In consideration of my being allowed to use the Easton Community Center Rock Climbing Wall (“Climbing Wall”), its related facilities and equipment (“Facilities”) and participate in the Climbing Wall Program (“Program”), I, the undersigned, hereby agree to and acknowledge the following:
1. ASSUMPTION OF
RISK: I hereby acknowledge
and accept and agree that the sport of rock climbing and the use of the
Climbing Wall involve inherent risks. I received full information regarding the
Climbing Wall at the ECC and had the opportunity to ask any questions that I
wished. I have examined the Climbing Wall and have full knowledge of the nature
and extent of all the risks associated with rock climbing and the use of the
Climbing Wall, including, but not limited to:
a.
All manner of
injury resulting from my falling off or from the Climbing Wall and hitting the
floor, wall faces, people or rope projections, whether permanently or
temporarily in place;
b.
Rope abrasion,
entanglement and other injuries resulting from activities on or near the
Climbing Wall such as, but not limited to, climbing, belaying, rappelling,
lowering of ropes, rescue systems, and any other rope techniques;
c.
Injuries
resulting from the actions or omissions of others, including but not limited to
falling climbers or dropped items, such as, but not limited to, ropes, climbing
hardware, wall parts or personal effects;
d.
Cuts and
abrasions resulting from skin contact with the Climbing Wall or any other
surface;
e.
Failure or
misuse of ropes, slings, harnesses, climbing holds, anchor points, or any part
of the Climbing Wall;
f.
Failure to
follow ECC employee instruction or failure to ask for information or
assistance.
I further acknowledge that the above list is not inclusive of all possible risks associated with the use of the Climbing Wall, the Program and Facilities and I agree that such list in no way limits the extent or reach of this Assumption of Risk, Release and Indemnification. If I hear or see anything I feel is questionable or dangerous, it is my responsibility to ask or inform ECC employees until corrected or satisfactorily answered.
2. RELEASE: In consideration of my use of the Climbing Wall, and/or the
Facilities and/or participation in any Program or competition offered by or
held at the ECC, I hereby release and discharge the Town of Easton, the Easton
Community Center Inc. (“ECC”), their directors, officers, affiliates, agents
and employees and their successors and assigns, from any and all liabilities,
suits, claims and demand actions or damages (including attorneys fees and
disbursement) incurred by me or in any way related to, or arising out of, the
use or intended use of the Climbing Wall, the Program and/or the Facilities
whether supervised or not, including, without limitation, all claims for
property damage, personal injuries or wrongful death including any such claims
which allege negligent acts or omissions of the ECC.
3. INDEMNIFICATION: I hereby agree to indemnify and hold harmless The Town Of
Easton, the ECC, their directors, officers, affiliates, agents and employees
and their successors and assigns, from any and all causes of action, claims,
demands, losses and costs of any nature whatever arising out of or in any way
relating to my use of the Climbing Wall, the Program or the Facilities, including
any such claims which allege negligent acts or omissions of the ECC.
I understand and
agree that the ECC and its personnel reserve the right to deny access to any of
the ECC facilities to any individual permanently, or for a specific period of
time, for any breach of any of the ECC’s policies, rules and regulations or for
any conduct that is viewed as unsafe or inappropriate.
I expressly state
that I have read, understand and am familiar with this document and all its
provisions and that I have full knowledge of the nature and extent of the risks
incident to and inherent in the sport of rock climbing and my use of the
Climbing Wall, the Program and/or Facilities. I hereby voluntarily and
knowingly assume those risks and understand that I will be solely responsible
for any injury, loss or damage, including death, which I sustain while using
the Climbing Wall, Program and/or the Facilities and that by this agreement, I
relieve The Town of Easton and the ECC from any and all liability for such
injury, loss, damage or death.
I expressly state
that I am in good health and that I have no physical limitations that would
preclude my safe use of the Climbing Wall, Program and/or the Facilities. I am
at least 18 years of age and otherwise legally competent to sign this
Assumption of Risk, Release and Indemnification. This Assumption of Risk,
Release and Indemnification shall be effective and binding upon me and upon my
assigns, heirs, representatives, executors and administrators. (If under the
age of 18, this release must be signed and filled out below by the parent of
the Minor). In the event that I file a lawsuit against the ECC, I agree to do
so solely in the state of Connecticut, and further agree that the substantive
law of that state shall apply in that action without regard to the conflict of
law rules of that state. I agree that if any portion of this Assumption of
Risk, Release and Indemnification is found to be void or unenforceable, the
remaining portions shall remain in full force and effect.
___________________________ _______________________________
___________________________ _______________________________
___________________________ ___________________________________
Today’s Date Home
Phone Date of
Birth
In consideration of _________________ (print minor’s name) being permitted by the ECC to participate in its activities and to use its Climbing Wall equipment and facilities, I further agree to indemnify and hold harmless the Town of Easton and the ECC from any and all claims which are brought by, or on behalf of Minor, and which are in any way connected with such use of participation of Minor. I hereby state that I am the parent or legal guardian of the Minor named above. I am familiar with and consent and agree to the terms and provisions set forth in this Assumption of Risk, Release and Indemnification for the ECC and the Town of Easton.
__________________________ _________________________________ __________________
Signature of Parent Parent’s Name (Print Clearly) Today’s Date