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BREVARD ROCK GYM

ASSUMPTION OF RISK, RELEASE OF LIABILITY, WAIVER OF ALL CLAIMS, AND INDEMNIFICATION

In consideration of being given the opportunity to participate in climbing activities including but not limited to climbing, bouldering, belaying, lowering on ropes, and rescue systems at the Brevard Rock Gym (hereafter referred to as “Climbing Wall Activities”), the right to engage in technical rock climbing, rock climbing classes, rock climbing trips, rock climbing, rappelling, hiking, other activities related to rock climbing, or other outdoor recreation activities outside of the physical location of Brevard Rock Gym (hereafter referred to as “Rock Climbing Activities” and, together with the Climbing Wall Activities, the “Activities”) which I participate in or any other activity or service provided to me by Nicholas Accardo LLC, a North Carolina limited liability company doing business as Brevard Rock Gym (referred to herein as “Brevard Rock Gym”), under the auspices and sponsorship of Brevard Rock Gym as a participant and/or volunteer, and the rate charged for those services, 

I, FOR MYSELF, MY PERSONAL REPRESENTATIVES, ASSIGNS, HEIRS AND NEXT OF KIN, HEREBY:

1. Acknowledge, agree and represent that I understand the nature of the Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activities. 

2. Acknowledge that the Activities entail both known and unanticipated risks which could result in emotional or physical injury, paralysis, death, or damage to property, or to third parties. I understand that such risks cannot be eliminated without jeopardizing the essential qualities of the Activities. These inherent risks include but in no way are limited to all manner of injury resulting from my falling during the Activities and hitting the floor, wall faces, people, ground, trees, or other fixtures whether permanently or temporarily in place. The risks also include but are not limited to rope abrasion, rope entanglement and burn, abrasions from the wall, ropes, and/or floor, injuries resulting from falling and dropped items and climbers, swinging belayers and climbers, faulty and/or loose holds, human error, failure of ropes, slings, harnesses, knots, anchors, latent or apparent defects or conditions in the equipment or property supplied by Brevard Rock Gym or other persons or entities, use or operation by myself or others, of equipment supplied by Brevard Rock Gym or other persons or entities, acts of other participants in this activity, weather conditions, contact with plants, animals or insects, condition of climbing routes, trails, roads, waterways or terrain, and accidents connected with their use, first aid, emergency treatment or other services rendered, consumption of food or drink, or any part of the climbing wall, strains, sprains, and other injuries from over-exertion or over-training. 

3. ACKNOWLEDGE THAT MY PARTICIPATION IN THE ACTIVITIES IS PURELY VOLUNTARY AND I CHOOSE TO PARTICIPATE IN FULL VIEW OF THE RISKS, AND I AGREE TO BEAR FULL RESPONSIBILITY FOR ANY INJURY OR DAMAGE I MAY SUFFER OR CAUSE WHILE PARTICIPATING IN THE ACTIVITIES. 

4. Represent that I have no physical or mental limitations which would preclude my safe use of the climbing walls, climbing equipment, or exercise equipment (each of the foregoing being referred to hereafter as the “Equipment”), or being in the landing zones, and I assume all risks that may be created by such limitations; further, I hereby certify that I am not currently mentally impaired or under the influence of drugs or alcohol and am otherwise legally competent to understand and sign this document. 

5. Will comply with all Brevard Rock Gym rules, both written and as stated to me by Brevard Rock Gym staff, during my participation in the Activities. I will obey the Brevard Rock Gym staff in regard to those rules as they affect the safety of myself, other participants and observers, the property of Brevard Rock Gym, and all natural resources used in conjunction with the Activities. 

6. Agree and warrant that I will inspect each portion of the Equipment used in connection with the Activities in which I take part and that if I find any condition which I consider to be unacceptable, hazardous or dangerous, I will notify the proper authority in charge of the Activities and will refuse to take part in the Activities until the condition has been corrected to my satisfaction. 

7. Understand that use of the Equipment and/or any instruction I receive at Brevard Rock Gym is not sufficient to prepare me for the risks and hazards of outdoor climbing. 

8. Understand that Brevard Rock Gym reserves the right to refuse or terminate service to me for any reason not unlawfully discriminatory, at any time. 

9. Acknowledge, agree and represent that I have full and sole responsibility for the safety and well-being for all minors whom I have invited to the climbing gym for as long as they are on the premises. 

10. Hereby release, discharge and covenant not to sue Brevard Rock Gym, its owners, shareholders, agents, employees, attorneys, legal representatives, successors, and assigns; and its directors, officers, contractors, representatives, divisions, subsidiaries, affiliates, other participants in the Activities, and all persons and entities acting by, through, under, or in concert with them, (collectively “Releasees”) from all liability, claims, demands, losses or damages caused or alleged to be caused in whole or in part by the negligence of any of the Releasees or otherwise, including negligent rescue operations, and I further agree that if despite this release, waiver of liability, assumption of risk, and indemnity agreement, I, or anyone on my behalf makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS, LIABILITY, DAMAGE OR COST WHICH ANY MAY INCUR AS A RESULT OF SUCH CLAIM. THIS RELEASE IS BINDING ON MY HEIRS, ASSIGNS AND AGENTS. 

I realize I am subject to injury from this activity and that risks and dangers may arise from foreseeable or unforeseeable causes to which I am exposing myself or my minor child as described in this “ASSUMPTION OF RISK, RELEASE OF LIABILITY, WAIVER OF ALL CLAIMS, AND INDEMNIFICATION.” The risks outlined in this document are not exhaustive and I acknowledge that there may be other risks, hazards, and dangers that, based on the circumstances, are integral to Climbing Wall Activities, recreational activities, and Rock Climbing Activities that take place in a wilderness or outdoor recreational environment or at the Brevard Rock Gym physical location. 

I HAVE READ THIS ENTIRE DOCUMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE, and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law. I agree that any legal disputes regarding the interpretation of this document will be determined by the substantive laws of the State of North Carolina, without regard to its conflicts of laws provisions. I also understand that I am free to seek the advice of independent legal counsel, at my own expense, prior to signing this document; and that any advice, suggestions or statements made by other participants or by anyone else, including the owners, agents or employees of Brevard Rock Gym may be incorrect and unsupported by the law. I also agree that if any portion of this agreement is held to be invalid, illegal, or unenforceable, said portion of this agreement shall be deemed separate, distinct, and independent, and shall be ineffective to the extent it (i) invalidates the remaining provisions of this agreement in that jurisdiction, or (ii) affects the legality, validity or enforceability of such provision in any other jurisdiction. 

By signing this agreement, I agree to be bound by its terms, and that no other representations have been made to me that change, alter, or modify anything within this written agreement. I understand that the Activities are dangerous. In addition, I certify that I am at least 18 years of age. If the participant listed in “Participant Information” is under age 18, I state that I am the parent or legal guardian of said participant and I agree to each of the above terms on his or her behalf, and I understand that said participant must sign his or her own waiver upon turning age 18. I give permission for my child to participate in the Activities. I also give Brevard Rock Gym permission to use in its catalog, brochure, or its website any picture in which the likeness of me or my child appears. 

Furthermore, I hereby give permission to the physician selected by Brevard Rock Gym to hospitalize, secure proper treatment for, and to order injections, anesthesia and surgery as needed for my child named as “Participant.” I do hereby give consent to Brevard Rock Gym to treat an injury occurring during the Activities and seek definitive care if it is deemed necessary. It is my intention to exempt, relieve, and hold harmless Brevard Rock Gym and each of the other released parties from liability for personal injury, illness, property damage or wrongful death while I am engaged in this event, even if caused by negligence or any other cause, to the fullest extent permitted by law. 

MY SIGNATURE BELOW INDICATES THAT I HAVE READ THIS ENTIRE DOCUMENT, UNDERSTAND IT COMPLETELY, AND AGREE TO BE BOUND BY ALL ITS TERMS AND CONDITIONS.

July 21, 2024



First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

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.
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Emergency Contact

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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*

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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