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Salt Pump Portsmouth

199 Constitution Ave.

Portsmouth, NH  03801

(603) 368-1019

info@saltpumpclimbing.com

Salt Pump Portsmouth, LLC

Outdoor Activities Assumption of Risk

Please read this document carefully. This Agreement must be signed by all participants in outdoor activities operated by SALT PUMP PORTSMOUTH, LLC, a New Hampshire limited liability company (“Salt Pump”). If the visitor is a minor, it must be signed by the minor’s parent, or legal (court appointed) guardian, who signs for themselves and, if allowed by law, the minor participant. “Participant” as used in this Agreement includes participants in Salt Pump activities and other persons that enter a Salt Pump facility or takes part in a Salt Pump activity.

In consideration of the services of Salt Pump, I, an adult participant or parent or legal guardian of a participant who is a minor, acknowledge and have voluntarily agreed to execute this Outdoor Activities Rider (this "Rider") and hereby agree to the following:

1.      I have agreed to Salt Pump’s Assumption of Risk, Release of Liability, and Indemnification Agreement (the “Agreement”).

2.      Activities. I understand that Salt Pump’s outdoor activities primarily take place outdoors, but may also include indoor classrooms. Activities can include, but are not limited to, camping, hiking, and backpacking through rocky, mountainous, and other terrain and/or climbing on boulders and cliffs. I further understand and acknowledge that the activities of the courses have risks, some of which are inherent. Inherent risks are those which cannot be eliminated without destroying the unique character of the activities. The same elements that contribute to the unique character of these activities and promote our educational objectives can cause loss or damage to equipment, accidental injury, illness, or, in extreme cases, permanent trauma, disability, or death. The following describes some, but not all, of the inherent risks of Salt Pump’s outdoor activities: Salt Pump activities may be strenuous, physically and emotionally; Salt Pump activities occur on lands open to the public, and exposed to the acts of persons not associated with Salt Pump and who may pose risks; physical activities include, but are not limited to, walking, hiking, backpacking, and climbing; certain activities will require travel by vehicle, on foot and by other means, over improved and unimproved roads, rugged trails and off-trail terrain, including boulder fields, downed timber, steep slopes, and slippery rocks; travel risks include collision, falling, drowning, becoming lost, and other risks usually associated with such travel, including environmental risks; environmental risks and hazards include, but are not limited to, flowing water; harmful insects, snakes, predators, and large animals; falling and rolling rock; lightning, flash floods, falling timber, and forces of nature, including weather which may change to extreme conditions quickly or unexpectedly; possible injuries and illness include hypothermia, immersion foot, sunburn, heatstroke, dehydration, insect or animal-borne diseases, and other mild or serious conditions; equipment may fail or malfunction; decisions made by the instructors, other staff (including volunteers), contractors and participants will be based on a variety of perceptions and evaluations, which by their nature are imprecise and subject to errors in judgment. Misjudgments may pertain to, among other things, a participant’s capabilities, environment, terrain, water and weather conditions, natural hazards, travel routes, and medical conditions; Salt Pump is not responsible for participants, before and after the day’s activities (per stated beginning and ending dates and times).

3.      Acknowledgment and Assumption of Inherent and Other Risks. I understand and acknowledge that the description above of the inherent risks of Salt Pump outdoor activities is not complete and that other risks, including unknown or unanticipated risks, inherent and otherwise, may result in injury, illness, death, or property loss. I acknowledge that participation in Salt Pump outdoor activities is purely voluntary, and I wish to participate in spite of and with knowledge of the inherent and other risks involved. I acknowledge and assume the inherent risks described above and all other inherent risks of Salt Pump outdoor activities as well as any other risks of enrolling, participating in, or being present for such activities. If the visitor is a minor, I have explained the activities and risks to the minor, and the minor wishes to participate in Salt Pump activities nevertheless.

4.      Except as specifically amended hereby all of the terms and conditions of the Agreement shall continue to be in full force and effect.

I HAVE CAREFULLY READ, UNDERSTAND, AND VOLUNTARILY SIGN THIS RIDER. I intend for it to apply to the fullest extent allowed by law, and to be binding upon members of my, or the minor child’s, family, parents, and our respective heirs, beneficiaries, personal representatives, executors, administrators, successors and assigns.

 

 

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*
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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