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Portland Rock Gym Release of Liability and Assumption of Risk

Release, waiver, and indemnification contract:

Climbers promises to the Portland Rock Gym.

I agree that Portland Rock Gym, Inc., its shareholders, owners, officers, directors, employees, successors, agents and insurers (hereinafter collectively referred to in this waiver and all subsequent waivers as "PRG") shall not be liable for any harm I may come to, or damage to my property, while on the premises of PRG, or off the premises participating in activities sponsored, organized, or otherwise provided by PRG. The activities may involve, without limitation, rock climbing (including but not limited to climbing on artificial surfaces, outdoor instruction, and expeditions) and other recreational activities programs, events, instruction, and classes (including but not limited to rappelling and hiking), both inside and outside the facility. I hereby release PRG from all liability for such harm (except for gross negligence or willful misconduct), including for economic and noneconomic damages resulting from the same, even though that harm may result from PRG’s negligence.

I acknowledge that I watched and understood the PRG waiver video about auto-belays and bouldering orientation and have no questions.

Further, PRG shall not be liable for any harm I may come to, or any property loss that I may incur anywhere while using techniques learned in the gym and/or by participating in activities sponsored, organized, or otherwise provided by PRG, even though that harm may result from their negligence. I hereby release PRG, from any and all liability (except for gross negligence or willful misconduct) for such harm.

I acknowledge that my participation in rock climbing, rappelling, and hiking entails both known and unknown risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. I assume all risk of injury, including paralysis and death.

The risks referenced above include, but are not limited to: falling rocks, equipment or other items; falling off a rock cliff or artificial wall; loose or damaged artificial or natural holds; rented equipment failure; falling to the ground, on other users, or being fallen on by other users; abrasions from the rocks or wall, ropes, pads, or the ground or floor; being hit or crushed by falling rock, equipment, or other items; equipment failure; belay and or belayer failure; climbing out of control or beyond one's personal limits; the negligence of other climbers, visitors, participants, or other persons who may be present; failure of fixed bolts, pitons, or other climbing equipment; improperly tied knots or buckled harnesses; musculoskeletal injuries and/or over training; head injuries; or my own negligence. I also understand that all of the injuries and hazards described above are described by way of example only and that there are numerous other hazards and risks inherent in rock climbing, rappelling and hiking.

I recognize that it is my responsibility to learn how to use my gear and the anchors and ropes provided by the gym correctly. I agree that if a person isn’t willing to learn how to use this gear properly, that person is a danger to themselves and others. I agree to be a responsible climber.

I agree PRG shall not be liable for any of claims, losses, liabilities, or damages (including without limitation economic and noneconomic damages), or attorney fees or costs (hereinafter "Claims"), that arise from or relate in any way to my own acts or omissions. I agree that should any such Claims be asserted, I shall provide PRG with sufficient notice such that PRG may participate in its defense. Nothing in this paragraph shall restrict PRG from electing to defend itself against such Claims, nor shall PRG's election to defend itself waive my responsibilities herein.

I hereby represent that I have participated in 20 hours of top-rope belaying experience in the last 12 months or that I have successfully passed a test provided by PRG to test my top-rope belaying abilities. (Top-rope belaying is belaying from the foot of the climb when the climber is attached to a rope that passes up through an anchor system at the top of the climb, then down the belayer).

I will not engage in top-rope belaying until I have sufficient experience and I have passed PRG’s test.

I hereby represent that I have participated in 20 hours of lead belaying experience in the last 12 months or that I have successfully passed a test provided by PRG to test my lead belaying abilities. (Lead belaying is when the lead climber wears a harness attached to a climbing rope, then connected to other climbers below the lead climber. The lead climber will periodically connect the rope to protection equipment during the climb).

I will not engage in lead belaying until I have sufficient experience and I have passed PRG’s test.

I have read the rules of PRG and I agree to abide by them. I am in good health and have no physical or mental limitations that would preclude my careful and reasonable use of PRG facilities or participation in activities sponsored, organized, or otherwise provided by PRG.

I hereby grant to PRG, and PRG reserves the right to use, any digital imaging or video of me for training, promotional, security, or any other purpose as PRG desires. I understand such images may be used in PRG brochures, posters, web pages, videos, or other promotional media. I forever release PRG from any liability relating to such digital imaging or video, and waive any right to compensation for use of the same, including the use of my likeness for PRG's monetary gain. I understand I have no copyright for such digital imaging or video.

By signing this document, it is my intent to release, waive, and indemnify PRG, and all other persons or entities, including any guide services, acting in any capacity on their behalf or in conjunction with them, from any and all liability connected with my participation in any and all rock climbing, rappelling, hiking, and other activity sponsored, organized, or otherwise provided by PRG.

I understand that use of PRG’s facilities and equipment, including but not limited to, auto-belays, ropes and other devices are my responsibility and to be used at my own risk. I further understand and agree that is my responsibility to ask PRG staff if I am unfamiliar with or have any questions at any time concerning the use of PRG's facilities and equipment.

I acknowledge the contagious nature of communicable disease, viruses, and other illnesses, including without limitation Coronavirus/COVID-19 (hereinafter “Disease”) and that the CDC and many other public health authorities still recommend practicing social distancing and wearing face coverings. I further acknowledge and agree that PRG has put in place reasonable preventative measures as required by law to reduce the spread of Disease. I further acknowledge and agree that PRG does not guarantee that I will not become exposed to or infected with Disease while using PRG facilities or equipment. I understand and agree that the risk of exposure to Disease is inherent and unavoidable. I understand and agree that this risk may result from the actions, omissions, or negligence of myself and/or others, including, but not limited to, PRG staff, members, clients, guests, and others using or visiting PRG facilities or participating in PRG activities.

I voluntarily seek PRG’s services and acknowledge that by doing so I am increasing my risk of exposure to Disease. I acknowledge that I must comply with PRG’s procedures to reduce the spread of Disease at PRG facilities. For my protection and the protection of others, in consideration of being granted access to PRG facilities and equipment, and knowing that PRG and its staff, members, clients, guests, and others will act in reasonable reliance on the truth of my statements herein, I represent, warrant, and attest that the following are true and shall remain true every day that I access PRG’s facilities and equipment:

A) I am not experiencing any symptoms of Disease, including but not limited to Coronavirus/COVID-19 symptoms (cough, shortness of breath or difficulty breathing, fever, chills, shaking, muscle pain, headache, sore throat, or loss of taste or smell).
B) Within the last 14 days, I have not traveled to an area currently impacted by a pandemic or epidemic such as Coronavirus/COVID-19 (as determined by the United States government or the government with jurisdiction over the area of travel), nor have I traveled internationally.
C) I have not been exposed to anyone suspected or confirmed to be afflicted with Disease in the last 14 days.
D) I have not been diagnosed with Disease (or I have been cleared as non-contagious by public health authorities after being diagnosed).
E) I have been following and will continue to follow all applicable guidelines relating to the prevention of disease and prevention of the spread of disease issued by the CDC and by the public health departments/officers of the cities, counties and states in which I work, live, and visited within the past 14 days, and in Portland, Oregon.

On behalf of myself, my family members, my heirs, representatives, and successors, I hereby willfully and voluntarily acknowledge and accept the risks of being present at and using PRG facilities and equipment and being near others using PRG facilities and equipment, and to the maximum extent permitted by law release and agree to hold PRG harmless from any and all causes of action, claims, demands, damages, costs, expenses and compensation for injury, illness, damage or loss to myself and/or property that may be caused by any act or failure to act (including ordinary negligence) of PRG, or that may otherwise arise in any way in connection with any services received or my presence at any PRG facility.

I recognize that this is a contract. I have read it carefully and I sign it of my own free will.

Date: September 17, 2021

 

First Adult Participant Name

First Name*

Middle Name

Last Name*

Phone*
First Adult Participant Date of Birth*
First Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
First Adult Participant Signature*
Second Adult Participant Name

First Name*

Middle Name

Last Name*
Second Adult Participant Date of Birth*
Second Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
Third Adult Participant Name

First Name*

Middle Name

Last Name*
Third Adult Participant Date of Birth*
Third Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
Fourth Adult Participant Name

First Name*

Middle Name

Last Name*
Fourth Adult Participant Date of Birth*
Fourth Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
Fifth Adult Participant Name

First Name*

Middle Name

Last Name*
Fifth Adult Participant Date of Birth*
Fifth Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
Sixth Adult Participant Name

First Name*

Middle Name

Last Name*
Sixth Adult Participant Date of Birth*
Sixth Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
Seventh Adult Participant Name

First Name*

Middle Name

Last Name*
Seventh Adult Participant Date of Birth*
Seventh Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
Eighth Adult Participant Name

First Name*

Middle Name

Last Name*
Eighth Adult Participant Date of Birth*
Eighth Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
Ninth Adult Participant Name

First Name*

Middle Name

Last Name*
Ninth Adult Participant Date of Birth*
Ninth Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
Tenth Adult Participant Name

First Name*

Middle Name

Last Name*
Tenth Adult Participant Date of Birth*
Tenth Adult Participant Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
Adult Participant 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*
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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 Information
Belay Experience. Please Select One option*
Lead Belay Experience- Please Select One*
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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