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Courageous Kids Climbing Participant Waiver
 

There are risks associated with rock climbing, but we will make every effort to eliminate those risks. you understand that your climber will be required to wear a climbing harness that fits snuggly around the waist and upper thighs and may be required to wear a chest harness. A limiteed supply of climbing shoes may be available. Not all climbers will be able to borrow a pair. If the climber should be allowed to wear a pair, you understand that these are designed to be worn tight on the feet. You understand that one care-giver shall remain on site during the entire event to assist with the climber's neeeds as they arise. You understand that if at any time the staff of this event feel that it is in your climber's best interest that the climber not climb, they will not be allowed to climb. The safety of your climber is our number one priorioty. You will be required to sign a waiver for your climber for the hosting climbing gym and CKC. If either waiver is not signed, your climber will not be allowed to participate in the event. Friends and family attending will also be reequired to complete a waiver(s). After the event is over, should your climber want to continue to climb, you will need to pay regular admission and equipment rental fees to the cimbing gym. You are encouraged to watch and encourage your climber and feel free to ask questions. No food or drink is allowed in the climbing area. Due to limited space, the first priority is to accept climber's with a disability. Open slots may be made available to siblings the day of the event. Event info can be found on Facebook.

INDOOR AND OUTDOOR ROCK-ClIMBING PARTICIPANTS

Hold harmless and acknowledgement of risk agreement.

1. Courageous Kids Climbing (CKC) particpants understand that recreational activities, to include but not limited to indoor/outdoor rock climbing and slacklining, do have inherent risks which are beyond the control of CKC and its staff including Jeff Riechmann, volunteers, members and the hostinr facility. We, the undersigned, do understand thyat upon participating in any CKC-sanctioned event, that we hereby assume all risks for the behavior, actions, and safety of myself, my minor child or children while involved in the activities.

2. In consideration for being permitted to participate in a CKC-sanctioned event, I acknowledge that I assume full responsibility for my safety. I further understand that I participate at my own risk, and I agree to hold CKC, its officers, employees, etc. harmless from every and all claim which may arise from injuryt, which might occur from my participation in a CKC-sanctioned event in facvor of myself, my heirs, representatives or dependents. I understand that CKC does not represent or warrant the quality or character of any equipment or services provided.

3. I have read and understand this agreement and release of liability and do voluntarily agree to sign. While on the premises of any CKC-sanctioned event, my family and I agree to act with Caring, Honesty, Respect, and Responsibility.

4. CKC reserves the right to use photographs and flash video taken during CKC-sanctioned events and activities for marketing and promotional purposes, unless noteed otherwise above.

5. I HAVE CAREFULY READ THIS AGREEMENT. I FULLY UNDERSTAND ITS CONTENTS AND SIGN IT OF MY OWN FREE WILL. THIS IS A RELEASE OF LIABILITY. DO NOT SIGN THIS AGREEMENT IF YOU DO NOT UNDERSTAND OR AGREE WITH ITS TERMS.

First Participant's Name

First Name*

Last Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
First Participant's Signature*
Second Participant's Name

First Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
Third Participant's Name

First Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
Fourth Participant's Name

First Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
Fifth Participant's Name

First Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
Sixth Participant's Name

First Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
Seventh Participant's Name

First Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
Eighth Participant's Name

First Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
Ninth Participant's Name

First Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
Tenth Participant's Name

First Name*

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

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
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:*
Caregiver's Name Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
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.
Caregiver's Name Name

First Name*

Last Name*

Phone*
Caregiver's Name Date of Birth*
Caregiver's Name Needs

Please provide more information about you or your child's needs, physical or developmental, that might help our staff provide the best climbing experience.
Caregiver's Name 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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