Loading...

Golden Rock Dog, LLC dba Boulder Rock Club; Total Climbing, LLC

Acknowledgment & Assumption of Risk and Release of Liability

There are significant elements of risk in any adventure sport or activity associated with a rock gym: climbing wall, bouldering area, rock climbing, and/or incidental weight and fitness training regimens and equipment (referred to herein as the ACTIVITY). We have taken reasonable steps to provide you with appropriate equipment and/or skilled instructors so you can enjoy an activity at which you may or may not be skilled; however, we wish to remind you the ACTIVITY has foreseeable and unforeseeable risks and certain risks cannot be eliminated without destroying the unique and exciting character of the ACTIVITY. The same elements that contribute to the unique and exciting character of the ACTIVITY can be causes of serious injury to persons, death, and/or loss of or damage to equipment and can occur by accident, through negligence, or even intentionally. It is important for you to know in advance what to expect and to be informed of the inherent risks.

PARTIAL LISTING OF RISKS. Some, but not all of the risks, foreseeable or unforeseeable, associated with the ACTIVITY follow:

  1. Slips, trips, falls and/or collisions while using the climbing walls, bouldering areas, landing pits, work-out areas, floors below climbing walls, bathroom facilities, stairs, exits and entrances, and other facilities or equipment existing now or in the future;
  2. Misuse of equipment or facilities, or failure of equipment and facilities, including but not limited to: loose or damaged holds, worn or defective ropes, and worn or defective safety devices;
  3. Your physical strength, coordination, sense of balance, and ability to follow or give directions while climbing, belaying, or working out;
  4. Abrasion from or entanglement with ropes or equipment; and
  5. Bad decision making by you or your belayers, and the presence, actions (including mistakes), or falls of other climbers, belayers and observers

I Agree

EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY. You hereby acknowledge that participation in the ACTIVITY is purely voluntary. In recognition of the inherent risks of the ACTIVITY in which you may engage, you confirm that you are physically and mentally capable of participating in the ACTIVITY and/or using all facilities and equipment situate at BRC. You participate in the ACTIVITY willingly and voluntarily, and you assume the risk of any and all personal injury and/or damages to or loss of your personal property that occurs while at BRC or while participating in any off-premise BRC-sponsored activity. You assume such risk even if the injury or damage is caused by the negligence of others, including but not limited to: members, visitors, BRC employees, officers, directors, agents, instructors, belayers or spotters. You further assume such risk whether the ACTIVITY in which you are participating is organized or unorganized, part of a class or instructional, supervised or unsupervised. You are aware of the meaning of the terms unroped climbing (bouldering), Top-rope climbing, and Lead climbing, and you understand the differences between the activities. You assume the risk(s) of personal injury, accidents and/or illness, including but not limited to: sprains, torn muscles and/or ligaments, fractures or broken bones, eye damage, cuts, wounds, scrapes, abrasions and/or contusions, dehydration, exposure and/or altitude sickness, head, neck, and/or spinal injuries, shock, paralysis, and/or death.

I Agree

HELMET WAIVER. You acknowledge a UIAA approved helmet may help prevent head injuries. You are refusing this safety precaution against the advice of BRC and its insurance company, and you hereby waive and release the BRC, its officers, directors, shareholders, employees, and agents from any and all liability associated with your voluntary refusal to wear a safety helmet.

I Agree

CAPABILITIES-HEALTH-INSTRUCTION. You recognize that BRC may find it necessary to refuse or terminate the participation of any person judged to be incapable of meeting the rigors or requirements of any ACTIVITY. You accept BRCs right to take such actions for the safety of yourself and/or other participants. You will not engage in the ACTIVITY beyond your capabilities and will not cause any third party to be endangered by any of your actions during the ACTIVITY or while using the facility or equipment. You understand that indoor climbing is not the same as outdoor climbing, which requires additional skills. You represent that you are in good health and have no physical or mental limitations or problems that would affect your safe use of the facilities or equipment. You agree to abide by all BRC rules as they currently exist and as they are amended, and will immediately comply with all instructions and requests from BRC staff.

I Agree

MEDICAL TREATMENT AND PHOTO AUTHORIZATION. You hereby authorize any medical treatment deemed necessary in the event of any injury or illness while participating in the ACTIVITY. You either have appropriate insurance or, in its absence, agree to pay all costs of rescue and/ or medical services as may be incurred on your behalf. You agree that any film or photographs of you, as participants, become the property of the BRC and may be used for promotional or commercial purposes.

I Agree

RELEASE. In consideration of being permitted to engage in the ACTIVITY and to use the facilities, equipment and services provided by BRC, you, on behalf of yourself and any minor children for whom you are the parent, legal guardian or otherwise responsible, your spouse, your heirs, personal representatives or assigns, do hereby release BRC, its parent company, subsidiaries, principals, directors, officers, agents, employees, and volunteers, and each and every land owner upon whose property the ACTIVITY is conducted, from all liability; and you waive any claim for damage arising from any cause whatsoever, including negligence. In addition to signing the Helmet Waiver, you have read and understand this Acknowledgment and Assumption of Risks and Release of Liability. You understand that by signing this form, you are waiving valuable legal rights.

I Agree

ATTORNEYS FEES & COSTS - INDEMNITY, JURISDICTION AND VENUE. In the event of any litigation involving any actions covered by this Acknowledgment and Assumption of Risk and Release of Liability, should BRC prevail in whole or part, you shall pay BRCs reasonable attorneys fees and costs, and you agree to indemnify and hold BRC harmless from any claims, demands, or causes of action which are related to participation in the ACTIVITY. You agree that if any portion of this Acknowledgment and Assumption of Risks and Release of Liability is found to be void or unenforceable, the remaining portions shall remain in full force and effect. You agree that sole jurisdiction and venue for any litigation involving any actions covered by this Acknowledgment and Assumption of Risk and Release of Liability shall be in Boulder County, Colorado.

I Agree

SAFETY GUIDELINES AND REGULATIONS FOR THE BOULDER ROCK CLUB (BRC).

Please read each of the following guidelines and initial in the box provided at the end of this section. If you have any questions please inquire with BRC staff. BRC requires that parents or legal guardians of participants under the age of 18 initial for that participant, after thoroughly explaining the guidelines.

  • I acknowledge and understand that, as a user of BRC, I have a responsibility to conduct myself and any and all persons under my supervision, including minor children, in a proper, courteous, and safe manner.
  • I acknowledge and understand that no one may use the equipment and/or facilities at BRC while under the influence of alcohol, drugs or controlled substances.
  • I acknowledge and understand that all climbers must wear a helmet or sign a Helmet Waiver.
  • I acknowledge and understand that in order to belay at BRC without staff supervision I must be Belay Certified.
  • I acknowledge and understand that in order to lead climb at BRC I must be Lead Certified.
  • I acknowledge and understand that the BRC has the right to deny access to its facilities to any person, permanently or for a specific period of time, for any failure to adhere to the Safety Guidelines and Regulations, or for any conduct that is viewed as unsafe, inappropriate, or unhealthy, including but not limited to: horseplay, foul or rude language, or defiance of a BRC staff request.

I Agree

April 26, 2024

First Participants Name

First Name*

Last Name*

Phone*
First Participants Date of Birth*
First Participants Information

What are your preferred pronouns
First Participants Signature*
Second Participants Name

First Name*

Last Name*
Second Participants Date of Birth*
Second Participants Information

What are your preferred pronouns
Third Participants Name

First Name*

Last Name*
Third Participants Date of Birth*
Third Participants Information

What are your preferred pronouns
Fourth Participants Name

First Name*

Last Name*
Fourth Participants Date of Birth*
Fourth Participants Information

What are your preferred pronouns
Fifth Participants Name

First Name*

Last Name*
Fifth Participants Date of Birth*
Fifth Participants Information

What are your preferred pronouns
Sixth Participants Name

First Name*

Last Name*
Sixth Participants Date of Birth*
Sixth Participants Information

What are your preferred pronouns
Seventh Participants Name

First Name*

Last Name*
Seventh Participants Date of Birth*
Seventh Participants Information

What are your preferred pronouns
Eighth Participants Name

First Name*

Last Name*
Eighth Participants Date of Birth*
Eighth Participants Information

What are your preferred pronouns
Ninth Participants Name

First Name*

Last Name*
Ninth Participants Date of Birth*
Ninth Participants Information

What are your preferred pronouns
Tenth Participants Name

First Name*

Last Name*
Tenth Participants Date of Birth*
Tenth Participants Information

What are your preferred pronouns
Participants 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*
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*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

What are your preferred pronouns
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE! and  Rock Gym Pro