Rock Solid Youth Center - Winona, MN
  Waiver - Rock Solid Youth Center

Acknowledgment of Risks, Release, Indemnification Agreement, and Covenant not to Sue
Each Part of this document must be completed and signed before using Rock Solid facilities or participating in Rock Solid activities.

User's Name: _____________________________________________________________

Phone: (____)_____________________________________________________________

Date of Birth: ____________________________________________________________

If under 18, Name of Guardian: ________________Relationship: _____________________

Address: _________________________________________________________________

City: __________________State: _______________Zip: ___________________________

Emergency Contact: ____________________Phone Number: ________________________
 (different from above number) Note: we will contact your home number first

Notice: This is a legally binding document. If not understood, legal advice should be sought. By signing this document, you give up your right and the right of your heirs, next of kin, personal representatives, and assigns to bring a court action, now or any time in the future to recover compensation or obtain any other remedy for an injury to yourself or your property or for your death, however caused, arising out of your use of the facilities of Rock Solid Youth Center or participation in Activities sponsored by Rock Solid Youth Center, including but not limited to use of the climbing areas, skate park areas, and inflatables, even if such claim is based upon actual negligence of Rock Solid Youth Center or its employees or volunteers.

1.Acknowledgement of Risks

The undersigned user ("User") hereby acknowledges and agrees that the use of the facility owned and operated by Rock Solid, including without limitation its climbing walls and equipment, skate park equipment, and inflatables has inherent risks. User fully recognizes and appreciates the dangers inherent with Rock Solid Youth Center activities. User is assuming the hazard of risk to User since User desires to use facilities at Rock Solid Youth Center. User realizes that User is subject to injury from these activities and that no form of preplanning can remove all of the danger to which User is being exposed. User further represents and warrants to Rock Solid Youth Center that User has full knowledge of the nature and extent of all risks associated with activities at Rock Solid and the use of equipment, including but not limited to:

  1. All manner of injury from falling off the climbing walls and hitting structure faces and projections, whether permanently or temporarily in place, or the floor;
  2. Rope Abrasion, entanglement, and other injuries resulting from activities on or near the walls such as, but not limited to climbing, belaying, rappelling, lowering on a rope, rescue systems, and any other rope techniques;
  3. Injuries resulting from falling climbers or dropped items such as, but not limited to ropes, or climbing hardware;
  4. Cuts and abrasions resulting from skin contact with the climbing walls;
  5. Failure of ropes, slings, harnesses, climbing hardware, anchor points, or any part of the climbing wall structure, regardless of whether the equipment was furnished by Rock Solid Youth Center or not;
  6. Injuries resulting from the actions, omissions or negligence of Rock Solid Youth Center or others;
  7. The risks that are inherent in the activities of skateboarding, inline skating, or riding bikes including but not limited to falling, coming in contact with ramps, walls, vehicles, other equipment or persons;
  8. Latent or apparent defects or conditions in equipment or property supplied by Rock Solid Youth Center;
  9. The condition of any track or ramp and accidents connected to their use;
  10. Injuries resulting from the physical condition or actions, omissions, negligence in any degree of User;
  11. All manner of injuries resulting from falling off the inflatables and hitting furniture or other items such as, but not limited to tables, chairs, skate equipment, the stage or the floor;
  12. Injuries resulting from contact with other users of Rock Solid facilities;
  13. Injuries resulting from contact with Rock Solid Facilities including, but not limited to stairs, doors, counters, arcade games, and furniture whether permanently or temporarily in place;
  14. First Aid, emergency treatment or other services rendered by Rock Solid Youth Center or others; and
  15. Consumption of any food or drink, whether or not provided by Rock Solid Youth Center.

User further acknowledges that the above list of risk factors is for illustration purposes only and is not inclusive of all possible risks associated with the use of the Rock Solid Facilities or participation in Rock Solid Activities and the above list in no way limits the absolute and comprehensive nature of this Waiver and Release, Indemnification and covenant not to sue ("Release").
Initial Here: _______________

2. Releases, Indemnification and Covenant Not to Sue

User voluntarily releases and forever discharges and covenants not to sue Rock Solid Youth Center, and all other persons or entities affiliated therewith, from any and all liability, claims, demands, actions, or rights of action, which are related to, arise out of or are in any way connected with User's attendance at Rock Solid or participation in any Rock Solid activity, including, but not limited to any and all negligence, of Rock Solid Youth Center, its agents or employees, and all other persons or entities, for any and all injury, death, illness or disease, and damage to User or User's property.

User further agrees, promises and covenants to hold harmless and to indemnify Rock Solid Youth Center, its agents and employees, and all other persons or entities against all damage which user may negligently or intentionally cause to spectators or other third parties in the course of User's participation in any Rock Solid activity.

User further agrees, promises and covenants not to use, assert or otherwise maintain any claim against Rock Solid Youth Center, its agents and employees, and all other persons or entities, for any injury, death, illness or disease, or damage to User or User's property, arising from or connected to User's participation in any activity or from any claims asserted against User by spectators or other third parties. In signing this document, User fully recognizes that if anyone is hurt or dies, or property is damaged while User is in Rock Solid Youth Center facilities, User will have no rights to make any claim or file a lawsuit against Rock Solid Youth Center, its agents or employees even if Rock Solid Youth Center, its agents or employees, or any of them negligently caused the bodily injury or property damage.
Initial Here: _______________

3. Acknowledgement of Effect of This Release Agreement

User Understands and acknowledges that by signing this document User has given up certain legal rights and/or possible claims which User might otherwise assert or maintain against Rock Solid Youth Center, its agents or employees, and other persons or entities, including but not limited to rights arising from or claims for the acts or omissions, fault or negligence of Rock Solid Youth Center, its agents or employees or any other persons or entities. User understands and acknowledges that by initialing and/or signing this document, User has assumed responsibility and LEGAL LIABILITY for the claims or other legal demands, including defense costs, which may be asserted by spectators or other third parties against User as a result of User's participation in this activity.
Initial Here: _______________

4. Participant Insurance Benefits and Representation of Physical Condition

User understands and acknowledges that no medical insurance benefits will be provided to User for injuries occurring while User is at Rock Solid Youth Center or for activities sponsored by Rock Solid Youth Center. User certifies that User has sufficient health, accident, and personal liability insurance to cover bodily, property damage, or any consequences resulting from User's attendance at Rock Solid Youth Center or participation in Rock Solid Activities. If User has no such insurance, User certifies that User is capable of personally paying for any and all expenses or liability. User further acknowledges that the undersigned is in good physical and mental health, not suffering from any condition, disease or disablement, which would or could potentially affect participation at activities at Rock Solid Youth Center.
Initial Here: _______________

5. Rules and Regulations

By Initialing User acknowledges that User has read and understood the complete list of rules and regulations and has received a copy.
Initial Here: _______________

6. Consideration

In consideration of this agreement, Rock Solid will permit User to attend Rock solid and/or participate in Rock Solid activities, subject to user's compliance with all Rock Solid Rules, Regulations and Safety Policy. Rock Solid retains the right to deny entrance to its facilities or participation in its activities, to anyone in its sole discretion.

7. Entire Agreement

User understands that this constitutes the entire agreement between undersigned ("User") and Rock Solid Youth Center, its agents or employees, and that it cannot be modified or changed in any way by the representations or statements of Rock Solid Youth Center, its agents or employees or by User.

User's signature below indicates that User has read this entire document in full, understands it completely, and agrees to be bound by its terms.
This Waiver and Release is a Minnesota contract and User consents to the jurisdiction and venue for any action relating to this Waiver and Release in Winona County, Minnesota, regardless of User's residence or domicile. User also agrees that any such action will be brought only in Winona County District Court in Winona, Minnesota.

 Users Signature: _______________________________________Date: _________________

Signature of Parent/Guardian (If under age 18): ____________________________________

Signature of Rock Solid Employee: ______________________________________________


8. Rock Solid Youth Center Rules, Regulations, and Safety Policies

  1. Obey and respect all leaders and staff.
  2. Respect all peers.
  3. Everyone needs a waiver on file.
  4. Check in at the front desk and sign in.
  5. Ask permission to use phone and elevator.
  6. No one is allowed in the following areas with out specific permission from Rock Solid Staff: *Kitchen *Studio *Basement *Storage Areas * Office Areas * Hallway Behind stage
  7. No persons under the influence of intoxicating substances are allowed on the premises
  8. No Drugs Allowed on the premises. This includes but is not limited to: *Cigarettes *Alcohol *Marijuana
  9. No romantic displays of affection -Six inches between boys and girls.
  10. No profanity, vulgar, offensive, or inappropriate language.
  11. No Fighting, Spitting, Hitting, Pushing, Kicking, or other type of physical altercation.
  12. No Weapons.
  13. Equipment must be used as intended.
  14. Store personal belongings in designated areas. Rock Solid is not responsible for lost/stolen items.
  15. Keep the place clean- use garbage cans for all trash.
  16. No Yelling.
  17. No Gambling.
  18. No Urinating in inappropriate areas.
  19. No food or drink in the climbing areas or upstairs.
  20. All injuries, whether major or minor in nature, must be reported to Rock Solid Staff IMMEDIATELY.
  21. All Damage to Facilities, Furniture, or Equipment must be reported to Rock Solid Staff.
  22. No Stealing.
  23. Only Authorized Climbers are allowed in the climbing areas.
  24. Any Member of Rock Solid Staff or Volunteer can suspend climbing privileges.
  25. No bare foot climbing or bare feet in the climbing areas.
  26. Bouldering is only allowed to a point on the wall where the feet of the climber are at shoulder level.
  27. Everyone bouldering needs a spotter unless otherwise stated by Rock Solid Staff.
  28. Solo or self-belayed climbing is not allowed.
  29. Roped Climbers have priority over those climbers bouldering.
  30. Technical instruction by non-Rock Solid Staff is not allowed on the premises.
  31. Skating is restricted to designated areas only.
  32. All Skaters must wear the following Rock Solid Approved equipment: *Helmet *Appropriate footwear *Knee/Elbow Pads *Wrist protection
  33. Do not stand or otherwise block access to obstacles. Stay back from coping until dropping in on ramp.
  34. No bicycles, unless BMX style, or roller skates allowed in the Skate Areas.
  35. Everyone must take turns on equipment.
  36. No More than 2 people on the inflatables at a time.
  37. No hits above the shoulders on the pedestal joist.
  38. This is in no way an exhaustive list! Rock Solid reserves the right to interpret any policy set fourth in this document.
  39. Policies may be added at any time without notice at the discretion of Rock Solid.
  © 2003 Rock Solid Youth Center