Loading...

Assumption of Risk, Liability Release and Induction 
Membership Agreement 

R&A Adventure Sports Pty Ltd t/as
Indoor Climb South Coast ABN: 54630101352

To R&A Adventure Sports Pty Ltd t/as Indoor Climb South Coast (“ICSC”), I declare the following:

In consideration for my/my child’s (the “Participant’s”) participation in indoor climbing at the ICSC indoor climbing gym in Huskisson NSW (the “Activity”) I agree to this Assumption of Risk, Liability Release and Medical Information Agreement (collectively, this “Agreement”).

Release of Liability
I WAIVE, RELEASE, AND DISCHARGE ICSC from any and all liability for my/the Participant’s death, disability, personal injury, property damage, property loss or property theft, or actions of any kind which may hereafter occur to me/the Participant from the Activity including my/the Participant’s travelling to and from the Activity and the Induction undertaken prior to the Activity.

I Agree

Risks
I understand that there are inherent and obvious risks associated with the Activity, including the likelihood of significant physical exertion, falls from heights, incorrect use of safety and climbing equipment and exposure to heights. I have considered these and am willing to undertake the Activity at my own risk, including utilising all climbing equipment only as directed by ICSC staff. If using any of my own climbing equipment, I take full responsibility for its correct application, maintenance and will only use equipment that meets all applicable Australian standards, is fit for purpose and in good working condition.

I Agree

Health and Fitness
I certify that I/the Participant am/is of suitable physical fitness and health to undertake the Activity and I understand that this may be physically demanding on me/the Participant and I have been made aware of the risks to myself/the Participant before signing this Agreement. If I am unsure as to whether I/the Participant is suitable for the Activity, I have obtained appropriate medical advice on my/the Participant’s behalf prior to signing this Agreement.

I Agree

Induction
All Participants are required to undertake an Induction into the safe and proper use of the facilities, all climbing equipment and key safety rules of the gym. This will include Participants demonstrating correct techniques to ICSC staff. Participants that do not successfully complete the Induction process will not be permitted to access the facility. This is at the sole discretion of ICSC. Returning Participants may be required to undertake a refresher Induction if they have not climbed at ICSC for more than 3 months.

I Agree

 

Terms and Conditions
- You must read and understand our Terms and Conditions prior to commencing your Activity.
- Our Terms and Conditions can be found inside our premises and on our website. A hard copy can be provided to you upon your request.
- If you do not agree to our Terms and Conditions, we are unable to approve you as a Participant. 

 

ICSC Code of Conduct
- Participants are not to be under the influence of drugs or alcohol and are not permitted to consume alcohol within the ICSC facility.
- Participants agree to behave in a friendly and respectful manner when interacting with other customers or staff. Any behaviours that constitute bullying or harassment will not be tolerated.
- Participants to wear appropriate clothing, including clean closed in joggers or climbing shoes. Participants agree to follow the directions of ICSC staff at all times.

I Agree

 

In the case of an emergency, I authorise ICSC, where it is impractical to communicate with me/my next of kin, to arrange for me/the Participant to receive such medical or surgical treatment as may be deemed necessary by ICSC.

I undertake to pay or reimburse ICSC for the costs which may be incurred by ICSC for medical attention, ambulance transport and medication while I/the Participant is attending the Activity. I understand that although ICSC will attempt to minimise any risk of personal injury within practical boundaries, accidents do happen and all physical activities carry the risk of personal injury. I acknowledge that there is an inherent and obvious risk of personal injury in physical activities that will be undertaken at ICSC as part of the Activity and I accept that risk.

Some laws, like the Australian Consumer Law, may create warranties, conditions, rights or remedies, in relation to the supply by ICSC of services or goods, that cannot be excluded, restricted, modified or limited (‘Non-Excludable Terms’). To the fullest extent permitted by law, ICSC ’s liability for breach of or under a Non-Excludable Term of which the Participant has the benefit is limited at ICSC ’s option to the following: 

a) in the case of services – supplying the services again or paying the cost of having the services supplied again; or
b) in the case of goods – repairing the goods, supplying equivalent goods or paying the cost of repairing the goods or supplying equivalent goods.

If you sign this waiver, you will be agreeing to exclude, restrict or modify the ICSC’s liability with the result that compensation may not be payable if the Participant suffers a personal injury.

I confirm that I am over 18 (eighteen) years of age and I am the Participant/the legal guardian of the Participant. I have read and understood this Agreement prior to signing this document and I agree that this Agreement will be binding upon me/the Participant, my heirs, next of kin, executors, administrators and successors. I agree that this document may be relied upon in any proceedings which relate to me/the Participant. I understand that this Agreement will cover my Activity on this date, and any and all future Activities undertaken at ICSC

I consent for ICSC to use photos, footage and images taken as part of the Activity, as part of marketing and promotional material, including posting on social media, noting that no personal details will be used in such materials.

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Suburb *

Postcode *
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Suburb *

Postcode *
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Suburb *

Postcode *
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Suburb *

Postcode *
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Suburb *

Postcode *
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Suburb *

Postcode *
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Suburb *

Postcode *
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Suburb *

Postcode *
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Suburb *

Postcode *
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Suburb *

Postcode *
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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 Information

Suburb *

Postcode *
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