MINOR Informed Consent & Acknowledgement

BY SIGNING THIS DOCUMENT, YOU WILL BE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE

PLEASE NOTE:  A witness is required for this form. If one is not present, please arrange for a witness before completing it.

1. ASSUMPTION OF RISK

1.1 I am aware that my child’s participation in the activities of climbing, belaying, rappelling, rescue systems and bouldering (the “Activities”) in the Northern Rockies Regional Recreation Centre (the “Facility”) has many inherent risks, dangers and hazards, including but not limited to the following:

a) Injury resulting from slips or falls on footholds, handholds, uneven floors, decks, floor padding or mats;

b) injury resulting from collision with climbing wall features such as protruding rocks, ledges, edges, railings, outcroppings or access ladders;

c) injury resulting from the use, misuse, non-use and failure of any of the equipment used in the Facility, including but not limited to ropes, slings, harnesses, climbing hardware and anchor points or any part of the climbing structure (the “Equipment”);

d) Rope abrasion, entanglement and other injury which results from the use of ropes;

e) Injury resulting from collisions with other users of the Facility or other users of the Facility acting recklessly;

f) Injury resulting from rock fall, falling climbers or dropped items or Equipment;

g) Cuts and abrasions resulting from skin contact with the climbing wall; and

h) Theft, vandalism or loss of personal property.

(Collectively, the “Risks”)

1.2 I understand and will instruct my child that all applicable rules for participation, including the Facility’s Climbing Centre Rules and the age restrictions on the Activities, must be followed and that at all times the sole responsibility for personal safety remains with my child.

1.3 I have satisfied myself and believe that my child is physically, emotionally and mentally able to participate in the Activities. I will notify a Facility employee if my child has any condition or requires any medication that may affect my child’s ability to participate in the Activities or which may affect my child’s interactions with employees or other users of the Facility.

1.4 I will direct my child to obey any instructions that my child may receive from Facility employees regarding the activities. I acknowledge on my child’s behalf that the Northern Rockies Regional Municipality will not be responsible for any injury that occurs as a result of my child’s failing to obey Facility employees.

1.5 I authorize the Northern Rockies Regional Municipality to consent to emergency medical treatment in accordance with the best interests of my child should I not be present at the relevant time to grant consent myself.