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Release, Waiver and Assumption of Risk Agreement
Centre d’escalade Bloc 9.81

14024419 Canada Inc. carrying on business as Bloc 9.81 Climbing Center (known as "Bloc 9.81") provides entertainment services, including climbing and fitness activities (the "Activities").

WARNING: Any activity or sport associated with a bouldering area, as well as related equipment and fitness regimes (hereinafter referred to as "activities"), involves significant risk elements. While we have taken responsible steps to provide you with appropriate instructions and/or competent instructors to enable you to enjoy an activity for which you may not be skilled, we would like to remind you that this activity is not without risks. Indeed, some risks cannot be eliminated without destroying the uniqueness of the activity. The elements that contribute to making this activity unique can cause the loss or damage of your equipment, or an accidental injury, illness, or, in extreme cases, permanent trauma or death. We don't want to scare you or reduce your enthusiasm for the activity, but we believe it's important that you know in advance what to expect and that you are warned of the inherent risks.

Risk recognition

By signing this agreement, I acknowledge and agree that the activities of Bouldering 9.81 involve known and unknown risks that can cause significant injury or death. Without limitation, the following describes some of the risks of indoor climbing and physical training:

1.   Slipping, tripping, falling or crashing painfully when using facilities or equipment, climbing walls, reception pits, floors under climbing areas, training areas, sanitary facilities or steps;

2.   Misuse of equipment or facilities, or equipment failures;

3.   Unexpected falls due to improper positioning, poorly performed parade or due to unexpected loss of control;

4.   My health, physical strength, coordination, sense of balance and ability to follow or give directions when climbing or training may not be enough to allow me to safely practice indoor climbing sport;

5.   Fatigue, chilling and/or dizziness, which can reduce my/our reaction time and increase the risk of an accident;

6.   Abrasions caused by equipment or structures;

7.   The presence, actions or falls of other participants;

8.   Lack of supervision, and/or lack of guardians;

9.   Multiple people participating in Activities at the same time

I understand that the description of these risks is not complete and that other unknown or unforeseen risks may result in injury, illness or death and I accept that these risks are an integral part of the practice of these Activities.

I am also committed to playing an active role in managing these risks, adopting a preventive attitude towards me, towards those who accompany me and towards the other people who participate in the activities.

Health and physical condition

I certify that I am in good physical condition and that I do not have any personal health problems preventing me from participating in the activities of the Centre d’escalade Bloc 9.81.

I agree to mention any physical or mental condition that could affect my safety or that of others.

Alcohol consumption

I understand and accept that it is strictly forbidden to do, at the Centre d’escalade Bloc 9.81, climbing or any other form of training under the influence of alcohol and that the consumption of alcohol, at the Centre d’escalade Bloc 9.81, is allowed only in the bistro and relaxation area. Therefore, I also understand that it is forbidden to consume alcohol in the areas reserved for climbing, on mattresses and in training areas. The area allowed for alcohol consumption ends where the mattresses begin and this, along the entire width of the center.

Alcohol consumption is reserved for 18 years and older, an identity document may be required.

In addition, I understand that it is strictly forbidden to use drugs or to be under the influence of drugs at the Centre d’escalade Bloc 9.81.

Acceptance of risk

I accept the risks of bodily injury, accidents and/or diseases, including but not limited to sprains, muscle and/or ligament tears, cracks or fractures, eye infections, cuts, injuries, scrapes, abrasions and/or bruises, dehydration, lack of oxygen, exposure and/or altitude sickness, head trauma, neck and/or spine, lung problems, nervous shock, paralysis and/or death.

I TAKE FULL RESPONSIBILITY FOR CHOOSING A RESPONSIBLE PERSON TO DEAL WITH IT.

Commitment to comply with rules and regulations

I affirm that I have read and understood and hereby agree to respect the rules and regulations of the Centre d'escalade Bloc 9.81, a copy of which is posted in the climbing centre. (A printed copy of the regulations is available upon request).

The Centre d'escalade Bloc 9.81 and its representatives reserve the right to refuse or suspend the right of Access to the Centre to any climber who demonstrates a dangerous attitude towards indoor climbing safety at the Centre d'escalade Bloc 9.81, or who does not respect the rules and regulations of the Centre d'escalade Bloc 9.81.

Wearing a helmet

I understand that wearing a climbing helmet can reduce the risk of head injury and I am personally responsible for my decision to wear a helmet or not. It is my responsibility to provide my own helmet.

Children climbers and visitors

I affirm that the child for whom I sign the form is indeed my child, my biological child or that I am the legal guardian. I agree to abide by the rules that I have read and understood when I am in the company of a child at the Centre d'escalade Bloc 9.81 as a climber or guide.

Photographs and advertising material

I acknowledge and agree that photographs and/or videos may be taken by Bloc 9.81 of the undersigned, without compensation by Bloc 9.81 or by its employees, representatives, agents, or by any person whose services are retained by Bloc 9.81 . I hereby assign all my rights in connection with these photos and/or videos, including my moral rights, in favor of the beneficiaries, their representatives, agents, affiliates, clients and assigns, without limiting the generality of the foregoing, and I authorize said beneficiaries to archive, edit, correct and compile for news, editorial, advertising or any other purposes on the Internet or in any other media. Accordingly, I assign to Bloc 9.81 the right to use my image in its publications, on its website, as part of its promotions or marketing, or in any other media, whether digital, print or otherwise, without payment or compensation and without the need for further approval or consent and I assign all my rights in connection with the photos and/or videos to Bloc 9.81.

Orientation and fall tests

I understand that, for the safety of all, I must participate in a safety orientation before starting my activity. I understand that I must respect my body and my skills by choosing the height to which I climb.

‘’I acknowledge that I have read and understood the recognition and acceptance of the above risks and responsibilities, I FREELY AND FULLY ACCEPT TO ASSUME ALL THE RISKS AND DANGERS MENTIONED ABOVE AND I UNDERTAKE TO COMPLY WITH THE RULES AND REGULATIONS OF THE CENTRE D'ESCALADE BLOC 9.81.’’

I further acknowledge that the term of this agreement is perpetual and shall be in full legal force and effect whenever the undersigned visits the Bloc 9.81 Climbing Center facilities, either at the present location or at any other location.

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

Signature of Participant (18 years and older must sign)

OR Signature of Parent (or Legal Court Appointed Guardian):

Date: December 11, 2024

First Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
Third Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
Fourth Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
Fifth Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
Sixth Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
Seventh Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
Eighth Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
Ninth Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
Tenth Participant's Name

First Name*

Middle Name

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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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:*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

I agree that my Minor child may participate in the Activities and use the equipment and facilities therein. I assume responsibility on behalf of the Minor child for any risks that may result from participation in the Activities or use of the Facilities, loss, damage or theft of personal items that may be incurred by my Minor child.



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

Home Phone:

Work Phone:

Cell Phone:
Can we email?*
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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