for Minor(s) to be signed by their Parent or Legal Guardian

RELEASE OF LIABILITY, WAIVER OF CLAIMS, AND INDEMNITY AGREEMENT

WARNING: PLEASE READ CAREFULLY BEFORE SIGNING.
YOU MUST BE 18 YEARS OF AGE OR OLDER TO SIGN THIS AGREEMENT.

THIS AGREEMENT MUST BE COMPLETED BY THE PARENT OR COURT-APPOINTED LEGAL GUARDIAN, WITHOUT EXCEPTION, OF ANY PARTICIPANT(S) UNDER THE AGE OF 18.
 

TO: Project Bouldering Inc. (operating under the trade name “Boulder Parc”)

In consideration of Boulder Parc allowing myself and the minor listed below of whom I am the parent or court-appointed legal guardian (my “Child”) to use its indoor climbing gym facility located at 2 - 1415 Morningside Ave, Scarborough, Ontario including its climbing walls, bouldering areas, training areas, activity rooms, belay equipment, ropes, Grigris, harnesses, climbing shoes, lockers, changerooms, washrooms, showers and any other facilities in the gym or the parking facilities and walkways outside of the gym (collectively, the “Facility”), I, on my behalf and on behalf of my Child, hereby agree, to the fullest extent permitted by law, as follows:
 

ACKNOWLEDGEMENT AND ASSUMPTION OF RISK

I understand that rock climbing, indoor bouldering, top-rope/lead/auto-belay climbing, weight training, strength training, fitness training, stretching, yoga, all instructional classes and coaching sessions, observing others engaged in these activities, school and institutional sessions, and all other activities, events and services in any way connected with or related to those activities (collectively, the “Activities”) at the Facility involve many inherent risks and dangers which include but are not limited to: bumps; bruises; abrasions; cuts; collisions; falling; illness or trauma; muscle and joint sprains and strains; broken wrists, ankles, legs and other bones; mechanical failure of equipment; misuse of equipment or facilities; defective flooring; loose or damaged climbing holds; worn or defective ropes; poor decision making by me or other persons; lack of fitness; loss of balance or control; failure to follow instruction; negligence of other persons; and negligence on the part of Boulder Parc or its staff. I have reviewed such risks and dangers with my Child.

I understand participating in climbing activities during a pandemic could result in me or my Child contracting the COVID-19 virus, which could involve flu-like symptoms, respiratory problems, organ failure, permanent disability or death.

I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS AND DANGERS ASSOCIATED WITH THE ACTIVITIES WHICH MAY RESULT IN PERSONAL INJURY, PERMANENT DISABILITY, DEATH, PROPERTY DAMAGE AND LOSS RESULTING THEREFROM.

Please initial: 

 

WAIVER OF CLAIMS, RELEASE OF LIABILITY AND INDEMNITY

I AGREE TO WAIVE ANY AND ALL CLAIMS that I or my Child have or may have in the future against Boulder Parc, its owners, shareholders, directors, officers, employees, coaches, instructors, contractors, subcontractors, agents, sponsors, volunteers, participants, representatives, successors and assigns (collectively, the “Released Parties”). 

I AGREE TO RELEASE the Released Parties from any and all liability for any loss, damage, expense or injury including death that my Child may suffer, or that my Child’s next of kin may suffer arising out of my Child’s participation in any of the Activities offered or made available at the Facility due to any cause whatsoever, even those claims that may arise from any negligent acts or conduct of the Released Parties.

I AGREE TO HOLD HARMLESS AND INDEMNIFY the Released Parties from any and all liability for damage to the property of or personal injury to any third party, resulting from my or my Child’s use of or presence at the Facility.

Please initial: 

 

HEALTH, SAFETY AND PERSONAL RESPONSIBILITY

I agree that my Child will not participate in any Activities at the Facility if:

  • my Child has experienced any flu-like symptoms over the past 14 days;
  • my Child has been in contact with, to the best of my knowledge and awareness, someone who has been diagnosed with COVID-19 over the past 14 days;
  • my Child has been in close contact with someone under self-quarantine after travelling outside of Canada over the past 14 days; or
  • my Child has been advised by any public health unit, government agency, or health care professional to self-isolate due to possible exposure to COVID-19.

I understand that my Child’s access to the Facility may be suspended as Boulder Parc and its staff deem necessary if: my Child has COVID-19; my Child has any symptoms of COVID-19; my Child is suspected of having COVID-19 based on screening; or my Child fails to follow policies put in place to protect themselves and persons around them while at the Facility.

I represent that my Child has no illnesses, disabilities or other conditions that prevent them from safely participating in the Activities. If any such conditions arise in the future, I will first discuss my Child’s participation in the Activities with a physician to determine the effect on my Child’s health.

It is my Child's right and responsibility as a participant to immediately cease participation in the Activities and notify the nearest official, if at any time my Child senses any unusual hazard or unsafe condition or if my Child feels physically, emotionally, or mentally unfit for continued participation in the Activities.

Please initial:

 

My Child and I freely accept full responsibility for my Child's safety and the safety of other climbers, and agree to abide by the following rules while using the Facility:

  • my Child will not consume any alcohol or any substance which would impair my Child's sense of judgement prior to or while using the Facility;
  • my Child will not be permitted to top-rope climb and/or boulder on any climbing wall or any bouldering wall until my Child has completed the pre-requisite top-rope belay test and/or bouldering orientation;*
  • my Child will always tie directly into the climbing harness when engaging with in top-roping with a figure-8 follow-through knot and a double fisherman’s keeper knot;*
  • all top-rope must be performed with a Grigri device and locking carabiner – roped climbers and belayers must only use equipment approved by Boulder Parc staff;*
  • my Child will only belay when knowledgeable and experienced at belaying;*
  • my Child assume full responsibility when choosing belayers – my Child understands that Boulder Parc provides the ropes, anchors and belay devices but will not be responsible for poor judgement by an ill-chosen belayer;*
  • my Child will only use the weight training equipment in a controlled and responsible manner, and will re-rack everything after use to avoid creating tripping hazards;*
  • my Child understands that climbing privileges will be revoked in the event that my Child engages in any activity deemed unsafe by the staff;
  • my Child will not hold Boulder Parc responsible for any lost or stolen personal belongings;
  • my Child must promptly report any equipment defects, unsafe situations, or accidents;
  • my Child understands that formal and informal teaching or coaching of individuals or groups, including but not limited to top-rope belaying, technical skills, or exercises may only be performed by Boulder Parc staff; and
  • my Child will comply with any policies implemented by Boulder Parc regarding self-screening, the use of PPE, and physical distancing to limit the spread of infectious disease.

*NOTE: Children under the age of 13 CANNOT belay, MUST have their harness and rope safety checked by an adult or Boulder Parc staff member before climbing, MUST be belayed by an adult or Boulder Parc staff member. Children under the age of 16 CANNOT use the weight training equipment unless supervised by a Boulder Parc coach or instructor.

Please initial: 

 

INFORMATION RELEASE FOR CONTACT TRACING

In consideration of the objectives of public health units to understand and control potential outbreaks, I am authorizing Boulder Parc to disclose information to Toronto Public Health regarding my and my Child's phone number, check-in and check-out times, and any other reasonable and necessary information incident to COVID-19 contact tracing, should the need arise.

Please initial: 

 

GENERAL

This Agreement and any rights, duties and obligations as between the parties to this Agreement shall be governed by interpreted solely in accordance with the laws of the Province of Ontario and no other jurisdiction. Any litigation involving the parties to this agreement shall be brought solely within the Province of Ontario and shall be within the exclusive jurisdiction of the courts of the Province of Ontario. If any part of this Agreement is held unenforceable, the validity of all remaining parts will not be affected.

I agree that this Agreement will bind and benefit my or my Child’s heirs, next of kin, executors, administrators, and assigns in the event of my or my Child’s death or incapacity. I will not assign my or my Child's rights and obligations under this Agreement.

 

PARENT OR LEGAL GUARDIAN

I CONFIRM THAT I AM THE PARENT OR LEGAL GUARDIAN OF THE MINOR(S) LISTED BELOW.

I Agree

 

IN ENTERING INTO THIS AGREEMENT, I am not relying upon any oral or written representations or statements made by the Released Parties other than what is set forth in this Agreement.

I HAVE READ AND FULLY UNDERSTAND THIS AGREEMENT. I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I MAY OTHERWISE HAVE AGAINST THE RELEASED PARTIES AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

DATE: August 4, 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*
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
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*

Relationship*

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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