Loading...

I, (Parent or Legal Guardian), on behalf of the Minor Participant acknowledge the following:

  • I am aware that the Minor Participant named above (the “Minor”) will be participating in physical fitness activities solely at my own discretion and the discretion of the Minor. Those activities could include all activities, events, or services provided, arranged, organized, conducted, sponsored, or authorized by The Hive Heights, Honeycomb Climbing Incorporated, The Hive North Shore, & The Hive Port Coquitlam (collectively, the “Companies”), including without limitation: indoor climbing, outdoor rock climbing, indoor bouldering, outdoor bouldering, training, stretching, observing others engaged in these activities, school and instructional sessions, transportation to outdoor climbing sites, and all other activities, events, and services in any way connected with or related to those activities (collectively, the “Climbing & Fitness Activities”).

 

  • I UNDERSTAND THAT PARTICIPATION IN THE CLIMBING & FITNESS ACTIVITIES CAN BE HAZARDOUS AND MAY INVOLVE THE RISK OF PHYSICAL INJURY OR DEATH. I acknowledge that participation in the Climbing Activities entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to me or the Minor, to my or the Minor’s personal property, or to third parties. I understand that those risks cannot be eliminated without jeopardizing the essential qualities of the Climbing & Fitness Activities. The risks include but are not limited to: scrapes, cuts and bruises; falling off of equipment; muscle and joint sprains and strains; broken wrists, ankles, legs, and other bones; participants falling and falling on each other resulting in broken bones and other serious injuries including death, participants failing to wear their harness properly, participants failing to clip into the auto-belay device before climbing, or clipping the auto-belay device into the wrong part of the harness or into something other than a real harness; in the context of roped climbing: swinging and penduluming; failing to climb or belay safely or within one’s own ability; failure to act safely on the part of instructors or supervisors or other climbers or belayers; failure of climbing equipment including ropes, harnesses, slings, anchor points, climbing holds, or any other equipment associated with or related to climbing and belaying; and misuse of any of the aforementioned equipment; and in the context of outdoor rock climbing, in addition to the injuries and risks listed above, include but are not limited to: failure to act safely on the part of instructors or supervisors or other climbers or belayers, trips arising from walking on uneven terrain, falling whether roped or un-roped off a route, falling rocks or other objects, rope burns, weather which may cause injury due to extreme heat, cold or lightning, wild animals, insect bites, hazardous plant life, and transport by public or private vehicles to and from the activity site.

 

  • I am not aware of the Minor having any existing health, mental, or physical conditions that may increase his or her risk in participating in the Climbing & Fitness Activities.

 

  • I UNDERSTAND PARTICIPATING IN THE CLIMBING & FITNESS ACTIVITIES COULD RESULT IN THE MINOR’S INFECTION WITH THE COVID-19 VIRUS, WHICH COULD INVOLVE FLU-LIKE SYMPTOMS, RESPIRATORY PROBLEMS, ORGAN FAILURE, PERMANENT DISABILITY, OR DEATH. I agree that I will not permit the Minor to participate in any of the Climbing & Fitness Activities, if: (1) to the best of my knowledge and awareness, the Minor is experiencing, or has experienced in the prior 14 days, flu-like symptoms or symptoms of any transmissible viral or bacterial infection or disease; or (2) to the best of my knowledge and awareness, the Minor has been in contact in the prior 14 days with any person diagnosed with the COVID-19 virus. I will not permit the Minor to participate in any Climbing & Fitness Activities if I have been advised by the Minor, the BC Centre for Disease Control, any government agency, or the Minor’s doctor to physically isolate due to possible exposure to COVID-19.

 

  • The Minor has been informed that he or she must follow the rules and instructions communicated by the Companies and its staff.

 

  • I understand that if the Minor does not follow the Companies’ rules and instructions, he or she might lose their privilege to participate in the Climbing & Fitness Activities.

 

  • I understand that putting the harness on, clipping into the auto-belay device, tying into the rope and belaying are unsupervised and that a Minor aged 16 years and older is permitted to do these tasks and is solely responsible for properly doing them.

 

  • I understand that putting the harness on, clipping into the auto-belay device, tying into the rope and belaying are unsupervised and that a Minor between 13 and 16 years of age who has successfully taken The Hive’s “Independent Climber Class” is permitted to do these tasks and is solely responsible for properly doing them.

 

  • I understand that putting the harness on, clipping into the auto-belay device, tying into the rope and belaying are unsupervised and that the Parent or Legal Guardian is solely responsible for properly doing these tasks for Minors under 13 years of age who have not taken The Hive’s “Independent Climber Class”.

 

  • In permitting the Minor to participate in the Climbing & Fitness Activities, I am not relying on any oral, written or visual representations or statements made by the Companies or their directors, officers, employees, guides/instructors, agents, or representatives or any other inducement.

 

  • Based upon my understandings and acknowledgements described herein, I give the Minor permission to participate in the Climbing & Fitness Activities.

 

Date: April 26, 2024

 

updated: August 31, 2021

document type: Youth AOR 2022

First Parent / Legal Guardian Name

First Name*

Last Name*
First Parent / Legal Guardian Age Acknowledgment*
First Parent / Legal Guardian Date of Birth*
I certify that I am 19 years of age or older
First Parent / Legal Guardian Signature*
Second Parent / Legal Guardian Name

First Name*

Last Name*
Second Parent / Legal Guardian Date of Birth*
Third Parent / Legal Guardian Name

First Name*

Last Name*
Third Parent / Legal Guardian Date of Birth*
Fourth Parent / Legal Guardian Name

First Name*

Last Name*
Fourth Parent / Legal Guardian Date of Birth*
Fifth Parent / Legal Guardian Name

First Name*

Last Name*
Fifth Parent / Legal Guardian Date of Birth*
Sixth Parent / Legal Guardian Name

First Name*

Last Name*
Sixth Parent / Legal Guardian Date of Birth*
Seventh Parent / Legal Guardian Name

First Name*

Last Name*
Seventh Parent / Legal Guardian Date of Birth*
Eighth Parent / Legal Guardian Name

First Name*

Last Name*
Eighth Parent / Legal Guardian Date of Birth*
Ninth Parent / Legal Guardian Name

First Name*

Last Name*
Ninth Parent / Legal Guardian Date of Birth*
Tenth Parent / Legal Guardian Name

First Name*

Last Name*
Tenth Parent / Legal Guardian Date of Birth*
Parent / Legal Guardian 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 Legal 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*
How did you hear about The Hive?
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 19 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


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 Legal Guardian's Name

First Name*

Last Name*

Relationship*
Parent or Legal Guardian's Age Acknowledgment*
Parent or Legal Guardian's Date of Birth*
I certify that I am 19 years of age or older
Parent or Legal 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