CMS Climbing Wall Waiver
Release of liability
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Provide the name of all legal guardianships and birthdates, that this waiver will apply for, including yourself. (Example: John Doe 2-2-04)
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Climbing Wall Release/IndemnificationOf all Claims and Covenant Not to Sue NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. By signing this agreement, you give up your right to bring a court action to recover compensation or obtain any other remedy for any injury to yourself or your property or for your death however caused arising out of your use of the Climbing Wall, now or any time in the future.Acknowledgment of RiskI HEREBY ACKNOWLEDGE AND AGREE that the sport of rock climbing and the use of the Climbing Wall (hereinafter referred to as the Climbing Wall) has inherent risks. I have full knowledge of the nature and extent of all the risks associated with rock climbing and the use of the Climbing Wall, including but not limited to: 1. All manner of injury resulting in falling from the Climbing Wall and hitting rock faces and projections, whether permanently or temporarily in place, or the floor; 2. Rope abrasion, entanglement and other injuries resulting from activities on or near the Climbing Wall such as, but not limited to, climbing, belaying, rappelling, lowering on rope, rescue systems, and any other rope techniques; 3. Injuries resulting from falling climbers or dropped items, such as, but not limited to, ropes or climbing hardware; 4. Cuts and abrasions resulting from skin contact with the Climbing Wall; 5. All manner of injury resulting from failure of ropes, slings, harnesses, climbing hardware, anchor points, or any part of the Climbing Wall structure. I further acknowledge that the above list is not inclusive of all possible risks associated with the use of the Climbing Wall and that the above list in no way limits the extent or reach of this release and covenant not to sue.Release/Hold Harmless and Covenant Not to Sue In consideration of my use of the Climbing Wall, I(name of Parent/guardian), the undersigned user, on behalf of myself, my heirs, representatives, executors, administrators, and assigns, HEREBY RELEASE Delta County Joint School District 50J, its officers, agents, and employees from any cause of action, claims, or demands of any nature whatsoever, including but not limited to, a claim of NEGLIGENCE, which I, my heirs, representatives, executors, administrators and assigns may now have, or have in the future against DCJSD 50 on account of personal injury, property damage, death or accident of any kind, arising out of or in any way related to my use of the Climbing Wall whether that use is supervised or unsupervised, however the injury or damage is caused, including, but not limited to the NEGLIGENCE of DCJSD 50, its officers, agents, and employees.In consideration of my use of the Climbing Wall, I, the undersigned user, agree to HOLD HARMLESS DCJSD 50, its officers, agents and employees from any and all causes of action, claims, demands, losses, or costs of any nature whatever arising out of or in any way relating to my use of the Climbing Wall.I hereby certify that I have full knowledge of the nature and extent of the risks inherent in the use of the Climbing Wall and that I am voluntarily assuming the risks. I understand that I will be solely responsible for any loss or damage, including death, I sustain while using the Climbing Wall and that by this agreement, I am relieving DCJSD 50 of any and all liability for such loss, damage, or death. I hereby COVENANT not to file any lawsuit, claim, or other action for any injuries related to my use of the climbing wall.I further certify that I am in good health and that I have no physical limitations, which would preclude my safe use of the Climbing Wall. I further certify that I am therefore of lawful age or my legal guardian is (18 years or older) and otherwise legally competent to sign this agreement. I further understand that the terms of this agreement are legally binding and I certify that I am signing this agreement, after having carefully read it, of my own free will. Contract to Follow Climbing Wall Safety Policies: I, (name of climber) accept full responsibility for my own safety and the safety of other climbers while in the climbing gym area. I agree to abide by, and to help enforce, the following climbing wall safety policies: 1. No unbelayed climbing above the bouldering line. 2. Climbers must be roped and belayed through a belay plate. Belays must be anchored. Roped climbersand belayers must wear harnesses. 3. Lead climbers must use adequate protection to eliminate the possibility of a ground fall at all times. 4. I will inform other climbers of any situation seen as unsafe or not in accordance with the Climbing Wall Safety Policies. All climbers are asked to assist and encourage less experienced climbers. 5. All accidents or equipment damage must be reported immediately to the supervising school personnel. 6. DCJSD 50 reserves the right to prohibit use of the wall to any individual permanently or for aspecified period of time for breach of contract in following the Climbing Wall Safety Policies, or for any conduct that is viewed as unsafe or inappropriate. Check the box if you have read and accept the waiver of liability for climbing at CMS.
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Please provide the last 4 of your S.S. number for proper identification of respondent
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