Registration Form: ASSUMPTION OF RISK, RELEASE OF LIABILITY & WAIVER OF CLAIMS AGREEMENT:

In consideration of being allowed to use the facilities and participate in Guided Rock Climbing and other
activities (collectively the ďActivitiesĒ) provided by Sierra Rock Climbing School, Inc. (the ďHostĒ), the
Participant, and the Participantís parent(s) or legal guardian(s) do hereby agree, to the fullest extent permitted
by law, as follows:
a) TO WAIVE ALL CLAIMS that they have or may have against the Host, its owners,
affiliates, employees, and/or agents arising out of the inherent risks of participating in
the Activities; b) TO ASSUME ALL RISKS INHERENT IN PARTICIPATING IN THE
ACTIVITIES; and c) TO RELEASE the Host, its owners, affiliates, employees, and/or agents, from all
liability for any loss, damage, injury, or expense forming the basis for a claim and/or
cause of action that the Participant [or his/her parent(s) or legal guardian(s)] may suffer,
arising out of the inherent risks of participation in the Activities.
Personal Responsibility
The Participant and his/her parent(s) or legal guardian(s) certify that Participant has no physical or
mental condition that precludes him/her from participating in the Activities and that he/she is not
participating against medical advice.
The Participant and his/her parent(s) or legal guardian(s) understand that Participantís participation
in the Activities is voluntary and further understand that they have the opportunity to inspect the
Hostís equipment and facilities before any participation.
The Participant and his/her parent(s) or legal guardian(s) understand that Participant is obligated to
follow the rules of the Activities and that he/she can minimize his/her risk of injury by doing so and
through the exercise of common sense and by being aware of his/her surroundings.
If, while participating in the Activities, the Participant and/or his/her parent(s) or legal guardian(s)
observe any unusual hazard or condition, which they believe jeopardizes Participantís personal safety
or that of others, Participant and/or his/her parent(s) or legal guardian(s) will remove Participant
from participation in the Activities and immediately bring said hazard or condition to the attention of
the Host.
I, ___________________________________ (parent/legal guardian), hereby agree that I will explain to
my child that the risk of injury while participating in the Activities can be reduced by following the
rules and through the use of common sense and good judgment.
FORM 1513 (1212) General Waiver B Ė Page 1
To the extent that any portion of this Agreement is deemed to be invalid under the law of the applicable
jurisdiction, the remaining portions of the Agreement shall remain binding and available for use by the Host
and its counsel in any proceeding.
I/WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I/WE HAVE
GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, HAVE NOT CHANGED IT ORALLY, AND
SIGN IT VOLUNTARILY.
Participantís Name (Printed):_______________________________
Participantís Signature:____________________________________ Date:______________

Parent/Legal Guardian Name (Printed):_______________________
Parent/Legal Guardian Signature:____________________________ Date:______________

Email Address:

Emergency Contact Phone# 1:                                                      Emergency Contact Phone #2:

Each Participantís past 5 years medical history: (i.e. prescriptions, injuries, allergies, limitations, surgery, other?)