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In consideration for participating in Guided Rock, Ice, Mixed, and Instructional Climbing activities provided by Midwest Mountain Guides, the Participant, and the Participant’s parent(s) or legal guardian(s) if the Participant is a minor, do hereby agree, to the fullest extent permitted by law, as follows: 

I UNDERSTAND THAT I AM BEING ASKED TO READ EACH OF THE FOLLOWING PARAGRAPHS CAREFULLY & INITIAL. I UNDERSTAND THAT IF I WISH TO DISCUSS ANY OF THE TERMS CONTAINED IN THIS AGREEMENT, I MAY CONTACT: Allen D. Wiberg, owner of Midwest Mountain Guides at (715) 226-0723.


VOLUNTARY PARTICIPATION: My involvement or participation is voluntary and is not required by Midwest Mountain Guides.


RISK FACTORS: I understand and acknowledge that participation in rock and ice climbing activities may be hazardous, and that the hazards associated with such activities include, but are not limited to: temporary or permanent muscle soreness; sprains; strains; cuts; bone fractures; abrasions; bruises; ligament and/or cartilage damage; head, neck or spinal injuries; paralysis; eye damage; disfigurement; and possibly death. 

Bodily injury or illness may be caused due to exposure to temperature extremes; inclement weather; accident or illness in remote places without medical facilities; falls; rock fall; handling of heavy packs; inadequate foot care; animal or insect bites; traveling by foot through rough, hilly, or forested terrain; improper hydration or nutrition; and accidents while traveling to and from the activity site. I realize that these dangers and other hazards may result in injury to myself or other participants, including the possibility of broken limbs, paralysis or even fatal injury.


ASSUMPTION OF RISK: Being fully aware of the risks that may arise out of or result from participation in rock, ice, and climbing instruction activities or the use of equipment, and/or services, regardless of whether such risks are known or unknown, foreseen or unforeseen, disclosed or undisclosed, including but not limited to those risks described above, I VOLUNTARILY DESIRE TO PARTICIPATE IN SUCH ACTIVITIES BEING FULLY AWARE OF THE DANGERS AND VOLUNTARILY ASSUME ALL RISK OF LOSS, DAMAGE OR INJURY.


COMPLIANCE WITH POLICIES & PROCEDURES: I agree to act in a reasonable and safe manner while participating in Midwest Mountain Guides activities so as not to endanger the lives of persons or property. Furthermore, I agree to comply with and abide by all rules, policies and procedures of Midwest Mountain Guides. Additionally, I agree to comply with verbal guidance and warnings of MMG staff. I understand that the safe and proper use of equipment, or participation in the rock and ice climbing activities is dependent upon carefully following such rules, policies, and procedures. 


HEALTH DISCLOSURE: I certify that I have consulted with a physician as appropriate to determine any potential conditions that may adversely affect my participation. I agree to notify the Midwest Mountain Guides staff (e.g., guides/instructors) of any changes to my health and fitness, which may occur during a program.


MEDICAL TREATMENT:  I give permission for the guides/instructor(s) to seek emergency medical or services for me should I become injured or ill. I am solely responsible for any and all medical, health, or personal injury or illness costs related to my participation in Midwest Mountain Guides activities, services and equipment.


RELEASE of LIABILITY & INDEMNITY: To the fullest extent allowed by the laws of the State of Wisconsin (which may limit the scope of the following) I, an adult participant, or Parent of a minor participant (for myself and on behalf of the child), hereby release and agree to indemnify (“indemnify” meaning protect by reimbursement or payment) and hold harmless, and not to sue Midwest Mountain Guides and its employees and volunteers (“Released and Indemnified Parties”) with respect to any and all liability for any loss, damage, expense or injury, including death, arising from or in any way related to my (or the minor’s) enrollment or participation in an activity of Midwest Mountain Guides.


By signing below, I understand that I assume all of the above described responsibilities. Furthermore, it is my understanding that Midwest Mountain Guides, and their employees assume no liability and further disclaim all responsibility in my use of the services and equipment described above.


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First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Parent or Guardian's Email Address
Email*
Confirm Email*
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Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Emergency Contact's Relation to Participant
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*
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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