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WAIVER AND INDEMNITY AGREEMENT

I UNDERSTAND THAT THIS DOCUMENT, WHEN AGREED TO BY ME, WILL WAIVE LEGAL RIGHTS AND CREATE LEGAL OBLIGATIONS IN ACCORDANCE WITH ITS TERMS AND I MAKE THESE AGREEMENTS AND DECLARATIONS UNDERSTANDING SUCH CONSEQUENCES.

I HEREBY DECLARE AND AGREE AS FOLLOWS: 
That I am Member at Five Point Climbing Ltd. DBA. Climb Base5 North Vancouver and/or City Cliffs Climbing Gyms Ltd. DBA. Climb Base5 Coquitlam, hereinafter referred to as “the Gym”.

WAIVER, RELEASE AND INDEMNITY 

  1. . By checking “I Agree”, I hereby declare and agree to the following: In recognition of the infectious nature of COVID-19, and the potential to be infected by a person showing no symptoms of exposure to the virus, I understand that there exists a risk that I could be infected with COVID-19 as a result of my attendance at the Gym and suffer serious medical consequences, even death, as well as financial loss, and in full knowledge and understanding of these risks, I declare that I freely assume such risks as the consequence of my choice to use the Gym, that such use shall be entirely at my own risk, and that I, on behalf of myself, my heirs, successors and estate, hereby irrevocably waive as against the Gym and its directors, officers, employees, sponsors, independent contractors and agents, as well as my fellow Members, any and all recourse, proceedings, claims, and causes of action of any kind whatsoever, in respect of any and all COVID-19-related personal injury, loss or death which I may suffer arising out of or connected with my attending at and using the facilities of the Gym, even if such injuries or losses may have been caused solely or partly by the negligence or breach of duty of the Gym.

    I Agree
  2. By checking “I Agree”, I hereby declare and agree to the following: I do hereby, on behalf of myself, my heirs, executors and my estate, release the Gym from all liability to myself, my heirs, successors, and my estate from any consequence, claim, or liability arising from any harm, loss, injury, or other adverse effect related to COVID-19, including death, occurring to me as a result of my attendance at and usage of the facilities of the Gym.

    I Agree
  3. By checking “I Agree”, I hereby declare and agree to the following: I acknowledge that I would not be permitted to attend at the Gym and participate in sports and other activities during the current COVID-19 pandemic crisis if I did not make the agreements and declarations hereunder, and that I am bound by the terms and conditions of this agreement.

    I Agree
  4. I hereby declare that I have read, understood, and agreed to act in all respects in compliance with the policies and guidelines currently posted at the Gym premises or onthe Gym’s website or circulated by email by the Gym, as such may be amended from time to time.

    I Agree
  5. I hereby acknowledge, accept, and agree that the information provided herein is accurate to the best of my knowledge. I agree to strictly observe all regulations and rules established and posted by the Gym for the purpose of protecting the safety of our members and staff during the COVID-19 pandemic. Breach or contravention of any of the posted rules and regulations, or conduct that may place the health of staff or Members in jeopardy, and inaccuracies in these health declarations, may be grounds for me to be removed from the Gym premises or denied access to the Gym for the duration of the COVID-19 pandemic, and may be grounds for my suspension or expulsion from the Gym.

    I Agree
  6. HEALTH DECLARATIONS: I hereby declare that neither I nor anyone else in my household, nor anyone with whom I have had contact within the last fourteen days, has to my knowledge been exposed to the Novel Corona Virus or experienced any symptoms known or understood or suspected to be associated with the Novel Corona Virus. The aforementioned symptoms include, but are not limited to, fever, cough, sore throat, respiratory illness, difficulty in breathing, and any other symptoms published by any authority of the provincial health ministry for BC. If I or anyone in my household, or any person with whom I have had contact, to my knowledge, develop or experience any such symptoms after I submit this form, I agree that I will not visit the Gym for a minimum of fourteen days after such symptoms have entirely disappeared.

    I Agree
  7. . By checking “I Agree”, I hereby declare and agree to the following: I UNDERSTAND THAT BY COMPLETING AND SUBMITTING THIS DOCUMENT I AM WAIVING LEGAL RIGHTS THAT I MAY OTHERWISE HAVE, AND ASSUMING LEGAL OBLIGATIONS BY THE INDEMNITY HEREIN GRANTED BY ME. I ACKNOWLEDGE THAT THIS IS A LEGAL DOCUMENT AND THAT, AS THE SIGNATORY, I AM ADVISED TO SEEK LEGAL ADVICE.

    I Agree
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
  8. Agreed and Declared upon this date: October 24, 2020
First Participant's Name

First Name*

Last Name*
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*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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. IF I AM THE PARENT AND/ OR LEGAL GUARDIAN OF THE PARTICIPANT, I HAVE READ AND UNDERSTAND AND AGREE TO EXECUTE “THE AGREEMENT” ON BEHALF OF CHILD/ WARD, I HEREBY AGREE TO INDEMNIFY AND SAVE HARMLESS THE COMPANY AND AGENTS FOR ANY AND ALL CLAIMS, BY OR ON BEHALF OF OUR SAID CHILD IN RESPECT OF, OR ARISING OUT OF, ANY NEGLIGENCE, BREACH OF CONTRACT, BREACH OF STATUTORY DUTY OF CARE AS IT RELATES TO ALL THE EVENTS ORGANIZED BY “THE COMPANY” AND/OR “THE AGENTS.
Parent or Guardian's Name

First Name*

Last Name*
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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