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Waiver of Liability

(Acknowledgement of Risk Agreement)

 

Climbing, bouldering and abseiling are dangerous recreational activities that carry obvious risks. All climbers and belayers must be willing to take personal responsibility for their own safety and actions and acknowledge the inherent risks involved.

 

YOU ARE PARTICIPATING AT YOUR OWN RISK

 

As acknowledgement of my understanding I agree to initial each statement below and fill in all personal details for myself and minors in my care, sign and declare all information contained herein to be true and correct. By checking "I agree", completing my details and signing this document I am entering into a legally binding agreement on behalf of myself and any minors.

I Agree

I agree that climbing and activities associated with climbing are dangerous recreational activities and that there is a significant risk of injury within the relevant definitions in the Civil Liability Act.

I Agree

I am aware that climbing and activities related to climbing carry obvious risks, including but not limited to: injuries from falling, impact injuries, pulling injuries, exertion injuries, and rope entanglement injuries. Such injuries may result in death or serious disability. I also understand that climbing is physically demanding and may cause panic, hyperventilation or heart attack.

I Agree

To minimise risk, I agree to comply with all directions given by Pulse Climbing Pty Ltd, both verbal directions and signs. I agree that, prior to participating in activities related to climbing, I will ask for assistance or explanations if I do not understand any directions. I will only commence activities related to climbing when I am satisfied that I understand the rules and safety instructions provided by Pulse Climbing and have been assessed as competent during a belay induction by a Pulse Climbing staff member.

I Agree

I understand and accept the risks of climbing and activities related to climbing. I participate in this activity entirely at my own risk. I accept full liability for my own actions and decisions in relation to my participation in activities related to climbing.

I Agree

I release Pulse Climbing Pty Ltd, its management, employees and assistants, and the owner of the premises from any suit, demand, action or claim for compensation for death or personal injury, regardless of how such a claim arises, whether in tort, contract or under statute, in relation to my participation in activities related to climbing. This clause does not apply to significant personal injury suffered by me/us that is caused by reckless conduct of Pulse Climbing.

I Agree

I release Pulse Climbing Pty Ltd, its management, employees and assistants, and the owner of the premises from any suit, demand, action or claim for compensation, in tort or in contract, whether for personal injury, death or damage to property, however arising, whether from negligence or otherwise, in relation to my participation in activities related to climbing.

I Agree

I agree that I will not participate in activities related to climbing while under the influence of any drugs or alcohol. I agree that Pulse Climbing may require me/us to leave the premises immediately if it forms the opinion that I am under the influence of any drugs or alcohol. In such an event I will not be entitled to a refund or recourse of any nature.

I Agree

I agree that if, in the opinion of Pulse Climbing staff, my actions or the actions of those in my care pose a danger to me/us or to others, then Pulse Climbing may require me/us to leave the premises immediately. In such an event I will not be entitled to a refund or recourse of any nature.

I Agree

This waiver is ongoing and will apply to all future occasions I participate in activities related to climbing either at Pulse Climbing premises or organised by Pulse Climbing.

I Agree

This agreement may be relied upon in any proceedings by me, my heirs, executors or assigns.

I Agree

 

 

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*
11 Participant's Name

First Name*

Middle Name

Last Name*
11 Participant's Date of Birth*
Participant's Address
Address Line1:*
Street address, P.O. box, company name, c/o
Address Line2:
Apartment, suite, unit, building, floor, etc.
City:*
State/Province:*
Zip/Postal:*
Country:*
Parent or Guardian's Email Address

Email*

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

Emergency Contact's Name*

Emergency Contact's Phone Number*
Where did you hear about us?
*
Word of mouth
Newspaper Ad
Radio Ad
Advertising trailer
Bus Ad
Facebook
Facebook Ad
Google Search
Google Ad
Website
Other
Are you part of a group? (School sport, scouts etc)
Select your group below
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.
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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