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RELEASE OF LIABILITY AND ASSUMPTION OF RISK

Please read and be certain you understand before signing.

The individual named below (referred to as "I" or "me") desires to participate in one or more of the following:  hiking, backpacking, rock and/or ice climbing, indoor climbing, mountaineering, skiing, snowboarding, snowshoeing, orienteering and similar outdoor activities (the "Activity") provided by EPIC ALPINISM LLC, a New York Limited Liability Company (the "Company").  In consideration of being permitted by the Company to participate in the Activity and the intangible value that I will gain by participating in the Activity, and in recognition of the Company's reliance hereon, I agree to all the terms and conditions set forth in this agreement (this "Release").

1. I am aware and understand that the Activity is a potentially dangerous activity and involves the risk of serious injury, disability, death, and/or property damage.

2. I hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risk associated with the Activity, transportation of equipment related to the Activity, and traveling to and from the Activity sites of which I am about to engage in.

3. I acknowledge that risk of injury from the Activity and equipment utilized in the same is significant and that inherent risks include, but are not limited to:

A. The potential for permanent disability and death as well as the risk of injury from possible equipment failure and/or malfunction of my own or others’ equipment.
B. My own negligence and/or the negligence of others, including employees, agents, independent contractors or representatives of EPIC ALPINISM LLC, including, but not limited to operator error.
C. Injury to hands, fingers, feet and toes, including but not limited to inflammation and/or strains of muscles, ligaments, and/or tendons, nerve damage or compression, and broken bones.
D. Injuries from falling may occur from exposure to high altitude, which may affect judgment and coordination, or from not paying close attention to my climbing or others climbing with or near me.
E. Broken bones, severe injuries to the head, neck, and back which may result in severe physical impairment or even death.
F.     Weather related injuries and illness including but not limited to frostnip, frostbite, heat exhaustion, heat stroke, sunburn, hypothermia, acute mountain sickness, exhaustion, cerebral, pulmonary edema and dehydration. Exposure to outdoor elements, including but not limited to avalanche, rock fall, inclement weather, lightning, high winds, temperature or weather conditions.  Weather and altitude can be extreme and can change rapidly without warning.
G.    Unforeseen incidents such as attack by or encounter with insects, reptiles, and/or animals or exposure to hazardous plant life and water hazards. 
H.    Discharge of weapons in or near the area of activity.
I.      Accidents or illness occurring in remote places where there are no available medical facilities.
J.      Fatigue, chill, and/or dizziness, which may diminish my/our reaction time and increase the risk of accident.
K.     My sense of balance, physical coordination, and ability to follow instructions.
L.     Slips and falls.
M.    The hazards of traveling on uneven terrain; hidden obstacles by snow including crevasses, ice and snow cornices, tree wells, tree stumps, creeks rocks and boulders, below the snow surface, rugged terrain, or natural forces including steepness of slopes, snow depth, instability of snowpack or varying and difficult weather; and snow conditions that may cause avalanches.
N.    Loss or damage to equipment being used, equipment failure and the use and potential or actual failure of climbing ropes and equipment.
O.    Falling objects, being struck by rock fall, icefall or other objects dislodged or thrown from above
P.     Being lost or separated from their guides or companions by traveling in forested areas,
Q.    The areas may not have been traveled previously and are not regularly patrolled. Communication is always difficult and in the event of an accident, rescue and medical treatment may not be immediately available

I understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness or death

4. I am also aware of the highly contagious nature of bacterial and viral diseases, including water borne diseases and  COVID-19 (collectively, the "Disease") and the risk that I may be exposed to or contract the Disease by engaging in the Activity, which may result in illness, personal injury, psychological injury, pain, suffering, temporary or permanent disability, death, property damage, and/or financial loss. I acknowledge that these risks may result from or be compounded by the actions, omissions, or negligence of Company employees or others, including negligent emergency response or rescue operations of the Company. I understand that the Company cannot guarantee that I will not be injured or become infected with the Disease or other infectious diseases while on the Premises or during my participation in the Activity and that being on the premises and engaged in the Activity, which Activity may increase my risk of contracting the Disease.

5. NOTWITHSTANDING THE  RISKS DECRIBED IN THIS AGREEMENT, I ACKNOWLEDGE THAT I AM VOLUNTARILY PARTICIPATING IN THE ACTIVITY WITH KNOWLEDGE OF THE DANGERS INVOLVED. I HEREBY AGREE TO ACCEPT AND ASSUME ALL RISKS OF INJURY, ILLNESS, DISABILITY, DEATH, AND/OR PROPERTY DAMAGE ARISING THEREFROM, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF THE COMPANY OR OTHERWISE.

6. I hereby expressly waive and release any and all claims now known or hereafter known against the Company and its members, employees, agents, affiliates, their successors, and/or assigns (collectively, "Releasees") on account of personal or psychological injury, illness, pain, suffering, disability, death, property damage, or financial loss arising out of or attributable to my participating in the Activity, whether arising out of the ordinary negligence of the Company or any Releasees or otherwise.  I covenant not to make or bring any such claim against the Company or any other Releasee and forever release and discharge the Company and all other Releasees from liability under such claims.  

7. I confirm that I: (a) am in good health and in proper physical condition and do not have any medical or other conditions that would impair my ability to participate in the Activity; (b) I have informed the Company by writing on this Agreement any medical conditions of which I am aware or which have been told to me by my treating physician which would impair in any way my ability to participate in the Activity, and (c) am not experiencing symptoms of the Disease (such as cough, shortness of breath, or fever), do not have a confirmed or suspected case of the Disease, and have not come in contact in the last 10 days with a person who has been confirmed to have or suspected of having the Disease.  I will comply with all federal, state, and local laws, orders, directives, and guidelines related to the Activity and the Disease while on the Premises or participating in the Activity, including, without limitation, requirements related to hand sanitation, social distancing, and use of face coverings and safety equipment.  I will also follow all instructions, recommendations, and cautions of the Company at all times while on the Premises or during the Activity.  If at any time I believe conditions to be unsafe, that I am unable to continue for any reason, that I am no longer in proper physical condition to participate in the Activity, or I begin experiencing symptoms of the Disease, I will immediately inform the Company of my condition and discontinue further participation in the Activity consistent with instructions from the Company.  If I am unable to so inform the Company, I will immediately undertake actions to mitigate any further risk to myself and continue reasonable attempts to inform the Company of my condition.

8. I shall defend, indemnify, and hold harmless the Company and all other Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind (including  reasonable attorneys' fees, fees, the costs of enforcing any right to indemnification under this Release, and the cost of pursuing any insurance providers) incurred by or awarded against the Company or any other Releasees in a judgment, arising out or resulting from any claim of a third party related to my participating in the Activity, including any claim related to my own negligence or the ordinary negligence of the Company.

9. I hereby consent to receive medical treatment deemed necessary if I am injured or require medical attention during my participation in the Activity. I understand and agree that I am solely responsible for all costs related to such medical treatment and any related medical transportation and/or evacuation. I hereby release, forever discharge, and hold harmless the Company from any claim based on such treatment or other medical services.

10. The Company reserves the right to use any photograph, video, audio recording or any other media taken of me at during the Activity, or in connection with any other activities, in the Company’s promotional materials, brochures, website, and any other advertising.

11. This Release constitutes the sole and entire agreement of the Company and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter.  If any term or provision of this Release is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Release or invalidate or render unenforceable such term or provision in any other jurisdiction.  This Release is binding on and shall inure to the benefit of the Company and me and our respective successors and assigns.  All matters arising out of or relating to this Release shall be governed by and construed in accordance with the internal laws of the State of New York, including its statute of limitations and N.Y. Gen. Oblig. Law § 5-1401,  without giving effect to any choice or conflict of law provision or rule whether of the State of New York or any other jurisdiction.  Any claim or cause of action arising under this Release may be brought only in the federal and state courts located in Saratoga County, New York and I hereby consent to the exclusive jurisdiction of such courts.

BY SIGNING, I ACKNOWLEDGE THAT I AM 18 YEARS OF AGE OR OLDER, HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS RELEASE AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE COMPANY.

First Participant's Name

First Name*

Middle Name

Last Name*

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
Third Participant's Name

First Name*

Middle Name

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
Fourth Participant's Name

First Name*

Middle Name

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
Fifth Participant's Name

First Name*

Middle Name

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
Sixth Participant's Name

First Name*

Middle Name

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
Seventh Participant's Name

First Name*

Middle Name

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
Eighth Participant's Name

First Name*

Middle Name

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
Ninth Participant's Name

First Name*

Middle Name

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
Tenth Participant's Name

First Name*

Middle Name

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

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
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 Information

Emergency Contact for participant *

Phone Number of Emergency Contact *

Relationship to participant *
I am the parent or legal guardian of the minor named above. I have the legal right to consent and, by signing below, I hereby do consent to the terms and conditions of this Release of Liability.


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 Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

MEDICAL FORM


Describe (if any) experience participant may have in this activity or related activity for which he/she is signing up: *

Describe participant's current level of activity and physical fitness: *
Does participant have any medical conditions?:*
No
Yes

If yes, explain
Does participant have any allergies?*
No
Yes

If yes, explain
Is participant taking any medication?*
No
Yes

If yes, explain
Are you fully vaccinated for COVID-19? (Check box if yes, leave blank for no)
Does participant carry any medical insurance?*
No
Yes
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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