Xtreeme Challenge LLC
Participant Agreement, Release and Acknowledgement of Risk Form
In consideration of the services at
Xtreeme Challenge LLC, their agents, officers, volunteers,
I acknowledge that participation in Adventure Learning activities,
and/or the use of Challenge Course Activities
I expressly agree and promise to
accept and assume all of the risks existing in this activity. My
participation in this
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.
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
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.
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
Participant's Signature ____________________________ Name (Print):________________________________
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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