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Moments Climbing Gyms

WAIVER AND RELEASE OF LIABILITY FOR ANY INJURY OR DEATH AND ASSUMPTION OF RISKS

PLEASE READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. THIS DOCUMENT INCLUDES A RELEASE OF LIABILITY AND MUST BE SIGNED BY A PARTICIPANT WHO IS AT LEAST EIGHTEEN YEARS OF AGE OR A PARENT OR LEGAL GUARDIAN OF ANY PARTICIPANT UNDER THE AGE OF EIGHTEEN.

The participant named below desires: (a) to use or be granted access to one or more of the Moments Climbing facilities, which may be owned, directly or indirectly, in whole or in part, by Moments Climbing USA, Inc. and all of their predecessors and successors (“Facility” or “Facilities”, or collectively, “Climbing Gyms”); (b) to participate in trips, competitions, camps, climbing courses, use of fitness equipment, to participate in fitness classes, and/or other types of events (collectively, “Events”) which may take place at a Facility or are otherwise sponsored by or involve the Climbing Gyms or the Climbing Gyms’ owners, officers, directors, employees, independent contractors, agents, affiliated entities or persons, landlords and property managers (together with the Climbing Gyms, collectively, “Released Parties”); and/ or (c) to engage in wall climbing, bouldering, other climbing activities, sports, fitness activities, use of fitness equipment, or any of the various other types of activities (collectively, “Activities”) which may take place at a Facility or are otherwise provided or sponsored by or involve the Climbing Gyms or any of the other Released Parties. All references to the “Facility” throughout this Waiver And Release Of Liability For Any Injury Or Death And Assumption Of Risks (“Release”) includes all rooms, areas, and spaces on the interior of each Facility, the exterior of each Facility, and the parking lot of each Facility.

I have agreed to execute this Release in consideration for the Climbing Gyms permitting myself and/or Participant (collectively “me”, “I” or “my”) to use the Facilities to participate in the Events and/or engage in the Activities.

A. I WAIVE AND RELEASE THE RELEASED PARTIES FROM MY DEATH AND ANY INJURY, LOSS, DAMAGE, EXPENSE, ACTION, CLAIM, AND LIABILITY ARISING OUT OF ANY USE OF THE FACILITIES, THE PARTICIPATION IN ANY OF THE EVENTS, OR THE ENGAGEMENT IN ANY OF THE ACTIVITIES:

I agree to release and discharge the Climbing Gyms and the other Released Parties from any and all liability for my death and any and all past, present, or future injuries, losses, damages, expenses, property damage, social losses, economic losses, actions, claims, and liabilities of any and every kind, whether at law or equity, under statute, in contract, or in tort, whether known or unknown, anticipated or unanticipated, suspected or unsuspected, relating to or arising from: (i) the use of any Facility or equipment located at any Facility; (ii) my participation in Events sponsored by or involving any Facility, the Climbing Gyms or any of the other Released Parties; (iii) participation in or observation of the Activities sponsored by or involving any Facility, the Climbing Gyms or any of the other Released Parties; or (iv) my interaction with any of the Released Parties. This Release is intended to release and discharge the Released Parties from any and all losses, damages, expenses, actions, claims and liabilities of any nature whatsoever, such as (but not limited to) losses, damages, expenses, actions, claims and liabilities arising from or related to the negligence of, or the breach of any duties which may be owed, whether by statute, in contract, or in tort, by the Released Parties. I understand that this Release prohibits me from filing any lawsuit against any of the Released Parties for any of the reasons identified in this paragraph, now or in the future, and from recovering any losses, damages or expenses against any of the Released Parties.

B. I ASSUME THE RISK OF INJURIES OR DEATH ASSOCIATED WITH THE USE OF THE FACILITIES, THE PARTICIPATION IN ANY OF THE EVENTS, OR THE ENGAGEMENT IN ANY OF THE ACTIVITIES:

I understand that there are significant elements of risk associated with use of the Facility, participation in the Events, and engagement in the Activities that may be sponsored by or otherwise involve the Facilities, the Climbing Gyms or any of the other Released Parties. I understand and acknowledge that certain risks cannot be eliminated due to the nature of the Events or the Activities, and that these elements and risks may be causes of injury, illness, permanent disability, trauma (physical and emotional), or death. These risks and dangers include but are not limited to falling; landing on or striking padded or unpadded surfaces; being injured by falling objects or participants; being injured by the actions or inactions of other participants, including but not limited to other participants’ failure; movement of climbing holds; equipment failures of any kind; and physical injury as a result of engaging in physical activity. I recognize that the foregoing list of risks are examples of the risks that I am assuming by using the Facilities and/or participating in the Events or Activities and that I am also assuming risks not specifically listed above. I recognize that if I encounter these risks, serious injury or death may result, and I understand that no amount of care, caution, instruction or expertise can eliminate these risks.

I understand there will be periods when my activities are not supervised or monitored by Facility personnel. I assume the responsibility for the protection and care of any personal property brought onto the premises, or rented from the Facility, and understand that the Facility and/or its staff have no duty to safeguard such property.

I acknowledge that using the Facilities, participating in the Events and engaging in the Activities sponsored by or involving the Facilities, Climbing Gyms or any of the other Released Parties involves certain risks, inherent and otherwise, including the risk of death or serious personal injury and potential exposure to communicable disease (including but not limited to coronavirus/COVID-19, other viruses, bacteria, and all other infectious pathogens and disease vectors) regardless of whether I follow the Climbing Gyms’ safety instructions or recommendations, such as those pertaining to Facility rules and regulations, climbing, bouldering, or instructional programs. I agree to assume all such risks, as well as any other risks involved in using the Facility, participating in Events, and/or engaging in the Activities sponsored by or involving the Climbing Gyms or any of the other Released Parties. I agree that my access or membership may be revoked, suspended, or terminated without a right to a refund if I do not follow all Facility rules and regulations that may be posted or communicated to me. I understand that the Facility reserves the right to refuse any person it deems incapable of meeting the requirements to safely participate in Activities.

C. I AGREE TO INDEMNIFY, HOLD HARMLESS, AND DEFEND THE RELEASED PARTIES:

I further agree to indemnify, hold harmless and defend the Released Parties from and against any and all loss, damage, liability, claim and expense, including costs and attorneys’ fees, incurred by any of the Released Parties as a result of my using the Facilities, participating in Events, and/or engaging in Activities sponsored by or involving the Climbing Gyms or any of the other Released Parties, including any loss, damage, liability, claim, and expense arising out of the Climbing Gyms’ own negligence. I understand that this Section means that I will have to reimburse the Climbing Gyms or any of the other Released Parties for any losses, damages, liabilities, claims, costs, attorneys’ fees, or expenses sustained by the Released Parties as a result of my using any Facility, participating in Events, and/or engaging in Activities sponsored by or involving the Climbing Gyms or any of the other Released Parties.  I hereby waive all claims that I may have against the Released Parties, and agree that neither I, nor anyone acting on my behalf, will make file suit against the Released Parties regardless of the negligence of any person, including but not limited to the negligence of the Released Parties. This Release includes, but is not limited to, claims for personal injury, property damage, wrongful death, products liability, or breach of contract.

D. I WAIVE MY RIGHT TO A JURY TRIAL AND CONSENT TO CHOICE OF LAW.  I SPECIFICALLY WAIVE THE RIGHT TO A TRIAL BY JURY IN ANY ACTION BROUGHT BY OR AGAINST THE CLIMBING GYMS OR ANY OF THE OTHER RELEASED PARTIES.

The laws of the State in which I use a Facility, participate in an Activity, or participate in an Event shall govern the rights and obligations of the parties to this Release and the interpretation, construction and enforceability of this Release. If any dispute shall arise between me and either the Climbing Gyms or any of the other Released Parties, I agree that any lawsuit brought by or on behalf of me against any Released Parties shall be brought solely in a federal or state court located in one of the states where a Facility is located or where an Event or Activity took place. This Release shall be effective upon my execution hereof and shall continue in force, unless sooner terminated pursuant to a written notice, for so long as I or (if applicable) Participant use a Facility, participate in an Event, and/or engage in an Activity sponsored by or involving the Climbing Gyms or any of the other Released Parties

E: I PERMIT THE USE OF MY LIKENESS:

I acknowledge and agree that the Climbing Gyms reserve the right to use any photograph, video recording, audio recording, or any other media taken at the Facilities, during Events, or in connection with any of the Activities involving the Climbing Gyms or any of the other Released Parties in connection with the Climbing Gyms and the Released Parties’ promotional materials, brochures and website.

F: MEDICARE TREATMENT:

I authorize any of the Released Parties to obtain or provide medical care for me without liability and to transport me, or arrange for transportation of me, to a medical facility.  I authorized medical personnel to render such treatment deemed necessary for my health.  I understand the Released Parties have no obligation to provide medical treatment and I agree to pay all costs associated with any such medical care and transportation.

G: SEVERABILITY:

If any term, provision, or condition, or any part thereof, of this Release shall for any reason be found or held to be invalid or unenforceable by and court or governmental agency of competent jurisdiction, such invalidity or unenforceability shall not affect the remainder of such term, provision, or condition or any other term, provision, or condition, and this Release shall survive and be construed as if such invalid or unenforceable term, provision or condition had not been contained therein.

H: MISCELLANEOUS:

This Release constitutes the complete understanding and intent of the parties related to the subject matter herein, and cannot be modified, in whole or in part, except in writing signed by both parties.  The Parties acknowledge that they have had the opportunity to review this Release with counsel or advisor prior to its execution.

FACILITY ORIENTATION

  • All climbers and observers must check in at the front desk before proceeding into the facility.
  • Climbing is dangerous and there are inherent risks. Participants and observers must assume the risks of climbing and entering the facility. All climbers, participants, observers, individuals operating a safety system, and anyone proceeding past the check in area must sign (or their parent/ guardian must sign) the Waiver, Release of Liability form.
  • All persons using the facility are expected to respect other individuals and conduct themselves in good order. Participation in climbing or fitness activities while under the influence of drugs or alcohol is not permitted. Persons deemed by staff to be behaving in an unsafe or disorderly fashion will be asked to leave the facility.
  • Youth: Youth climbers under the age of 13 must be supervised by an adult (18 years or older) or by a staff member. Youth under the age of 13 are not permitted in fitness areas. Parents and caregivers are responsible for the supervision of their children. Limited exceptions to the fitness area age requirement are made for Moments Climbing team members.

BOULDERING ORIENTATION

I certify that I will watch the Bouldering Orientation video, confirm that I have watched it to a staff member, and ask any questions that I may have prior to participating in any activities.  If the participant is a minor, and this agreement is signed by a parent or legal guardian, I as the parent or legal guardian understand that it is my responsibility to review the video and orientation materials and provide the information therein to my child.

  • Bouldering (un-roped climbing) involves increased risks because of the likelihood of falling and all falls could result in injury or death.  Padded floors (where present) do not and cannot guarantee prevent of injury or death.
  • To reduce your risk of injury down climb when possible instead of jumping off walls.
  • Keep Landing Zones Clear: Do not lay on pads or walk under climbers. Remove all personal items from landing zones.  Be aware at all times because you could land on or be landed on by other participants.
  • Proper Falling Technique Can Reduce Injuries:
  • Prior to, or upon falling, spot your landing.
  • Stay relaxed and bend your knees and elbows.
  • Pull in your arms.  Avoid extending your arms to reach for the floor.
  • As you land, absorb the impact with your legs bent and roll to the ground.
  • Ratings: Boulder problems are rated using the V-Scale (V-intro or V0, V1, V2, V3, etc.) with V-Intro being the easiest.
  • New Climbers: Those who are new to bouldering should start with easier problems (V-Intro or V0) and avoid climbing the full height of the wall until they are more comfortable with climbing, down climbing, and proper falling technique.

I HAVE READ AND UNDERSTAND THE FOREGOING ACKNOWLEDGEMENT OF RISK, ASSUMPTION OF RISK AND RESPONSIBILITY, AND RELEASE OF LIABILITY FOR ANY INJURY OR DEATH.  I UNDERSTAND THAT BY VOLUNTARILY SIGNING THIS FORM I MAY BE WAIVING VALUABLE LEGAL RIGHTS FOR MYSELF, MY PERSONAL REPRESENTATIVES, ASSIGNS, HEIRS, AND SUCCESSORS.

I acknowledge, for myself and any minor child or children on whose behalf I signed this Release that: (a) I have read the Release and I fully understand all of the terms of the Release; (b) I agree that nothing in the Bouldering Orientation unto which this Acknowledgement is attached shall be construed to alter, modify, or extinguish any element of the Release, or any agreement made by me thereunder; (c) I understand that I or such minor child or children identified as the “Participant” on the Release require orientation and/or training before participating in climbing and bouldering activities in any Moments Climbing facilities; (d) I understand that any Moments Climbing facility may require me to pass an assessment or assessments prior to allowing me or such Participant to participate in certain activities; (e) I understand that if I or such Participant needs additional assistance, orientation, instruction, training, or assessment during my or such Participant’s participation at a Moments Climbing Facility at any future time, then it is my responsibility to seek such assistance, orientation, instruction, training, or assessment from the Moments Climbing staff prior to participating in any activity for which I am not, or such Participant is not, trained or qualified; (f) my signatures indicates that I understand the information and acknowledgements set forth above; and (g) I am at least eighteen years of age and of sound mind.

Today's Date: November 24, 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*
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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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