Xtreeme Challenge LLC

Participant Agreement, Release and Acknowledgement of Risk Form

 

In consideration of the services at Xtreeme Challenge LLC, their agents, officers, volunteers, participants, employees, 
and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as the "XC"), 
I hereby agree to release and discharge the XC, on behalf of myself, my children, parents, heirs, assigns, personal 
representatives and estate as follows:

 

1.   I acknowledge that participation in Adventure Learning activities, and/or the use of Challenge Course Activities 
entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to my property or to third parties.  I understand that such risks cannot be eliminated without jeopardizing the essential qualities 
of the activity.  Furthermore, XC facilitators have difficult jobs to perform.  They seek safety, but they are not infallible.  They might be ignorant of a participant’s fitness or abilities.  They might misjudge the weather or the terrain.  They may give inadequate warnings or instructions, and the equipment being used might malfunction.

2.   I expressly agree and promise to 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 recognize that the XC adheres to a

philosophy of "Challenge By Choice" and that I have the right to not participate in any activity during the event. 

3.   I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless the XC from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity, or my use of XC equipment or facilities.

4.   Should the XC, 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.

5.   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 damage or injury myself.  I further certify that I have no medical or physical conditions, which could interfere with my safety in this activity, or else I am willing to assume - and bear the costs of - all risks that may be created, directly or indirectly, by any such condition.

6.   In the event that I file a lawsuit against the XC, I agree to do so only in the state of NC, and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that 
if any portion of this agreement is found to be void or unenforceable, the remaining portion shall remain in full force and effect.

7.  I am aware that the XC requires strict adherence to its standards of safety and conduct.  I agree to fully abide by these standards or to accept dismissal for refusing to adhere to them.  I hereby grant the XC the right to use for promotional purposes only any photographs taken of me during my participation in any activities at the XC.

8.  By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against the XC on the basis of 
any claim from which I have released them.  I have had sufficient opportunity to read this entire document.  I have read and understood it and agree to be bound by its terms.

 

Participant's Signature  ____________________________ Name (Print):________________________________

 

Address:___________________________________________________________________________________

 

Phone:_________________________ Date____/____/____  Group Name_______________________________

 

PARENT’S OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (if under 18)

 

In consideration of ____________________________(print minor’s name) (“Minor”) being permitted by the XC to participate in it’s activities and to use it’s equipment and facilities, I further agree to indemnify and hold harmless the XC from any and all Claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.

 

Parent or Guardian Signature ___________________________Name (Print)________________________________

 

Address if different:_______________________________ Phone if different:______________ Date____/____/___

 

 

A word document file for this waiver is available by click here

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