Loading...

BASECAMP CLIMBING - DUAL****2024 WAIVER

RELEASE​ ​OF​ ​LIABILITY,​ ​ASSUMPTION​ ​OF​ ​RISKS​ ​AND INDEMNITY​ ​AGREEMENT​ ​FOR​ ​BASECAMP​ ​CLIMBING​ ​INC. (“BASECAMP”) 


ln consideration of my being allowed to use BASECAMP’s rock climbing facilities, I the undersigned, agree to and acknowledge the following:

  1. ASSUMPTION OF RISK: I acknowledge and agree that the sport of rock climbing and use of BASECAMP’s facilities for any available activities (such as indoor rock climbing, bouldering, yoga, or weight lifting), involves inherent risks, dangers and hazards, which may result in personal injury, death or damage to my property. I freely accept and fully assume responsibility for all such risks, dangers and hazards, even if caused by negligence, including, but not limited to:
  2. a. Injury resulting from my performing strenuous manoeuvres, falling off or from the Climbing Wall and hitting the floor, wall faces, exposed or unexposed structural supports, people or rope projections, whether permanently or temporarily in place;
  3. b. Rope abrasion, entanglement and other injuries resulting from activities on or near the Climbing Wall such as, but not limited to climbing, belaying, lowering on ropes, rescue systems, and any other rope techniques;
  4. c. Injuries resulting from falling climbers or dropped items, including, but not limited to, ropes, holds, climbing hardware or wall pads;
  5. d. Cuts and abrasions resulting from skin contact with the Climbing Wall or any other surface; and
  6. e. Failure of ropes, slings, harnesses, climbing holds, anchor points, hardware, or any part of the Climbing Wall; and
  7. f. Increased risk of illness, personal injury or death resulting from exposure to or infection by the novel coronavirus, COVID-19. 
  8. I expressly acknowledge that the above list is not inclusive of all possible risks associated with the use of BASECAMP’s facilities and that I have been provided with an opportunity to ask questions regarding the risks prior to signing this agreement.
  9. AGREEMENT RE BASECAMP SAFETY POLICIES: I accept full responsibility for my own safety and the safety of other climbers while on BASECAMP’s premises. I agree to adhere to and help to enforce BASECAMP’s Safety Policies:
  10. a. I will not visit BASECAMP’s facilities or attempt to use BASECAMP’s facilities if I am physically unwell, experiencing COVID-19 symptoms, or if I have been exposed to or in close contact with anyone with a confirmed or suspected case of COVID-19.
  11. b. I agree that I will not be permitted to climb or boulder on the Climbing Walls until I have completed a BASECAMP orientation.
  12. c. I will not consume any alcohol or any other substance which would impair my senses or judgment prior to or while using BASECAMP’s facilities.
  13. d. I will only belay other climbers (on top-rope or lead) once I have been trained and/or qualified by a BASECAMP Instructor. I accept responsibility for my choice in belay partner and will ensure that any such belay partner has also been qualified by BASECAMP.
  14. e. I will ensure that any climbing equipment used by me, which is not provided by BASECAMP, is in good condition and will accept full responsibility for the safety and integrity of my rope and belay device when I am lead climbing or belaying.
  15. f. All top-rope climbing must be on ropes provided by BASECAMP. All climbers (top-rope/lead) must be belayed using a Gri-Gri. Roped climbers and belayers must wear a harness approved by a Basecamp staff member.
  16. g. Climbers will tie the rope directly into their harness with a figure eight retrace knot and a keeper knot.
  17. h. Helmets are required for all climbing unless the Helmet Waiver is signed.
  18. i. All climbers must inform BASECAMP staff immediately of any equipment defects, accidents, damage, or of any situation which is believed to be unsafe/contrary to the safety policies.
  19. j. Experienced climbers are encouraged to assist less experienced climbers with respect to safety concerns.
  20. k. I understand and agree that BASECAMP reserves the right to deny access to its facilities to any individual permanently or for a specified period of time for any breach of any of the Safety Policies, or for any conduct that is viewed as unsafe or inappropriate.
  21. WARNING: By signing this Agreement, you are giving up the right to sue BASECAMP and seek compensation or damages for property damage, personal injury or death, regardless of how such damages or injury was caused:

  22. WAIVER AND RELEASE: I hereby release and discharge BASECAMP CLIMBING INC and its owners, directors, officers, employees, independent contractors, agents, successors and assigns (collectively the “Releasees”) from any and all liabilities, suits, claims, demands, actions or damages that I have, or may have in the future against BASECAMP arising out of my use of or presence at the BASECAMP facility, including, without limitation, all claims for property damage, negligence, personal injury, or wrongful death. I waive all rights to make or bring any claims, demands, actions, suits or proceedings against any of the Releasees. This waiver and release is binding on my heirs, executors, assigns and agents.
  23. INDEMNIFICATION: I agree to indemnify and hold harmless the Releasees from any and all causes of action, claims, demands, losses, liabilities, costs or expenses arising out of or in any way relating to my use of BASECAMP’s facilities, or presence at the BASECAMP’s facilities, or violation of any BASECAMP policy., including specifically any damage or injury caused to a 3rd party resulting from my participation in available activities at BASECAMP.For clarity, I understand and agree that if BASECAMP is sued by a third party for damages in relation to my conduct at any BASECAMP facility, I will be responsible for BASECAMP’s reasonable legal costs to defend that claim and any damages owing. This indemnification is binding on my heirs, assigns and agents.

 

​I​ ​HAVE​ ​READ​ ​AND​ ​UNDERSTOOD​ ​AND​ ​AGREE​ ​TO​ ​THE​ ​TERMS​ ​OF​ ​THIS​ ​RELEASE,​ ​WAIVER​ ​AND INDEMNITY​ ​AND​ ​AM​ ​VOLUNTARILY​ ​SIGNING​ ​BELOW:

*​ ​Please​ ​note​ ​that​ ​contact​ ​information​ ​will​ ​not​ ​be​ ​shared​ ​with​ ​any​ ​third​ ​parties​ ​and​ ​will​ ​only​ ​be​ ​used​ ​to​ ​send​ ​you​ ​emails​ ​about​ ​gym​ ​deals, sales​ ​and​ ​discounts,​ ​if​ ​you​ ​so​ ​choose!​ ​You​ ​will​ ​be​ ​able​ ​to​ ​unsubscribe​ ​from​ ​these​ ​emails​ ​at​ ​any​ ​time.

 

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

First Name*

Last Name*

Emergency Contact's Phone Number*
Helmet Waiver
I, being over the age of 18; or either the parent/legal guardian of the minor participant, acknowledge and agree that I have been informed of the hazards, dangers, and potential injuries associated with climbing, belaying, and bouldering at BASECAMP CLIMBING INC. without a helmet. In particular, I understand that climbing with a helmet can help to prevent a head injury. BASECAMP CLIMBING INC. will provide a helmet at no charge to use in the facility at any time, but I have chosen not to have the minor participant wear a helmet/wear a helmet myself while using the facilities and assume full responsibility of any injury, up to and including death that may result from my not using a helmet. I​ ​have read, understood, agree to the terms of the HELMET WAIVER and am voluntarily signing.*
Yes
No
I, BEING OVER THE AGE OF 18 AND EITHER THE PARENT OR LEGAL GUARDIAN OF THE MINOR PARTICIPANT, HAVE READ AND UNDERSTOOD AND AGREE TO THE TERMS OF THIS RELEASE, WAIVER AND INDEMNITY AND UNDERSTAND THAT IT APPLIES TO THE MINOR PARTICIPANT(S), AND I AM VOLUNTARILY SIGNING ON BEHALF OF THE MINOR PARTICIPANT(S) BELOW:


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*

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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE! and  Rock Gym Pro