This document must be read, initialed on the line items, signed and
completely filled out to allow
participation at any level.
In consideration of services of Little Brick House Inc dba Outside-In Climbing Gym (OICG), Chocolate Moose (CM), and Mountain State Miniature Golf, Inc. (MsMg), its agents, owners, officers, volunteers, participants, employees, property owners, and all other persons or entities acting in any capacity on its behalf, I hereby agree to release and discharge all of these organizations and individuals on behalf of myself, my children, my parents, my heirs, assigns, personal representatives and estate AS FOLLOWS:
1. I acknowledge that rock climbing on an artificial wall contains inherent risks and entails both known and unanticipated risks which could result in physical or emotional injury, paralysis, death, or damage to myself, to property or to third parties. To eliminate such risks would eliminate the positive inherent qualities which lend to the purpose of the activity. Such risks include, among other things: falling off the wall, loose and/or damaged artificial holds, falling to the ground or on other participants, being fallen on by other participants; abrasions from the wall, ropes, pads, or the floor; equipment failure; belay and/or belayer failure; reckless climbing or climbing beyond my personal limits, the negligence of other climbers, visitors, participants, or other persons who may be present; head injuries; and the results of my own negligence.
2. I will obey and comply with all policies rules, regulations, and instructions of CM/OICG/MsMg and its employees and agents. I accept the responsibility to ask questions and clarify rules, regulations, and instructions that I do not understand, fully comprehend or have any doubts about.
3. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate despite the risks.
4. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless CM/OICG/MsMg from any and all claims, demands, or cause of action, which are in any way connected with my participation in this activity or my use of CM/OICG/MsMg equipment or facilities, including any such claims which allege negligent acts or omissions of CM/OICG/MsMg.
5. Should CM /OICG/MsMg or anyone acting on its behalf incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold it/them harmless for all such fees and cost.
6. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or agree to bear the cost of such injury or damage to myself. I further certify that I have no medical or physical conditions which could interfere with my safety in this activity, or I am willing to assume and bear any cost of all risks that may be created, directly or indirectly, by any such condition.
7. In the event that I file a lawsuit against OICG & MsMg, I agree to do so solely in the state of West Virginia, and I 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 portions of this agreement are found to be void or unenforceable, the remaining portions shall remain in full force and effect.
Optional:
8. Personal Gear: I voluntarily choose to use my own equipment that has been approved by the Outside-In Climbing Gym and accept personal responsibility for injuries that may occur through the failure or misuse of the equipment.
PARENT / GUARDIAN INDEMNIFICATION
(must be completed if participant is under the age of 18)
In consideration of (“Minor”) being permitted by CM/OICG/MsMg to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless CM/OICG/MsMg, its agents, owners, officers, volunteers, participants, employees, property owners, and all other persons or entities acting in any capacity on its behalf, from any and all claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.
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