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University of Nebraska

Outdoor Adventures

930 N. 14th St.

Lincoln, NE 68588

Climbing Wall Form

University of Nebraska

Outdoor Adventures

WAIVER AND RELEASE OF LIABILITY for Campus Recreation Outdoor Adventure Activities

DISCLAIMER: The UNIVERSITY OF NEBRASKA is NOT RESPONSIBLE for any injury or loss of property to any person suffered while warming up, practicing, traveling, playing, or participating in Campus Recreation Outdoor Adventure Activities for any reason whatsoever, including ordinary negligence.

This WAIVER and RELEASE OF LIABILITY was executed March 19, 2024, at Lincoln, Lancaster County, State of Nebraska by participant, (Releasor) in favor of the UNIVERSITY OF NEBRASKA and its Regents, Officers, Employees, Instructors, Staff, agents, operators, successors, and assigns (University).

The Releasor wishes to participate in Campus Recreation Outdoor Adventure Activities. In consideration for the privilege of participation in the program, the Releasor consents and agrees to the following:

  1. Releasor represents that he/she is physically capable of participating in Campus Recreation Activities and that he/she will take responsibility for physical fitness and capability to perform any Campus Recreation Activities in which Releasor participates whether in-person at a Campus Recreation facility or remotely. Releasor is encouraged to get his/her physician’s opinion prior to participating in any Campus Recreation Activities. In the event of a medical emergency, the University of Nebraska or its representatives have Releasor’s permission to take whatever measures they deem reasonable to render assistance and that Releasor and/or Releasor’s family will be financially responsible for any expenses involved.
  2. Releasor realizes that participation in Campus Recreation Activities involves certain risks and danger and is a vigorous activity involving severe respiratory and cardiovascular stress. Releasor has hereby been made aware that participation in Campus Recreation Activities has the following non-exclusive list of certain risks which I accept: 
  3. Activities
  4. Activities presently include, climbing indoors/ outdoors on an artificial wall or boulder, rappelling, challenge course high course events, team building activities on and near the ground, dynamic stretching, as well as any other activities which may be offered by Campus Recreation. Campus Recreation may discontinue or add certain Activities at its sole discretion. Releasor, understands, acknowledges and agrees that these activities are inherently dangerous activities that require moderate to heavy physical exertion and are physically and mentally demanding.
  5. Risks
  6. The Releasor has been made aware risk of these Activities include exposure to vigorous activity involving severe respiratory and cardiovascular stress, collision, falling, and all manner of injury, including, but not limited to: death; head, eye, neck, and spinal injury resulting in complete or partial paralysis; brain damage; heart attack; blisters; cuts; lacerations; abrasions; dismemberment; concussions; contusions; strains; sprains; dislocations; fractures; cold and heat injuries; water immersion; drowning; lightning strikes; injury to bones, joints, muscles, internal organs; environmental conditions; and animal and insect bites/ stings may expose participant to illnesses/ diseases. In addition, I understand and accept the incidental risks of travel to and from the site of activity, and the possible reckless conduct of other participants, loss or damage to property, accidents, illness, or fear of heights and other phobias, resulting from:
  7. a) falling from or off the climbing structures/ towers (up to 50 feet), boulder (up to 14 feet) b)exiting the wall, boulder or tower c) colliding with, hitting, or being hit by, other persons, rock faces, holds and other projections (permanent or temporary), mats, the floor or the ground; d) rope or webbing abrasion or entanglement; e) activities on or near the climbing wall, climbing structures, or boulder, including, among others, climbing, belaying, rappelling, lowering on a rope or auto belay system, and other rope uses and techniques; f) falling climbers or dropped items, including, among others, ropes and climbing hardware or wall components; g) use of ropes, auto-belay devices, slings, harnesses, climbing hardware, anchor points, or any part of the climbing wall or boulder structure; h) all aspects of the premises and fixtures and their use, including exercise equipment and machines and other items located on the premises; i) equipment failure, malfunction, or incorrect use; j) other harm or damage which may not be readily foreseeable including other presently unknown risks and dangers.

This list does not describe all possible risks associated with the premises, equipment and Campus Recreation Activities and the list in no way limits the extent or scope of the following assumption of risk, release and indemnity. Releasor has been made aware that the risks described in this document, and others, are inherent in the Activities – that is, they cannot be eliminated without destroying the basic nature of the Activities and reducing the appeal and value of the Activities.

  1. Consequently, while understanding that the University has taken precautions to provide organization, supervision, and equipment for reasonable safety, Releasor assumes joint and personal responsibility for safety while participating in Campus Recreation Activities. Pursuant to that joint and personal responsibility, Releasor agrees to comply with the instructions and direction of representatives and staff members of Campus Recreation. Releasor understands that failure to abide by the instructions and rules may result in his/her termination from the activity. Releasor accepts personal responsibility to ensure that any equipment needed to participate in the Campus Recreation Activities and used by the Releasor is safe and functioning properly and to refrain from causing loss or damage to the property of the University and Campus Recreation. Releasor realizes that he/she is solely responsible for any personal equipment, supplies, or property he/she may choose to use during the duration of the activity.
  2. Releasor further agrees to indemnify and hold harmless the University for any and all claims or actions as a result of engaging in, using University facilities and equipment, or receiving instruction for Campus Recreation Activities or any activities incidental thereto whatsoever, whenever, or however the same may occur, including whether Releasor is participating in-person or remotely.
  3. Releasor acknowledges that photographs and digital images may be taken during participation. Releasor understands and agrees that the images may be published and used by the University.
  4. Releasor is aware that if he/she uses a vehicle not operated by the University for transportation to, at, or leaving the activity site, the University is NOT responsible for any damage caused by or arising from Releasor’s use of such vehicle. Furthermore, Releasor acknowledges that he/she is solely responsible for any action he/she takes outside the scope of those actions permitted by the University for purposes of the particular activity regardless if occurring before, during, or after the duration of the activity. Releasor agrees to follow University policies when operating a University owned vehicle.
  5. In consideration of participation in Campus Recreation Activities, Releasor hereby RELEASES and covenants not-to-sue the UNIVERSITY for any and all present and future claims resulting from ordinary negligence on the part of the UNIVERSITY for property damage, personal injury, or wrongful death arising as a result of my engaging in, using University facilities and equipment, or receiving instruction for Campus Recreation Activities or activities thereto, wherever, whenever, or however the same may occur. Releasor hereby voluntarily waives any and all claims or actions resulting from ordinary negligence, both present and future, that may be made by Releasor’s family, estate, personal representative, heirs, or assigns.

I have read and understand that this WAIVER is intended to be as broad and inclusive as permitted by the laws of the State of Nebraska and agree that if any part is held invalid, the remaining parts of this WAIVER AND RELEASE will continue in full force and effect as intended. I further agree the venue for any legal proceeding shall be in the State of Nebraska.

I understand the rights that I am waiving and that I am freely signing this WAIVER AND RELEASE. I have read and fully understand that by signing this agreement I am giving up legal rights and remedies, which may be available to me for ordinary negligence of the University. I further agree to follow and abide by the regulations and rules of the UNIVERSITY as they pertain to Campus Recreation Activities and to reimburse and make good to the UNIVERSITY any loss, damage, or cost the UNIVERSITY may have to pay as a result of my participation in the program.

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.

Date: March 19, 2024

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*
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*
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Customer Type
Which best describes your association with UNL Campus Recreation*
Currently enrolled student at UNL
UNL Campus Rec Member, but not as an enrolled student.
A member of the general public

If a current UNL student, please enter your NUID
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. This WAIVER and RELEASE OF LIABILITY was executed, at Lincoln,Lancaster County, State of Nebraska by Guardian as Legal Guardian of CLIMBER's listed above (referred to in this document as Minor) in favor of the UNIVERSITY OF NEBRASKA and its Regents, Officers, Employees, Instructors, Staff, agents, operators, successors, and assigns (UNIVERSITY).   In consideration for the Minor’s participation in Campus Recreation Activities, Releasor hereby RELEASES and covenants not-to-sue the UNIVERSITY for any and all present and future claims resulting from ordinary negligence on the part of the UNIVERSITY for property damage, personal injury, or wrongful death arising as a result of engaging in, using University facilities and equipment, or receiving instruction for Campus Recreation Activities or activities thereto, wherever, whenever, or however the same may occur. Releasor hereby voluntarily waives any and all claims or actions resulting from ordinary negligence, both present and future, that may be made by Releasor’s family, estate, personal representative, heirs, or assigns. University of Nebraska Youth Safety The University of Nebraska-Lincoln has implemented a Youth Activity Safety Policy to provide a safe environment for youths participating in UNL sponsored activities, clinics or conferences. Our policy includes safe interaction guidelines as well as background and sex registry checks for Activity Workers. This policy will help to protect youth from potential misconduct incidents and provide a safe, educational and enjoyable activity/program experience.   Activity Workers 1. All Activity Workers must successfully pass a sex offender registry search for Nebraska and the state(s) they reside. 2. All Activity Workers driving activity vehicles must successfully pass a Driving Record Check. 3. In the case of an emergency or accident involving your youth, Parents/Guardians will be notified, following notification of the appropriate emergency personnel. 4. All UNL activities will comply with UNL’s Youth Activities Safety Guidelines. 5. As parent(s) or legal guardian(s) you give permission to this activity to use photos of your child in promotional media.   Disciplinary Action The Activity Directors of University-sponsored Youth Activities reserve the right to immediately dismiss any youth from the Youth Activity who is found to have violated behavioral expectations. Dismissed youth will be sent home at their expense and will be responsible for all other expenses associated with their dismissal. Parent(s)/guardian(s) will be immediately notified of a youth’s dismissal.


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*

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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