Valley Crag Waiver It looks like your internet is very good, do you want to synchronize the data? Total Signed: Total Returning: Sync data Thank you for completing our waiver form. Your submission for Waiver event was processed successfully. Hi - welcome! Please let us know if you are a new customer, or a returning customer.... Make a selection New customer Returning customer (please use same email address). Name * Surname * email * Are you a new customer? I'm a new customer Are you completing this on behalf of a minor? Make a selection No Yes For legal Guardian (All fields compulsory) Guardian Full Name and Surname * Relationship to minor * Guardians valid Email Address * Guardians contact number (also for emergencies) * Minor 1 Remove Minor's name * Minor's Surname * Minor's date of birth * Day1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MonthJanuary February March April May June July August September October November December Year2025 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Minor's gender * Make a selection Male Female Minor's age * Make a selection 123456789101112131415161718 Any medical conditions * Make a selection Yes No INSERT DETAILS HERE Add another minor First name First name * Last name Last name * Email Email * Contact Number Contact Number * Physical Adress Physical Adress City City Gender Gender * Make a selection Male Female Age Age * Emergency Contact person Emergency Contact person Emergency Contact Number Emergency Contact Number How did you hear about us? How did you hear about us? * Make a selection Brochure Word of mouth Printed advert Internet search Social media Road Signage Other Subscribe to our newsletter Subscribe to our newsletter * Make a selection Yes No By completing and submitting this form you are agreeing to the following: 1. ACKNOWLEDGEMENT OF RISK In consideration of the services of VALLEY CRAG CLIMBING CENTRE, their agents, its owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “VALLEY CRAG CLIMBING CENTRE“), I hereby agree and acknowledge the risk associated with activities associated with the Centre and agree to release, indemnify, and discharge VALLEY CRAG CLIMBING CENTRE, on behalf of myself, my children, my parents, my heirs and estate as follows: 1.1 I acknowledge that climbing an artificial climbing wall entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I acknowledge that personal risk/injury may arise from the following: 1.1.1 All manner of injury resulting in falling off the Climbing Wall and hitting climbing wall faces and projections, whether permanently or temporarily in place, and/or other climbers/spectators, and/or the padded or non padded portions of the floor; 1.1.2 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 on rope, rescue systems and striking the impact absorbing floor & any other rope techniques; 1.1.3 Injuries resulting from falling climbers or dropping items, such as, but not limited to, ropes or climbing hardware; 1.1.4 Cuts and abrasions resulting from skin contact with the Climbing Wall or climbing floor; 1.1.5 Failure of rope, slings, harnesses, climbing hardware, anchor points, or any part of the Climbing Wall structure. 1.1.6 Belay and/or belayer failure; climbing out of control or beyond one’s personal limits; the negligence of other climbers, visitors, participants, or other persons who may be present; musculoskeletal injuries and/or over training; head injuries; or my own negligence. 2. I further acknowledge that the above list is not inclusive of all possible risks associated with the use of the Climbing Wall and that the above list in no way limits the extent or reach of this release and covenant not to litigate. I understand that INJURIES OF ALL TYPES ARE A COMMON AND ORDINARY OCCURRENCE of the activities at VALLEY CRAG CLIMBING CENTRE. I acknowledge that the risk of SEVERE INJURY (and even DEATH), while unlikely, exists when participating in the activities at the Centre. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of these activities and the experience. 3. I expressly agree to and both accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks. I further agree that I have the following obligations to VALLEY CRAG CLIMBING CENTRE: 3.1 to act as a reasonably prudent person when engaging in activities at VALLEY CRAG CLIMBING CENTRE, and to obey and follow the instructions, rules and regulations notified (whether in writing, on signs or otherwise) at any time; 3.2 that I will not participate in any activity at VALLEY CRAG CLIMBING CENTRE whilst intoxicated or under the influence of alcohol or drugs; 3.3 to advise VALLEY CRAG CLIMBING CENTRE staff of any known health problems or medical condition or disability and any prescribed medication that may be used in the treatment of such health problems, medical condition or disability; 3.4 to notify VALLEY CRAG CLIMBING CENTRE staff of any incident or accident involving personal injury or illness experienced during the course of any activity at VALLEY CRAG CLIMBING CENTRE; 3.5 that should I suffer any injury or illness at VALLEY CRAG CLIMBING CENTRE staff may, at my own cost, arrange such medical treatment and emergency evacuation service, as they shall consider necessary for my health and safety. 4. I understand that maintenance of the Facility and equipment, training, coaching, instruction, supervision, enforcement or lack thereof of any rules or regulations, route setting, or any added safety measures by VALLEY CRAG CLIMBING CENTRE and all its affiliates does not and cannot guarantee my safety. I hereby represent that I am fit and suffer from no adverse health condition or effect that would limit my ability to participate safely in any activities offered by VALLEY CRAG CLIMBING CENTRE. I hereby represent that any of my own equipment that I use at the Facility is safe and in good working order and that in no way shall VALLEY CRAG CLIMBING CENTRE be liable for any damages caused to myself or a third party for any failure of any of my personal equipment. 5. WAIVER and RELEASE: 5.1 I hereby unconditionally WAIVE AND RELEASE ANY AND ALL CLAIMS AND CAUSES OF ACTION OF ANY KIND OR NATURE AGAINST VALLEY CRAG CLIMBING CENTRE, AND ANY MANUFACTURERS OR DISTRIBUTORS OF EQUIPMENT USED BY VALLEY CRAG CLIMBING CENTRE, RELATED IN ANY WAY TO USE OF THE EQUIPMENT, ACTIVITIES OR THE ASSOCIATED ACTIVITIES. VALLEY CRAG CLIMBING CENTRE PROVIDES NO WARRANTIES EITHER EXPRESS OR IMPLIED WITH RESPECT TO THE EQUIPMENT, ACTIVITIES OR ASSOCIATED ACTIVITIES. 5.2 I agree to hold harmless, defend and indemnify VALLEY CRAG CLIMBING CENTRE from any claim or action, present or future, related to injury or damage to myself, my property, or to any other person or property. This will include any loss, damage, expense or injury (including DEATH) suffered by any person from (or in connection with) my participation in any activities due to any cause whatsoever. This will include negligence and/or breach of express or implied warranty on the part of VALLEY CRAG CLIMBING CENTRE. 5.3 I acknowledge that VALLEY CRAG CLIMBING CENTRE does not have medical facilities on-site and does not employ medical personnel to render medical assistance. As a result skilled medical assistance may be delayed. In the event of an emergency or potential injury, I authorise VALLEY CRAG CLIMBING CENTRE to contact or call other emergency medical personnel to provide medical care for, or transport me to a private medical facility or hospital if, in the opinion of VALLEY CRAG CLIMBING CENTRE medical attention is required and I am unable to make such decisions for myself and further acknowledge that this will be at my own expence. I authorise the disclosure of any protected medical information in the possession of VALLEY CRAG CLIMBING CENTRE that is necessary to provide. I agree to pay all costs associated with such medical care and related transportation and shall DEFEND, INDEMNIFY AND HOLD HARMLESS VALLEY CRAG CLIMBING CENTRE of and from the consequences of such decision and from any such costs incurred relating to the provision of my medical care. 5.4 This Liability Waiver shall continue in effect in perpetuity so that each time I use the Facility or participates in any Outside Activities from the date this waiver is signed forward he/she shall be bound by the terms and conditions herein. If any provision of this agreement or the application of any such provision to any person or circumstance is held invalid, the remainder of this agreement, and the application of such provision other than to the extent it is held invalid, will not be invalidated or affected hereby. 6. Should VALLEY CRAG CLIMBING CENTRE or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have. 7. VALLEY CRAG CLIMBING CENTRE shall not be responsible for the safekeeping, loss, theft or damage of any Participant’s property or the property of any User or Member that is brought into the Facility or brought on any Outside Activity. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms. If the above terms of Indemnification are not be acceptable you are requested to immediately leave the premises of VALLEY CRAG CLIMBING CENTRE, on request, refund of any fees that may have been paid. Thank you I agree to these terms and conditions