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Triangle Rock Club/Adventure Capitalists, Inc.

ORIENTATION DOCUMENT AND SAFETY DEMONSTRATION AGREEMENT

102 Pheasant Wood Ct., Morrisville, NC 27560 • 919.463.7625

6022 Duraleigh Rd., Raleigh, NC 27612 • 919.803.5534

5213 Raeford Rd., Fayetteville, NC 28304 • 910.868.7625

1010 Martin Luther King Jr. Pkway, Durham, NC 27713 • 919.981.7441

4700 Thalbro St., Richmond, VA 23230 • 804.215.3200

TriangleRockClub.com


ORIENTATION DOCUMENT

I have watched the Orientation Video prior to completing this document.

I Agree

I understand that I require an orientation before participating in any activities at Triangle Rock Club (TRC). If the participant is under the age of 18, this agreement must be signed by a parent or legal guardian. I, as the parent or legal guardian, understand that it is my responsibility to ensure that my child has watched and understands the orientation video and that I have reviewed it with them. If the participant is under the age of 12, I understand that they must be accompanied by an adult at all times while in the facility.

I also understand that if I need additional assistance, instruction, or assessment during my participation at TRC that it is my responsibility to seek it from TRC Staff prior to participating in any activity.

Furthermore, I acknowledge that climbing is dangerous and involves risks including, but not limited to, injury and death. I understand that it is my personal responsibility to follow facility rules and procedures, and manufacturer instructions, while participating in climbing activities at TRC, and that I am at risk even while following all facility rules and procedures.


BOULDERING ORIENTATION

I affirm that I understand TRC’s Bouldering rules, policies, and procedures. These include, but are not limited to: the inherent risks of bouldering including serious injury and death; awareness of surroundings including items in potential landing zones; purpose and limitations of padded flooring; and top-out bouldering, down climbing, and falling technique.


AUTO BELAY ORIENTATION

I affirm that I understand TRC’s Auto Belay rules, policies, and procedures. These include, but are not limited to: the inherent risks of Auto Belays, including serious injury and death; the proper use and function of Auto Belays; understanding that a climber using the Auto Belay does not have a partner and is solely responsible for ensuring that they are clipped in correctly; checking for the retraction of the tether; climbing on the appropriate route for the Auto Belay; and proper lowering technique.

I further affirm that I understand that I must be age 12 or older and pass an assessment with TRC Staff prior to using an Auto Belay. I understand that anyone under the age of 12 may only use an Auto Belay with the assistance of someone who has passed an Auto Belay proficiency assessment and that the assisting person must perform a safety check prior to the climber leaving the ground for each climb.


TOP ROPE AND LEAD CLIMBING AND BELAYING

I affirm that I understand TRC’s Top Rope and Lead rules, policies, and procedures. These include, but are not limited to: the inherent risks of Top Rope and Lead Climbing and Belaying, including serious injury and death; the age limits associated with Belay Certification; and prerequisites for accessing Top Rope and Lead climbs.

I affirm that I understand that I must pass an assessment with TRC Staff prior to Top Rope Belaying, Lead Climbing, or Lead Belaying, unless supervised by TRC Staff.



My signature indicates that I understand the information in this document and that I have watched the Orientation Video. 

July 27, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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.


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*

Last Name*

Relationship*

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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