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This Waiver Agreement (“this Agreement”) affects your legal rights and obligations. You must read it carefully and must not sign it or participate in any activities at Climb West Melbourne unless you are satisfied that you understand and agree to its contents.

Climb West Melbourne Pty Ltd ACN 633 184 353 (referred to in this Agreement as “Climb West Melbourne” and includes its owners and staff) provides bouldering, rock climbing, climbing training facilities (Train To Climb, Kilter Board, Campus Board), slackline, gymnasium and weight training, and yoga classes and facilities (referred to in this Agreement as “Activities”) at 193 Maidstone Street, Altona, Victoria, 3018 (“Location”).

 

I, as the name listed below (referred to in this Agreement as “I”, “my”, “me” or “Participant”), acknowledge and agree to the below terms and conditions as consideration for Climb West Melbourne allowing me to attend the Location and participate in the Activities:

 

1.I understand that the Activities are physically and mentally demanding, inherently dangerous and involve significant risks, including but not limited to the following risks:

I may suffer various physical or mental injuries or die;
my property may be damaged, lost or stolen; and
I may injure other persons or damage their property.

 

2.I understand that Climb West Melbourne:

Is not responsible for the safekeeping of my property; and
are not trained medical professionals.

 

3. I promise to Climb West Melbourne that:

I am, or my parent or legal guardian is, aged 18 years or over;
I am in good physical and mental condition;
I am not aware of any physical or mental limitations, or medical or other reasons that could potentially impact, limit or prevent my ability to participate in any of the Activities or to exercise generally;
I will notify Climb West Melbourne if I have any concerns in relation to my ability to participate safely in any of the Activities; and that
the information I provide Climb West Melbourne will be true, complete and not misleading or deceptive in any way.

 

4. I will always follow the rules and directions of Climb West Melbourne, including but not limited to any rules or directions advised by any of its staff or contained in any signage or other documentation provided to me by Climb West Melbourne.

 

5.If I am injured or my property is damaged, lost or stolen, I agree not to make any actions, claims or legal proceedings for compensation (including but not limited to compensation for medical expenses, lost wages, pain and suffering, or repair or replacement of property) against Climb West Melbourne now or in the future in respect of any such injury or damage.

 

6.To the maximum extent permitted by law, I release and indemnify Climb West Melbourne, its staff, the registered proprietor of the Location and any other persons involved in my participation in any of the Activities:

From all actions, claims or legal proceedings for death, personal injury or damage, loss or theft of property arising from my participation in any of the Activities (including but not limited to direct, indirect, special or consequential loss or damage, or compensation for medical expenses, lost wages, pain and suffering, or repair or replacement of property), which may be made by me (including other parties on my behalf) or by other parties; and against any liabilities or losses (including but not limited to legal costs) incurred by Climb West Melbourne as a result of my negligence, a breach of any of the terms of this Agreement or if any of my promises in this Agreement are untrue.

 

7.I consent to Climb West Melbourne taking and publishing photos of me for use in any advertising or promotional material (including but not limited to printed materials or on social media).

 

8.Each time I participate in any of the Activities, I do so under the same terms and conditions of this Agreement and make the same promises to Climb West Melbourne. It is my responsibility to notify Climb West Melbourne if any of the promises in this Agreement cease to be true at any time or if I have any concerns in relation to my ability to participate safely in any of the Activities.

 

9.This Agreement is binding on my heirs, executors and assigns and may be relied upon by Climb West Melbourne in connection with any actions, claims or legal proceedings made by me, my dependants, heirs, executors and assigns, Climb West Melbourne or any other party.

 

10.If any part of this Agreement is deemed by a court of competent jurisdiction to be invalid, then the remainder of this Agreement shall remain in full force and effect and the offending part of this Agreement shall be severed.

 

11.I have carefully read and fully understand and agree to all of the terms of this Agreement, I wish to participate in the Activities, and I voluntarily assume all dangers or risks of, and responsibility for, any death, injury, or damage, loss or theft of property, in connection with my participation in any of the Activities or attendance at the Location.

 

Where Participant is under 18 years of age:

 

I, being the parent or legal guardian of the Participant, hereby acknowledge and agree to the below terms and conditions as consideration for Climb West Melbourne allowing the Participant to attend the Location and participate in the Activities:

 

I have read and understand this Agreement in its entirety;

 

I am aware of the risks, dangers and obligations set out in this Agreement;

 

I consent to the Participant participating in the Activities;

 

I agree to all of the terms in this Agreement on behalf of the Participant;

 

If the Participant is under 16 years of age, I will supervise the Participant at all times whilst the Participant is within the Location; and that

 

to the maximum extent permitted by law, I personally release and indemnify Climb West Melbourne, its staff, the registered proprietor of the Location and any other persons involved in the Participant’s participation in any of the Activities:

from all actions, claims or legal proceedings for death, personal injury or damage, loss or theft of property arising from the Participant’s participation in any of the Activities (including but not limited to direct, indirect, special or consequential loss or damage, or compensation for medical expenses, lost wages, pain and suffering, or repair or replacement of property), which may be made by me (including other parties on my behalf), the Participant or by other parties; and
against any liabilities or losses (including but not limited to legal costs) incurred by Climb West Melbourne as a result of the Participant’s negligence, a breach of any of the terms of this Agreement or if any of my promises in this Agreement are untrue.

April 22, 2021

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*

Phone*
Second Participant's Date of Birth*
Second Participant's Signature*
Third Participant's Name

First Name*

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's Signature*
Fourth Participant's Name

First Name*

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's Signature*
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*
info@climbwestmelbourne.com.au
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Induction Safety Video
By checking here, I agree that I have watched the Climb West Melbourne Induction Safety Video. I understand and agree to comply with all Rules and Safety Instructions given in this video, in person by members of staff and printed on signs throughout Climb West Melbourne or displayed on the website www.climbwestmelbourne.com.au.
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*

Relationship*

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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