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Portland Rock Gym Release of Liability and Assumption of Risk

YOUTH WAIVER

Climbing Gym Release of Liability and Assumption of Risk

Release, waiver, and indemnification contract:

Parent’s 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 my child may come to, or damage to their 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 any and all liability for such harm, (except for gross negligence or willful misconduct) even though that harm may result from their negligence.

 

Further, PRG, shall not be liable for any harm my child may come to, or any property loss that my child 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 and/or willful misconduct) for such harm also.

 

I acknowledge that my child’s participation in rock climbing, rappelling, and hiking entails known and anticipated risks that could result in physical or emotional injury, paralysis, death, or damage to my child, 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 for my child.  

 

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 child’s 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 child’s responsibility to learn how to use his or her gear and the anchors and ropes provided by the gym correctly. I further agree that I am responsible to ensure my child has learned how to use his or her 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 gear properly, that person is a danger to themselves and others. I agree that my child will be a responsible climber. 

 

As a parent of a climber, I agree on my child’s behalf to release, hold harmless, and indemnify PRG, from any and all harm. Further, I agree on my own behalf and not for my child that if any lawsuit is filed against PRG, on account of my child’s injuries or injuries to another on account of my child’s actions, I will defend, indemnify, and hold harmless, PRG.

 

I hereby represent that my child will not engage in top-rope belaying unless my child has had 20 hours of top-rope belaying experience in the last 12 months and has successfully passed a test provided by PRG to test my child’s top-rope belaying abilities. (Top-rope belaying is belaying from the base of a climb when the climber is attached to a rope that passes up through an anchor system at the top of that climb, then down to the belayer).

I hereby represent that my child will not engage in lead belaying or lead climbing unless my child has had 20 hours of lead belaying and lead climbing experience in the last 12 months and has successfully passed a test provided by PRG to test my child’s lead belaying and lead climbing abilities. (Lead belaying is belaying from the base of a climb when the lead climber is attached to a rope that the lead climber will periodically connect to protective equipment as they ascend that climb).


My child and I have read the safety rules of PRG and we agree to abide by them. My child is in good health and has no physical or mental limitations that would preclude him or her from careful and reasonable use of PRG facilities and participation in activities sponsored, organized, or otherwise provided by PRG (available at www.portlandrockgym.com or at the gym’s counter).

 

I hereby grant to PRG, and PRG reserves the right to use, any digital imaging or video of my child 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. On my child’s behalf 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 child’s likeness for PRG's monetary gain. I understand my child has no copyright for such digital imaging or video.

 


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

 

I understand that use of PRG’s facilities and equipment, including but not limited to, auto-belays, ropes and other devices are mine and my child’s responsibility and to be used at our 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 on behalf of my child that it is also my child’s responsibility to ask PRG staff if my child is unfamiliar with or has any questions at any time concerning the use of PRG’s facilities and equipment

 

By signing this document on behalf of my child, 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 child’s participation in any and all rock climbing, rappelling, hiking, and other activity sponsored, organized, or otherwise provided by PRG.

 

I acknowledge the contagious nature of communicable disease, viruses, and illnesses, including without limitation Coronavirus/COVID-19 (hereinafter “Disease”). 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 my child 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 my child 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 on behalf of my child and acknowledge that by doing so I am increasing my child’s risk of exposure to Disease. I acknowledge that my child must comply with PRG’s procedures to reduce the spread of Disease at PRG facilities. 

On behalf of myself, my family members, my heirs, representatives, and successors, I hereby willfully and voluntarily acknowledge and accept the risks of my child 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 child’s 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.


Parent(s) or Court-Appointed Legal Guardian(s) must sign below for my child, and agree that they and the minor are subject to all the terms of this document, as set forth above.


Today's Date: April 28, 2024

First Minor Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Minor Participant's Date of Birth*
First Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
First Minor Participant's Signature*
Second Minor Participant's Name

First Name*

Middle Name

Last Name*
Second Minor Participant's Date of Birth*
Second Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
Third Minor Participant's Name

First Name*

Middle Name

Last Name*
Third Minor Participant's Date of Birth*
Third Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
Fourth Minor Participant's Name

First Name*

Middle Name

Last Name*
Fourth Minor Participant's Date of Birth*
Fourth Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
Fifth Minor Participant's Name

First Name*

Middle Name

Last Name*
Fifth Minor Participant's Date of Birth*
Fifth Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
Sixth Minor Participant's Name

First Name*

Middle Name

Last Name*
Sixth Minor Participant's Date of Birth*
Sixth Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
Seventh Minor Participant's Name

First Name*

Middle Name

Last Name*
Seventh Minor Participant's Date of Birth*
Seventh Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
Eighth Minor Participant's Name

First Name*

Middle Name

Last Name*
Eighth Minor Participant's Date of Birth*
Eighth Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
Ninth Minor Participant's Name

First Name*

Middle Name

Last Name*
Ninth Minor Participant's Date of Birth*
Ninth Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
Tenth Minor Participant's Name

First Name*

Middle Name

Last Name*
Tenth Minor Participant's Date of Birth*
Tenth Minor Participant's Information
Top Rope Belay Experience
Lead Belay Experience
Minor 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

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or Court-Appointed Legal Guardian(s) must sign below for minor(s) 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*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Top Rope Belay Experience
Lead Belay Experience
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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