This Assumption of Risk, Waiver of Liability, and Indemnification is being executed in connection with the above-named
Participant’s use of the Brushy Creek Municipal Utility District (the “District”) climbing wall located in the District’s Community Center
Gymnasium (the “Climbing Wall”). I freely, voluntarily, and without duress execute this Assumption of Risk, Waiver of Liability, and
Indemnification.
1. ASSUMPTION OF RISK. I understand that use of the Climbing Wall and relating activities, including belaying, repelling, and spotting,
have inherent risks. I further understand and agree that the District does not have the ability to eliminate all risk and danger in connection
with Participant’s use of the Climbing Wall and related activities. Such injuries may include, but are not limited to, injury or death from
falling; injury in the form of cuts, bruises, abrasions; muscle and tendon strains; injury from rope burns; injury or death from falling equipment,
debris or personal property; and injury resulting from materials falling into Participant’s eyes. By execution below, I acknowledge, agree
and understand that this description of risk is not complete and that other unknown and unanticipated risks associated with use of
the Climbing Wall and related activities may result in injury, illness, death or property damage.
I VOLUNTARILY AND EXPRESSLY AGREE AND PROMISE THAT I ASSUME ALL RISK ASSOCIATED WITH USE OF THE
CLIMBING WALL AND RELATED ACTIVITIES AND FULL RESPONSIBILITY FOR ANY PERSONAL INJURY, INCLUDING
DEATH, WHETHER OR NOT CAUSED BY NEGLIGENCE OF THE
DISTRICT’S PERSONNEL. I certify that Participant is in good health and has no physical limitations that would preclude or impede
Participant’s safe use of the Climbing Wall or participation in related activities. Participant’s use of the Climbing Wall and performance of
related activities is voluntary and with full knowledge of the danger and risks related thereto.
2. RELEASE. I DO HEREBY RELEASE, DISCHARGE AND AGREE NOT TO SUE THE DISTRICT AND ITS
DIRECTORS, EMPLOYEES AND AGENTS (COLLECTIVELY, THE “RELEASED PARTIES”) FROM AND AGAINST ANY
LIABILITY, CLAIMS, CAUSES OF ACTION AND DEMANDS OF WHATEVER KIND OR NATURE, INCLUDING A CLAIM
OF NEGLIGENCE, WHICH ARISE FROM PARTICIPANT’S USE OF THE CLIMBING WALL AND RELATED ACTIVITIES,
INCLUDING DEATH, INJURY OR LOSS OF PROPERTY.
3. INDEMNIFICATION. I HEREBY FURTHER AGREE TO INDEMNIFY THE RELEASED PARTIES FROM AND AGAINST
ANY AND ALL LIABILITIES, LOSSES, DAMAGES, COSTS, CLAIMS, EXPENSES, DEMANDS AND CAUSES OF ACTION OF
EVERY KIND AND CHARACTER OCCURRING OR ANYWISE INCIDENT TO, IN
CONNECTION WITH, OR ARISING OUT OF, PARTICIPANT’S USE OF THE CLIMBING WALL AND RELATED
ACTIVITIES, INCLUDING CLAIMS FOR PERSONAL INJURIES, DEATH, OR DAMAGE TO PROPERTY, WHETHER OR
NOT CAUSED OR CONTRIBUTED TO BY THE NEGLIGENCE, CARELESSNESS OR WANT OF SKILL OF THE RELEASED
PARTIES.
4. PERSONAL EQUIPMENT. By execution below, I hereby certify and agree that I assume sole responsibility for any personal injury
that arises out of or in connection with any personal climbing equipment, including a climbing harness, that I utilize in connection
with the Climbing Wall. I agree that the District is not responsible for inspecting such equipment, but may disallow use of any
personal equipment that District staff deems unsafe. The use of personal ropes or belay devices is prohibited.
5. CLIMBING WALL RULES. By execution below, I hereby certify and agree that I have read the Climbing Wall Rules attached
hereto, and agree to comply with such rules in all respects.
IF PARTICIPANT IS 18 YEARS OR OLDER, PARTICIPANT MUST SIGN BELOW:
I certify that I am of lawful age (18 years or older) and legally competent to sign this agreement. I certify that
I have fully read and understand all of the terms set forth above. I agree to follow all directions of the District
staff relating to use of the Climbing Wall and comply with all applicable rules of the District related thereto. I
further understand that the terms of this agreement are legally binding, and I am signing this agreement of my
own free will.
IF PARTICIPANT IS UNDER 18, THE PARENT (OR LEGAL GUARDIAN, IF ANY) MUST SIGN
BELOW:
If the Participant named above is under age 18, I hereby certify that I am the parent or legal guardian of the
Participant, and that he/she has my permission to use the Climbing Wall and participate in related activities
without the presence of the Participant’s parent or legal guardian, including spotting, belaying and rappelling.
I have read and agree to the terms of this Assumption of Risk, Waiver of Liability, and Indemnification on my
behalf and on behalf of the Participant.
BRUSHY CREEK MUD CLIMBING WALL RULES
1. All participants must have a waiver signed in order to climb. Children under 18 years old
must have a waiver form signed by a parent/guardian in order to climb. If staff has any
reason to believe that a parent or guardian has not legitimately signed a waiver, that
child will not be allowed to climb.
2. All climbing is prohibited without District personnel being present.
3. Climbers must have the harness checked by staff prior to climbing. A staff member will
hook the harness to the carabineer.
4. All children must be at least 6 years old to climb. If there is any question about a child’s
age, they will not be allowed to climb.
5. If a climber cannot safely fit into Brushy Creek’s harnesses, they will not be allowed to
climb.
6. No one is permitted to belay or tie themselves in to the wall.
7. Climbing on the climbing wall without a rope is prohibited.
8. No one is allowed to tighten, loosen or move holds on the climbing wall. Bolt holes and
lead carabiner may not be used as holds.
9. Closed toe shoes are required for climbing.
10. To avoid possible injury while climbing, climbers must remove any items from their
pockets, hanging jewelry, and hats that may get caught on holds or in belay system.
11. Only climbers and staff are allowed in "fall zone" (blue pads). All other participants must
remain in the warm-up/observing area until it is your turn to climb. No items (cell
phones, water bottles, etc.) may be on the blue pads.
12. Anyone who behaves in a manner that can adversely affect their safety, the safety of
other guests or staff at the Climbing Wall will not be allowed use of the Wall. This
includes, but is not limited to, walking under an area where someone is climbing, using
equipment improperly or without staff permission, inappropriate language, distracting
climbers or any refusal to obey rules. All situations are subject to staff discretion.
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