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New Rochelle Racquet Club, LLC

Liability Waiver



THIS RELEASE IS A BINDING LEGAL CONTRACT. PLEASE READ IT CAREFULLY BEFORE SIGNING.


I, on behalf of myself and/or as the parent or guardian of the minor child identified herein ("Participant"), desire to use the facilities and/or programs of Pine Brook Fitness LLC, including The New Rochelle Racquet Club LLC, The Rock Club LLC, and/or The Studios at Pine Brook Fitness, LLC, all located at 130 Rhodes St, New Rochelle, New York ("The Club"). In consideration of The Club permitting said use, I, on behalf of myself and/or as the parent or guardian of the minor child identified herein, hereby agree to be bound by the terms of this Assumption of Risks, Release of Liability and Indemnification and by the provisions of the Rules and Regulations of The Club (together, the "Release").

ACKNOWLEDGMENTS AND ASSUMPTIONS OF RISKS

I hereby acknowledge, accept and agree that the sport of rock climbing, the use of The Club's climbing wall (the “Wall”), tennis courts, fitness studios, and other facilities (collectively, the "Facilities") and participation in the Club’s numerous and varied activities, classes, clinics, training, coaching, demonstrations, programs and trips to other activity sites, including the use of equipment in connection therewith (collectively, "Programs") involve inherent and significant risks. I am aware that there are also specific and significant risks associated with rock climbing. I assume all of these risks, including but not limited to:

1. All manner of injury resulting from my falling from or colliding with the Wall, the climbing site, features and/or obstacles on or near the Wall, landing on the floor or ground, including where there may be seams or gaps in the mats, colliding with other people or tangling in ropes, whether permanently or temporarily in place;

2. Rope abrasion, entanglement, and any other injuries resulting from activities on or near the Wall, including but not limited to, climbing, belaying, rappelling, lowering on ropes, rescue systems, and any other rope techniques;

3. All manner of injury resulting from the actions, omissions or negligence of other participants, visitors or other persons who may be present including, but not limited to, falling climbers or dropped items, such as, but not limited to, ropes, climbing hardware, spinning or broken holds, other wall parts, falling rocks or other objects, fitness equipment, or personal effects;

4. All manner of injury resulting from loose clothing, skin, hair, jewelry, or any other accessory becoming entangled in the Wall or its features, ropes, or belay devices, or any other part of the Facilities--including but not limited to: tennis courts, public areas, locker rooms, fitness rooms, hallways, entrance/exits, and parking area.

5. Theft, damage, and destruction of any clothing, accessories, equipment, or personal products, including any wallet, handbag, purse, cell phone or other electronics that are brought into The Club;

6. Mental anguish or trauma resulting from injuries or experiences with climbing or exercising;

7. All manner of injury or illness resulting from factors that can be affected by climbing or an increase in physical activity, including but not limited to: heart disease, numbness, fainting/dizzy spells, high or low blood pressure, high cholesterol, bone and/or joint pain, medication, recent illness, diabetes, epilepsy/seizures, recent surgery, under/overweight, chest pains, pregnancy, a smoker, someone unaccustomed to regular exercise, or concerns based on your age;  

8. Illnesses or injuries resulting from fluids or blood on the Wall, any equipment, surface--including but not limited to: tennis courts, public areas, locker rooms, fitness rooms, hallways, entrance/exits, and parking area.;

9. Cuts and abrasions resulting from skin contact with the Wall or any other surface--including but not limited to: tennis courts, public areas, locker rooms, fitness rooms, hallways, entrance/exits, and parking area.;

10. Failure or misuse of ropes, harnesses, belaying equipment, climbing holds, or anchor points on any part of the Wall or climbing site, and fitness equipment;

11. Failure to follow The Club's posted rules and regulations, employee's instructions or failure to ask for information or assistance.

I further acknowledge that the above list is not inclusive of all possible risks associated with the use of the Facilities or Program participation and I agree that such list in no way limits the extent or reach of this Release.

I Agree

SPECIFIC RISK ASSOCIATED WITH COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. It may also be spread by contact with contaminated surfaces or by exposure to particles in the air.

I acknowledge that The Club has put in place numerous preventative measures to reduce the spread of COVID-19; however, The Club cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, visiting The Club or participating in The Club’s activities or events could increase your risk and your child(ren)’s risk of contracting COVID-19.

I acknowledge that I have read and understood this warning and assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by visiting The Club or participating in The Club’s activities or events and that such exposure or infection may result in illness, permanent disability, or death.

I Agree

ADDITIONAL ACKNOWLEDGEMENTS AND CERTIFICATION OF HEALTH

I understand and acknowledge that certain risks cannot be eliminated due to the nature of the Programs, and that these risks may be causes of injury, illness, permanent disability, paralysis, trauma or death.

I understand and acknowledge that no amount of care, caution, instruction or expertise can eliminate certain of these risks, regardless of whether I follow The Club’s instructions and recommendations, my choice of equipment, or whether I wear a helmet or other personal safety device.

I understand and acknowledge that The Club does not have medical personnel or treatment available to Participants on premises. I authorize and grant permission to The Club to secure emergency medical treatment for me or to transport me to any nearby medical facility or hospital. I authorize any qualified person or medical personnel to render necessary emergency medical care for me.

I certify that I have no medical, physical or other conditions that could interfere with my ability to climb, belay, or perform any other activity at The Club, or follow or give directions while climbing, belaying or performing any other activity at The Club. I agree to comply with the Club's rules and regulations.

I Agree

MISCELLANEOUS

I understand that indoor rock climbing is not the same as outdoor climbing and that additional skills and training are necessary for outdoor climbing that cannot be acquired indoors. I agree to seek qualified instruction before attempting to climb outdoors.

I understand that The Club reserves the right to refuse any person entry to The Club, use of the Club’s equipment and property, or participation in Programs at any time for any reason whatsoever.

The Club reserves the right to use any photograph, video, audio recording and/or other images taken at The Club or in the course of Programs for promotional materials, brochures, social media, and/or its website. The Club retains exclusive rights to such photographs and videos.

*Submitting this waiver is an automatic agreement to all terms. If you wish to opt out of photographs, videos, audio recordings and/or other images taken at the Club, please email Marketing Director Paul Cesario at pcesario@pinebrookfitness.com

Be sure to include your full name and the Club you most frequently attend along with your request. Additionally, if you see one of our photographers taking photos while you are at the club, please tell them directly you do not want your photo taken.


Release of Claims and Indemnification

I, on behalf of myself and/or as the parent or guardian of the minor child identified herein, hereby agree to release and discharge Pine Brook Fitness LLC, The Rock Club LLC, New Rochelle Racquet Club LLC, and The Studios at Pine Brook Fitness, LLC, and all of their respective members, employees, agents and representatives, as well as all other persons, corporations, or entities that might have any liability to me (the "Released Parties"), from and against any and all damages, actions, claims and liabilities, whether known or unknown, anticipated or unanticipated, suspected or unsuspected, relating to or arising from any activity, occurrence or otherwise involving the use of The Club’s Facilities or participation in The Club’s Programs, including but not limited to rock climbing, exposure to or infection by COVID-19, and the particular risks identified herein. This Release is intended to release and discharge the Released Parties from all damages, actions, claims and liabilities of any nature, specifically including, but not limited to, those arising from or related to the negligence of any Released Parties.

I further agree personally, and on behalf of the Participant to indemnify, hold harmless, and defend the Released Parties from and against any loss, damage, liability and expense, including costs and attorneys' fees, incurred by a Released Party as a result of my or the Participant’s using the Facilities or participating in Programs sponsored by or involving The Club.

The laws of the State of New York shall govern the rights and obligations of the parties to this Release and Indemnification, and the interpretation, construction, and enforceability thereof, without regard to its conflict of law rules. I agree that any lawsuit brought against any Released Party shall be brought solely in the New York State Supreme Court in Westchester County and as to any claims brought against me, I hereby consent to personal jurisdiction in that Court. I hereby voluntarily waive any right I may have to a trial by jury in any action, proceeding, or litigation involving any Released Party.

I Agree

Date: November 21, 2024

 


First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
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*
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Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Pronouns
Please feel free to share your preferred pronouns*

Please feel free to share your pronouns if you prefer to self-describe
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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