Loading...

I (Parent, Guardian or Responsible Adult), on behalf of the Minor Participant acknowledge:

-  I am aware that the Minor Participant named above (“Minor”) will be participating in an activity solely at my own discretion and the discretion of the Minor. Those activities could include all activities, events, or services provided, arranged, organized, conducted, sponsored, or authorized by Cliffside Climbing Gym Ltd. (“Cliffside”) including without limitation indoor roped climbing, indoor bouldering, training, stretching, observing others engaged in these activities, volunteering, supervision of children by parents or guardians, school and instructional sessions, and all other activities, events, and services in any way connected with or related to those activities (collectively, the “Climbing Activities”).

-  I UNDERSTAND THAT PARTICIPATION IN CLIMBING ACTIVITIES CAN BE HAZARDOUS AND MAY INVOLVE THE RISK OF PHYSICAL INJURY OR DEATH. I acknowledge that participation in Climbing Activities entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to me or the Minor, to my or the Minor’s personal property, or to third parties. I understand that those risks cannot be eliminated without jeopardizing the essential qualities of the Climbing Activities. The risks include but are not limited to slips, trips and falls; scrapes, cuts and bruises; sprains and strains; broken wrists, ankles, legs and other bones; concussions or other brain injuries; falling off walls; colliding with walls, climbing holds, the floor, and other individuals; colliding with or being landed on or struck by climbers; gymnastic/parkour maneuvers including flipping and somersaulting; swinging and penduluming; failing to climb or belay safely or within one’s own ability; failure of climbing equipment including ropes, harnesses, slings, anchor points, climbing holds, or any other equipment associated with or related to climbing and belaying; and misuse of any of the aforementioned equipment.

-  I am not aware of the Minor having any existing health, mental or physical condition(s) that may increase his/her risk in participating in the Climbing Activities.

-  I UNDERSTAND PARTICIPATING IN THE CLIMBING ACTIVITIES COULD RESULT IN THE MINOR’S INFECTION WITH THE COVID-19 VIRUS, WHICH COULD INVOLVE FLU-LIKE SYMPTOMS, RESPIRATORY PROBLEMS, ORGAN FAILURE, PERMANENT DISABILITY, OR DEATH. I agree that I will not permit the Minor to participate in any of the Climbing Activities, if: (1) to the best of my knowledge and awareness, the Minor is experiencing, or has experienced in the prior 14 days, flu-like symptoms or symptoms of any transmissible viral or bacterial infection or disease; or (2) to the best of my knowledge and awareness, the Minor has been in contact in the prior 14 days with any person diagnosed with the COVID-19 virus. I will not permit the Minor to participate in any Climbing Activities if I have been advised by the Minor, the BC Centre for Disease Control, any government agency, or the Minor’s doctor to physically isolate due to possible exposure to COVID-19.

-  The Minor has been informed that she or he must follow the rules and instructions communicated by Cliffside and its staff.

-  I understand that if the Minor does not follow Cliffside’s rules and instruction, he or she might lose their privilege to participate in the Climbing Activities.

-  In permitting the Minor to participate in this activity, I am not relying on any oral, written or visual representations or statements made by Cliffside or its directors, officers, employees, guides/instructors, agents of representatives or any other inducement.

Based upon my understandings and acknowledgements described herein, I give the Minor Participant permission to participate in the activities.

Today's Date: November 21, 2024

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 19 years of age or older
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*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 19 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.




By signing below the parent or court-appointed legal guardian agrees that they are also 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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 19 years of age or older
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!