ASSUMPTION OF RISKS, RELEASE OF LIABILITY AND INDEMNIFICATION
THIS RELEASE IS A BINDING LEGAL CONTRACT. PLEASE READ IT CAREFULLY BEFORE SIGNING.
Full Name of minor child ("Participant"): [FIRSTNAME][LASTNAME] Date of birth: [DOB]
Street Address: [ADDRESS]
City: [CITY] State: [STATE] Zip Code: [ZIP]
Primary Phone or cell: [PHONE1] Secondary or Emergency Phone: [EMERCONTACTPHONE]
I certify and attest that I am age 18 or over.
I certify and attest that I, [Emergency Contact], am the parent or legal guardian (“Parent”) of the above named Participant.
My minor child, [FIRSTNAME] [LASTNAME], desires to use the facilities or programs of The Rock Club LLC, the New Rochelle Racquet Club LLC, The Studios LLC and /or Pine Brook Fitness LLC, all of 130 Rhodes St, New Rochelle, New York ("The Club"). In consideration of The Club permitting Participant’s said use, I hereby agree to be bound by the terms of this Assumption of Risks, Release of Liability and Indemnification and by the provisions of the Rules and Regulations of The Club (together, the "Release").
I hereby acknowledge, accept and agree that the use of The Club's climbing wall, tennis courts and other facilities (collectively, the "Facilities") and participation in activities, classes, training, coaching, programs and trips offered by The Club (collectively, "Programs") involves inherent and significant risks. I am also aware that there are also specific and significant risks associated with the sport of rock climbing, the use of the climbing wall, its component and fixtures (”Wall”) and participation in Programs, including but not limited to:
1. All manner of injury resulting from my falling from the Wall, the climbing site, hitting the floor, ground, wall faces and features, people or ropes, whether permanently or temporarily in place;
2. Rope abrasion, entanglement and any other injuries resulting from activities on or near the Wall, including but not limited to, climbing, belaying, rappelling, lowering on ropes, rescue systems, and any other rope techniques;
3. All manner of injury resulting from the actions, omissions or negligence of other participants, visitors or other persons who may be present including, but not limited to, falling climbers or dropped items, such as, but not limited to, ropes, climbing hardware, spinning or broken holds, other wall parts, falling rocks or other objects, climbing hardware or personal effects;
4. Cuts and abrasions resulting from skin contact with the Wall or any other surface;
5. Failure or misuse of ropes, harnesses, belaying equipment, climbing holds, anchor points, on any part of the Wall or climbing site;
6. Failure to follow The Club's posted rules and regulations, employee's instructions 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 Club, its Facilities or Programs and agree that such list in no way limits the extent or reach of this Release
I certify that the Participant has no medical, physical or other conditions that could interfere with his or her ability to participate, belay and follow or give directions while climbing, belaying or any other activity within The Club. I agree to comply with The Club's rules and regulations.
I understand that indoor rock climbing is not the same as outdoor climbing and that additional skills and training are necessary for outdoor climbing that cannot be acquired indoors. I agree to seek qualified instruction on behalf of Participant before attempting to climb outdoors.
The Club reserves the right to use any photograph or video taken at The Club or in the course of Programs for promotional materials, brochures, and/or website, whether in the course of a Program, open climbing, birthday party, private group or otherwise. The Club retains exclusive rights such photographs and videos.
I also agree to release and discharge The Club and all of its respective officers, directors, shareholders, members, partners, employees, agents and representatives, as well as all other persons, corporations, or other entities that might have any liability to me (the "Released Parties"), from and against any and all damages, actions, claims and liabilities, whether known or unknown, anticipated or unanticipated, suspected or unsuspected, relating to or arising from any activity, occurrence or otherwise involving The Club, Facilities or Programs. This Release is intended to release and discharge the Released Parties from all damages, actions, claims and liabilities of any nature, specifically including, but not limited those arising from or related to the negligence of any Released Parties. I further agree to indemnify, hold harmless, and defend the Released Parties from and against any loss, damage, liability and expense, including costs and attorneys' fees, incurred by a Released Party as a result of my using the Facilities or participating in any activity sponsored by or involving The Club.
The laws of the State of New York shall govern the rights and obligations of the parties to this Release and the interpretation, construction, and enforceability thereof. I agree that any lawsuit brought against any Released Party shall be brought solely in the New York State Supreme Court in Westchester County. I hereby voluntarily waive any right I may have to a trial by jury in any action, proceeding, or litigation involving any released party.
I agree, personally and on behalf of Participant, to be bound by the terms and conditions of this Release. I further agrees to indemnify, hold harmless and defend the Released Parties from and against any loss, damage, liability and expense, including costs and attorneys' fees, incurred by a Released Party to the same extent as in the terms of the indemnification contained in the Release as a result of Participant using the Facilities or participating in any other Program or activity involving The Club.
Participant's Signature [SIGNATURE]
Parent Name: [EMERCONTACTNAME]
Parent’s Signature: [SIGNATURE PARENT]
Thank you for completing the online waiver!