Petra Rock Climbing Gym

Petra Rock Climbing Gym
Waiver & Acknowledgement of Risk

Participation in Activities at Petra Rock Climbing Gym Involves Risk
Attendees must be at least 18 years of age and (or a parent / guardian of participant) must read and sign a yearly waiver, sign a daily waiver, read the posted gym rules, and double check all safety equipment.
Initial X’s
X_____ 1. By signing below and completing required contact information, you, “the participant", are demonstrating your willingness to participate in the sport of indoor and outdoor rock climbing at, and or with, Revelation LLC, dba Petra Rock Climbing Gym, or Petra Rock Gym LLC, and knowledge the inherent risks that come along with the sport of rock climbing and related activities.
X_____ 2. By signing below, you are demonstrating that you understand and are aware that indoor rock climbing at, and or with, Revelation LLC, dba Petra Rock Climbing Gym, or Petra Rock Gym LLC, like many sports, is a potentially hazardous activity that can produce injuries, during normal activities, that include, but are not limited to, abrasions, cuts and bruises, broken bones, tendonitis, emotionally traumatic repercussions from stress, acrophobia attacks, heart attacks, and possibly death. You are further acknowledging that you understand that there are also other remote risks that may be associated with climbing or attending an activity at, and or with, Revelation LLC, dba Petra Rock Climbing Gym, Petra Rock Gym LLC, or its owner's, staff, volunteers, students, certified belayers, property owners, and contracted services.
X_____ 3. By signing below, you're representing, despite the fact that a complete accounting of the remote, but ever present risks of injury have been provided to you, that you're still interested and have a continued willingness and desire to pursue, and or allow the participant to pursue to activities at hand. You are at this time, acknowledging that all of your questions have been answered to complete satisfaction concerning risks involved and want to participate, and or allow as the parent or guardian an individual to participate after fully disclosing and discussing the risks describe within, but not limited to, this document.
X_____ 4. By signing below, you profess that you have read and understand the rules concerning climbing at Petra Rock Climbing Gym.
X_____ 5. By signing below, you're stating that you are participating at your own risk and will not hold Revelation LLC, dba Petra Rock Climbing Gym, Petra Rock Gym LLC, or its owner's, staff, volunteers, students, certified belayers, property owners, and contracted services liable for any situations that arise due to your negligence, misbehavior, any accidental faulty equipment, or misjudgment on behalf of Revelation LLC, dba Petra Rock Climbing Gym, Petra Rock Gym LLC, or its owner's, staff, volunteers, students, certified belayers, property owners, and contracted services.
X_____ 6. If you have participated in a belay certification class and / or have a complete understanding and working knowledge of the certification requirements at Revelation LLC, dba Petra Rock Climbing Gym, or Petra Rock Gym LLC, then by signing below you are acknowledging that you understand fully your responsibility to help keep those around you safe.
X_____ 7. By signing below, you are further acknowledging and agree that Revelation LLC, dba Petra Rock Climbing Gym, Petra Rock Gym LLC, and property owners reserve the right to deny or relinquish rock climbing privileges, and / or entrance to the facility for any reason it, or its owner's, staff, volunteers, and contracted services see fit. You now understand that a list of rules on the gym wall spell out general guidelines designed with safety in mind. You further understand that horseplay, misbehavior, breaking of rules, foul language, and no-compliance, or non-compliant, with any staff recommendations could result in the termination of your facility privileges. You also understand that foul language, fighting, smoking, and alcoholic beverages are prohibited on the premises.
X_____ 8. BY PRINTING & SIGNING NAME BELOW, YOU ARE AKNOWLEDGING THAT YOU HAVE READ and fully understand the information contained herein, agree to the terms, understand the potential risk of serious injury, or death, as a result of my participation, or the participation of those for which I am guardian, am at least 18 years of age, have medical insurance coverage, assume liability for actions, and waiver my right to sue Revelation LLC, dba Petra Rock Climbing Gym, Petra Rock Gym LLC, or is owner's, staff, volunteers, students, certified belayers, or property owners.
X_____ 9. BY SIGNING BELOW, YOU ARE AKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND, & AGREE TO ABOVE STATEMENTS.

Contact Parent's Name: __________________________________
Signature X_________________________________________ Date: _________

Email: _________________________________________________
Cell Phone: _________________________________________________

Participants /Child’s Names

1st Kid’s Name: ______________________________ Age: ______

Parent’s Signatures

Signature X ___________________________________________________

Address: ________________________________________________
City / State: _____________________________________ Zip: ________

Phone # ________________________________________________
Cell # ______________________________________________________

4th Name: ___________________________________ Age: ______

Parent’s Signatures

Signature X ___________________________________________________

Address: ________________________________________________
City / State: _____________________________________ Zip: ________

Phone # ________________________________________________
Cell # ______________________________________________________

Click Here For A Printable Version!
Click Here For Group Waiver
Click Here For Participant Waiver
Click Here For Portable Wall Form
Click Here For Camp Rock Waiver
Click Here For Rock Climbing Class Enrollment Form