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MUST PRESENT A GOVERNMENT-ISSUED PHOTO ID

Waivers for minors can only be signed by a parent or court-appointed guardian.

DO NOT SIGN IF THE MINOR IS NOT YOUR CHILD

Minors visiting without their parent or court-appointed guardian must bring a copy of the government-issued photo ID of the parent or court-appointed that signed the waiver.

In consideration of the services, activities, and equipment (collectively, the “Facilities”) provided by The Circuit Inc., its agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (collectively, "TC"), I hereby agree and acknowledge as follows, on behalf of myself Minors in my control (including my children), parents, spouse or partner, heirs, assigns, personal representative, and estate:

1. RISKS and ASSUMPTION OF RISKS: Using the Facilities (including climbing, non-climbing, and yoga) can be dangerous and include risks. These risks are both apparent and not apparent and include—but are not limited to—equipment failure, loose or slippery climbing holds, injuries from falling or twisting, and injuries from other people’s use of the Facilities. These risks could result in significant physical or emotional injury, paralysis, death, or damage to me, or to property, or to others. I assume responsibility for using the Facilities even though there are risks, and for any harm suffered or imparted while using the Facilities.  

2. VOLUNTARY PARTICIPATION: I understand that the Facilities are private and recreational in nature, and I have chosen voluntarily to use the Facilities over other recreational opportunities available to me.

3. SAFETY: I have watched (or before using the Facilities, I will watch) THE CIRCUIT BOULDERING GYM SAFETY VIDEO and I am familiar with the safety features of the Facilities and other equipment that I will use (whether or not such equipment is provided by TC). I acknowledge that these safety features and precautions may not be all that is necessary to minimize the risk of injury or provide protection from injury or death. I agree to abide by TC’s rules and directions while using the Facilities. I understand that using the Facilities may require strength, endurance, and agility, and I will refrain from or stop any activity that I believe is beyond my abilities. I acknowledge that climbing while impaired—either from alcohol, controlled substances, or anything else that could affect my ability to climb safely—is strictly prohibited and I agree to not climb while impaired.

4. RELEASE OF LIABILITY: FOR ANY AND ALL CLAIMS, DEMANDS, OR CAUSES OF ACTION (“CLAIMS”) THAT IN ANY WAY ARISE OUT OF OR ARE CONNECTED WITH THE FACILITIES, MY USE OF THE FACILITIES, AND ANY ALLEGED ORDINARY NEGLIGENCE OF TC, I—ON BEHALF OF MYSELF AND MINORS IN MY CONTROL (INCLUDING MY CHILDREN), PARENTS, SPOUSE OR PARTNER, HEIRS, ASSIGNS, PERSONAL REPRESENTATIVE, AND ESTATE—TO THE EXTENT PERMITTED BY LAW, HEREBY: (A) VOLUNTARILY RELEASE TC FROM SUCH CLAIMS; AND (B) COVENANT NOT TO SUE OR MAKE ANY CLAIMS AGAINST TC (WHETHER IN COURT OR IN ARBITRATION). THE CLAIMS RELEASED IN THIS SECTION 4 INCLUDE NEGLIGENCE BUT DO NOT EXTEND TO CLAIMS BASED ON GROSS NEGLIGENCE OR RECKLESS OR INTENTIONAL MISCONDUCT.

5. INDEMNIFICATION, HOLD HARMLESS, AND DEFENSE: I agree to indemnify, hold harmless, and defend TC against: (a) any and all Claims that in any way arise out of or are connected with the Facilities, the use of the Facilities by me or any Minors in my control (including my children), and any alleged ordinary negligence of TC; (b) against any and all claims for my own negligence; and (c) any other claim arising from use of the Facilities. I will reimburse TC for any damages, reasonable settlements, and defense costs, including attorneys’ fees, that it incurs because of any such Claims made against it.

6. MEDICAL INSURANCE AND CONDITIONS: I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while using the Facilities and that I have no medical or physical conditions which could limit or interfere with my use of the Facilities. I agree to assume and bear the costs of any injury or damage if not covered by insurance and of all consequences and risks that may be created, directly or indirectly, by any personal medical or physical condition that could limit or interfere with my use of the Facilities.

7. PHOTO RELEASE: I hereby agree that TC and its affiliates, successors and assigns may take photographs and videos of me while using the Facilities, and I hereby irrevocably permit, authorize, and grant TC and its affiliates, successors and assigns the right to display, publicly perform, exhibit, transmit, broadcast, reproduce, record, photograph, digitize, modify, alter, edit, adapt, create derivative works of, sell, rent, license, otherwise use, and permit others to use, names, images, likenesses, voices and appearances, and any and all materials collected or created by or on behalf of TC that incorporate any of the foregoing in perpetuity throughout the universe in any medium or format whatsoever now existing or hereafter created on any platform and for any purpose, including but not limited to advertising, public relations, publicity, and promotion of TC and its affiliates, successors and assigns, and their respective businesses, products and services, without further compensation to, or consent or permission from, me.

8. DISEASES: I am aware of the contagious nature of bacterial and viral diseases including the 2019 novel coronavirus disease (also known as COVID-19) (collectively, “Diseases”) and the risk that I may be exposed to or contract such Diseases by using the Facilities. I understand and acknowledge that such exposure or infection may result in serious illness, personal injury, permanent disability, death, or property damage. I acknowledge that this risk may result from or be compounded by the actions, omissions, or negligence of others, including TC. I understand that while TC may take measures to reduce the spread of the Disease, it cannot guarantee that I will not become infected while using the Facilities and that using the Facilities may increase my risk of contracting such Diseases. I understand that if requested, TC will cooperate with governmental agencies to provide them (or their agents) with information about such Diseases, which may include providing my name and contact information to such authorities, and I agree to TC sharing such information. 

NOTWITHSTANDING THE RISKS ASSOCIATED WITH SUCH DISEASES, I ACKNOWLEDGE THAT I AM VOLUNTARILY USING THE FACILITIES WITH KNOWLEDGE OF THE DANGER INVOLVED AND THAT THE RELEASE OF LIABILITY AND INDEMNIFICATION PROVISIONS IN SECTION 4 AND 5 ABOVE WILL APPLY TO ANY CLAIM ALLEGING THAT I CONTRACTED A DISEASE WHILE USING THE FACILITIES OR WHILE INTERACTING WITH ANYONE ELSE USING THE FACILITIES.

9. INTERPRETATION OF THIS AGREEMENT: I agree that the validity and enforceability of this agreement will be governed by Oregon law, and that if any section of this agreement is found unenforceable, the rest of the agreement will remain valid.

By signing this agreement, I acknowledge that if anyone is hurt or property is damaged during—or in any way connected with—use of the Facilities, a court of law (or an arbitrator) could bar any suit or Claim against TC.

I AM OVER 18 YEARS OF AGE AND HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I UNDERSTAND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS BY USING THE FACILITIES. I HAVE HAD THE OPPORTUNITY TO ASK QUESTIONS ABOUT THIS DOCUMENT AND I AM SATISFIED BY ANY ANSWERS TC PROVIDED. I HAVE READ AND I UNDERSTAND THIS DOCUMENT AND I AGREE TO BE BOUND BY ITS TERMS.


First Individual's Name

First Name*

Last Name*

Phone*
First Individual's Date of Birth*
First Individual's Signature*
Second Individual's Name

First Name*

Last Name*
Second Individual's Date of Birth*
Third Individual's Name

First Name*

Last Name*
Third Individual's Date of Birth*
Fourth Individual's Name

First Name*

Last Name*
Fourth Individual's Date of Birth*
Fifth Individual's Name

First Name*

Last Name*
Fifth Individual's Date of Birth*
Sixth Individual's Name

First Name*

Last Name*
Sixth Individual's Date of Birth*
Seventh Individual's Name

First Name*

Last Name*
Seventh Individual's Date of Birth*
Eighth Individual's Name

First Name*

Last Name*
Eighth Individual's Date of Birth*
Ninth Individual's Name

First Name*

Last Name*
Ninth Individual's Date of Birth*
Tenth Individual's Name

First Name*

Last Name*
Tenth Individual's Date of Birth*
Parent or Court Appointed Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Government Issued Photo ID (Drivers License, State ID, Military ID, Passport, etc)
Bring a government issued photo ID to the front desk to complete the waiver process. Parents - If you will not be attending with your child, please send a copy/photo of your government-issued photo ID. Your photo ID must be presented in order for your child to enter our facilities. *
I understand I must present a government issued photo ID to the front desk staff.
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. The "Relation" box below must state either parent or court appointed guardian.


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 Court Appointed Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Court Appointed Guardian's Date of Birth*
Parent or Court Appointed 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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