Fill and Sign the Minors Only Iowa State Recreation Services Form

- 1 – Copyright 2004 USLegalforms.com WAIVER AND RELEASE BY PARENT OF MINOR CHILD FROM LIABILITY FOR ROCK CLIMBING GYM I, , on behalf of (hereinafter referred to as “CHILD”) HEREBY WAIVE AND RELEASE, indemnify, hold harmless and forever discharge and its agents, employees, officers, directors, affiliates, successors and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilitie s, of every kind and nature, whether known or unknown, in law or equity, that I or CHILD ever had or may have, arising from or in any way related to CHILD’S participation in any of the events or activities conduc ted by, on the premises of, or for the benefit of, provided that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful or wanton misconduct. I understand that the activities that said CHILD will participate in are inhe rently dangerous and may cause serious or grievous injuries, including bodily injury, damage to personal property and/or death. On behalf of myself, CHILD, my heirs, assigns and next of kin, I and said CHILD waive all claims for damages, injuries and death sustained to me or my property, that I or said CHILD may have against the aforementioned released party to such activity. CHILD has the necessary and requisite skills to participate in all facets of, and activities of and requested of this facility, except as noted below. The nature of the activities has been full y disclosed and any flyer, advertisement, or brochure relating to the participating activities is expressly m ade a part of this WAIVER AND RELEASE. By this Waiver, I, on behalf of said CHILD, assume any risk, and take full responsibility and wa ive any claims of personal injury, death or damage to personal property associated with , including but not limited to training at the facility, receiving climbing le ssons, using the facility and its equipment, practicing and/or engaging in any climbing exercises or other related acti vities on and off the premises. This WAIVER AND RELEASE contains the entire agreement between the parties, and supercedes any prior written or oral agreements between them concerning the subject matter of thi s WAIVER AND RELEASE. The provisions of this WAIVER AND RELEASE may be waived, altered, amended or repealed, in whole or in part, only upon the prior written consent of all parties. The provision of this WAIVER AND RELEASE will continue in full force and effect even a fter the termination of the activities conducted by, on the premises of, or for the benefit of, whether by agreement, by operation of law, or otherwise. I have read, understand and fully agree to the terms of this WAIVER AND RELEASE. I underst and and confirm that by signing this WAIVER AND RELEASE said CHILD and I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all lia bility to the full extent of the law. Medical Conditions. CHILD is subject to the following allergies or medical conditi ons, and I authorize the facility to disclose these conditions to a physician or other medical professional in the event said CHILD should require emergency medical care: - 2 – Copyright 2004 USLegalforms.com Prohibited Activities. As a result of the above-mentioned medical conditions, I, on behalf of said CHILD, am prohibiting involvements in the following specific activities: Date Printed Name of CHILD Printed Name of Parent (Guardian) Signature of Parent (Guardian)