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PARTICIPANT / VISITOR RELEASE & ASSUMPTION OF RISK AGREEMENT

FACILITY RULES

 

The following rules apply to all persons using the facility operated by Theta Movement LLC and known as Little Rock Climbing Center (hereafter referred to as the “Facility”):

 

1. All climbers must have a current Facility waiver on file before climbing. Participants under 18 must have this form signed by their parent or legal guardian. No unaccompanied minors are allowed unless they are enrolled in a Facility program.

 

2. Only those currently climbing or belaying are allowed in climbing areas.

3. Store all gear away from climbing areas. No glass bottles, food or drinks are allowed on the gym flooring or bouldering areas. Closed toed shoes are required when climbing.

4. Participants must be at least 13 years of age to belay and lead climb. Guests age 15 and under must be accompanied by a parent or guardian at all times. The minimum age to climb is 5 years old.

5. Foul language, horseplay, tumbling on landing mats, swinging on ropes, running, and unruly conduct are not allowed at the Facility.

6. All climbers must use proper equipment. Equipment brought into the Facility shall be used at the sole and exclusive risk of the owner of such equipment.

7. All climbers and belayers must be trained or checked by Facility staff prior to climbing or belaying (auto-belay top-rope, lead, & bouldering). Breaking these rules is grounds for immediate removal from the Facility.

8. No bouldering above your head height. Do not boulder underneath roped climbers. It is recommended to have a minimum of one spotter per climber when bouldering.

9. No climbing or belaying is allowed while under the influence of intoxicating substances, or substances which may cause physical or mental impairment.

The Facility reserves the right to add to the above list as Facility staff deems appropriate in an effort to provide a safe environment for Facility patrons. Refusal to abide by any Facility rules can be cause for the loss of climbing privileges without a refund of any fees.

I agree that I have read and fully understand the rules of the Facility, and will abide by those rules, as well as others posted throughout the Facility. I further agree and consent to the following as a condition of using the Facility:


RELEASE AND ASSUMPTION OF RISK

1. I acknowledge that climbing on an artificial climbing wall (referred to in this Agreement as “Climbing”) can be dangerous. The inherent risks of Climbing are those that are normal or natural to that activity and cannot be eliminated with changing the primary nature of the activity. I acknowledge that there are inherent risks in the sport of indoor and/or outdoor rock climbing, including but not limited to those dangers associated with climbing, descending, and belaying. Some of the hazards of Climbing are, including but not limited to, falling because of improperly placed gear, loose or falling equipment or gear; getting dirt or other materials in the eyes; falling because of improperly tied knots or rope technique, or improperly buckled harnesses; acts of other participants; being hit by falling persons, equipment or debris; or falling onto another person, ledge or other protrusion; physical exertion; cuts, bruises, muscle and tendon strain, twisted or sprained ankles, rope burns, physical or emotional injury, paralysis, concussions, and even death, or other damage to myself, to property, or to third parties. I understand that there are more hazards than are enumerated here, and that there are also unknown and unforeseeable hazards. I understand that no amount of care, caution, instruction or expertise can eliminate the inherent dangers associated with these and other activities. I understand that climbing gear could become damaged or defective.

 

2. I am capable of examining and assessing my own equipment that I use during a climb and that I am solely responsible for inspecting and assessing the quantity and quality of my own gear. If I am not capable of examining and assessing my own equipment, I will learn to do so, or ask staff of the Facility for help. If damage occurs to equipment belonging to the Facility while I am using it, I will bring it to the attention of the Facility staff.

3. I confirm that I am physically and mentally capable of participating in all Facility activities. I understand that if my mental or physical condition changes after the execution of this release such that I am not capable of participating in the activity or using the equipment, I am obligated to cease participation in the activities immediately. 

 

4. I understand that wearing a helmet does not eliminate the dangers associated with Climbing but that in certain instances a helmet can reduce the risk of permanent injury or death. I understand that the Facility recommends that I wear a helmet and that if I choose not to wear a helmet I do so against the advice of the Facility.

 

5. I have read and agree to abide by the rules listed above on this waiver as well as other rules that may be posted throughout the Facility or Climbing sites.

6. I acknowledge that any Climbing instruction that I may receive from the Facility is general in nature and may not apply to all Climbing conditions. I understand that any instruction that I do receive does not prepare me to climb beyond my ability or without supervision.

 

7. I understand that this agreement shall remain in full force and effect until it is cancelled or modified by written agreement, signed by the parties hereto. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.


MEDICAL AUTHORIZATION: I agree, on behalf of myself, or on behalf of any minor children for whom I have signed this Agreement, to authorize any medical treatment deemed necessary by the Facility or third party emergency medical personnel, in the event of medical emergency, including injury or illness, while participating in the use of Facility equipment or premises. I agree on behalf of myself, or if for a minor, I agree as parent or guardian of such minor, to pay all costs of any medical services rendered on my behalf, or on behalf of the minor on whose behalf I am signing this Agreement.

ASSUMPTION OF RISK: I EXPRESSLY ASSUME ALL KNOWN AND UNKNOWN RISKS ASSOCIATED WITH MY PARTICIPATION IN ACTIVITIES AT THE FACILITY OR USE OF THE FACILITY’S PREMISES OR EQUIPMENT, INCLUDING RISKS OF INJURY, PARALYSIS OR DEATH, AND INCLUDING ANY RISKS ASSOCIATED WITH MY NOT WEARING A HELMET. My participation in Climbing and use of the Facility is purely voluntary and I choose to climb in spite of the risks.


RELEASE OF LIABILITY: I AGREE TO RELEASE AND FOREVER DISCHARGE THETA MOVEMENT LLC; AND ANY OF ITS MEMBERS, OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, REPRESENTATIVES, SPONSORS, INDEPENDENT CONTRACTORS, EQUIPMENT MANUFACTURERS, AND SUPPLIERS (COLLECTIVELY THE “RELEASED PARTIES”), FROM AND AGAINST ANY AND ALL DAMAGES, ACTIONS, CLAIMS, AND LIABILITIES, WHETHER KNOWN OR UNKNOWN, ANTICIPATED, SUSPECTED OR UNSUSPECTED, RESULTING FROM ORDINARY NEGLIGENCE ASSOCIATED WITH MY PARTICIPATION IN ANY ACTIVITY INVOLVING THE FACILITY OR MY USE OF OR PRESENCE AT THE FACILITY WITH THE EXCEPTION OF ANY WILLFUL AND WANTON, RECKLESS OR GROSSLY NEGLIGENT ACT OR OMISSION OF THE RELEASED PARTIES.


VENUE, JURISDICTION & WAIVER OF JURY TRIAL The laws of the State of Arkansas shall govern the rights and obligations of the parties to this Agreement and the interpretation, construction, and enforceability thereof. I agree that any lawsuit brought against the Released Parties shall be brought solely in the Circuit Court of Pulaski County, Arkansas. I VOLUNTARILY WAIVE ANY RIGHT I MAY HAVE TO A TRIAL BY JURY IN ANY ACTION INVOLVING ANY OF THE RELEASED PARTIES.


INDEMNITY AGREEMENT

 I agree, on behalf of myself or on behalf of any minor children for whom I have signed this Agreement, to indemnify, defend and hold harmless the Released Parties from any loss, liability, damages, expense, or costs, including attorney’s fees, incurred as a result of participation in any activities or use of the Facility.

I authorize the Facility to use any photograph of me taken at an event sponsored by the Facility to be used in promotional materials, brochures, and/or websites.

I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.

 



First Participant's / Visitor's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
How did you hear about our facility?
Google *
Current Member
Facebook
Birthday Party
Website
Instagram
Friend
Google

If friend, name

I represent that I am the parent or legal guardian of the participating individual and hereby consent to the participating individual’s use of the Facility and/or participation in activities sponsored by or located at the Facility. In consideration of the Facility allowing the participating individual to participate in activities at and/or use the Facility and as more fully described above, I agree to be bound by the terms and conditions of this Release. I, on behalf of myself and the participating individual, hereby agree to waive and release, indemnify, hold harmless and forever discharge the Released Parties, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that said participating individual ever had or may have, arising from or in any way related to such participating individual’s participation in activities sponsored by or in connection with the Released Parties, provided that this waiver of liability does not apply to any willful and wanton, reckless, or grossly negligent act or omission by any of the Released Parties. I further agree, on behalf of myself, to indemnify, hold harmless and defend the Released Parties from and against any loss, damage, liability, expense, or costs incurred due to acts of the participating individual, including attorneys’ fees, including related to those brought by or on behalf of, or otherwise related to or caused by the participating individual.





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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