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WAIVER FORM

READ THOROUGHLY AND CAREFULLY BEFORE SIGNING

Participant risk acknowledgement, release, waiver of claim and assumption of risk for Vertical Adventures and use of the climbing wall.

 

In consideration of permission granted now or in the future by Vertical Adventures (The "Owner") to use the Vertical Adventures Climbing Wall (the "Climbing Wall") or participate in any of the activities associated with the same, I agree and acknowledge that:

2. I will abide by the rules and regulations imposed upon all participants in the use of the Climbing Wall, and I recognize that it is my sole responsibility to acquaint myself with them.

3. I am fully aware that there are risks and hazards inherent in the very nature of the use of the Climbing Wall. I have full knowledge of the nature and extent of these risks and that in using the Climbing Wall I may suffer personal injury, death or property loss. The particulars of these types of injuries include, but are not limited to:

a) Any injury resulting from falling and impacting against the Climbing Wall faces or the ground;
b) Rope abrasion, entanglement, and other injuries resulting from activities on the Climbing Wall face;
c) Cuts and abrasions resulting from skin contact with the Climbing Wall;
d) Injury which results from falling equipment or contact with other persons using the Climbing Wall.
e) Injury which results from failure of ropes, slings, harnesses, climbing hardware, anchor points, or any other part of the climbing structure;

6. I hereby release and forever discharge and hold harmless Vertical Adventures, its Directors, Officers, employees, volunteers, agents, and contractors (All hereinafter referred to as the "Releasees") of and from any and all claims, demands, damages, proceedings, expenses, actions, or causes of action in law or in equity in respect to any death, injury, loss, or damage to myself or to my property howsoever caused and arising or to arise by my use of the Climbing Wall including, without limiting the generality of the foregoing, the negligence of the Releasees.

7. I agree to indemnify and save harmless the Releasees for any claim, including any claim for medical services arising from the use of the Climbing Wall.

8. I am aware of the nature and effect of this Release, Waiver of Claim and Assumption of Risk, my voluntary signature on this Release, Waiver of Claim and Assumption of Risk is binding upon myself, my heirs, my executors, administrators and assigns.

9. This Release and Waiver of Claim shall be binding upon me, my heirs, executors, administrators and assigns.

10. I am executing this Release and Waiver of Claim and Assumption of Risk freely and voluntarily without any compulsion on behalf of Vertical Adventure

 

Today's Date: December 2, 2021

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

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*

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.


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