· 2019. 12. 8. · hip hop dancing. spa day. talent show prep. 1. ircus performance: wacky talent...
TRANSCRIPT
Searching for a new and innovative way to fill your
child’s time this summer? Take a closer look at Club
Connection Day Camps serving children entering
Kindergarten through 5th grade.
At Club Connection we provide weekly field trips, on-site
learning activities, simple and extensive crafts,
cooperative games and physical challenges, team
building opportunities and access to enrichment
specialists from various fields.
Led by capable, engaging counselors whose top priority
is offering your child the best summer experience
possible; our staff are handpicked for their friendly
personalities, enthusiasm, and expertise. Your child is
guaranteed a day camp experience like none other!
REGISTER ONLINE
March 21—April 18, 2016
$50 per day minimum of
3 days per week
Who can register?
Any incoming Kinder—
5th graders currently
living within the Issaquah
School District boundaries
PROGRAM INFORMATION
Location: Grand Ridge
Serving Grand Ridge
Days of Operation:
June 20—August 17, 2016
Closed July 4 and 5
Hours: 7:00 AM—6:30 PM
www.beforeandafterschoolcare.weebly.com
Important Reminders!
Hours of Operation:
7:00 AM – 6:30 PM
$3 per minute per child late fee
if child is present past 6:30 PM
*Please remember to bring yourID upon pick up.
Every day, remember to bring . . .
a sack lunch with a drink
sunscreen
a swim suit and towel
a change of clothes
Field trips will depart at 9:30 AM
and return by 4:00 PM unless
otherwise indicated.
All campers will attend field trips
unless the trip is designated a
grade specific on the calendar.
All field trips, enrichment, and
scheduled activities are subject
to change without notice based
upon weather, attendance,
and other unforeseen
occurrences.
BLUE—On-Site Activity
PINK—Field Trip
PURPLE—On-Site Enrichment
ORANGE—Spirit Day
BLUE—On-Site Bouncy Houses
UNDERLINED EVENTS—Requires
an additional permission form—
see the website for more details.
Grand Ridge Elementary 1739 NE Park Drive
Issaquah, WA 98029
Sign In / Sign Out: Multi-Purpose Room (down the stairs to the left of the main entrance)
Site: 425-837– 7943 Cell: 425-864-4590
Theme: Monday Tuesday Wednesday Thursday Friday
WEEK 1:
Super Hero
Showdown
20 Staff vs Kids Games
Spirit Stick
Meet Your
Counselors
21
Super Hero Training
Costume Creation
Lucky Strike *socks
Lunch Provided (3-5)
22
Spin Alley
* socks (K-2)
Superman vs.
Kryponite
23
Sub Zero Ice Cream
Giant Mural
Whirlyball
(4-5)
24 321 Bounce
*socks (K-3)
Sub Zero Ice Cream
Super Hero
WEEK 2:
Under the
Big Top
27
Watercolor
Circus Cuisine
Family Fun Center
(3-5)
28
Family Fun Center
(K-2)
Water Color
World Records
29
Hip Hop Dancing
Lego Masters
Spa Day
Laser Quest (3-5)
30
Jim’s U--Fish (K-2)
Hip Hop Dancing
Spa Day
Talent Show Prep
1 Circus Performance
Wacky Talent Show
Balloon Artist
Costume Day
WEEK 3:
Nickelodeon
4 CLOSED
Independence Day
5 CLOSED
6
TMNT Pizza
Glow Oobleck!
Luther Burbank
Beach (3-5)
7
Luther Burbank
Beach (K-2)
TMNT Pizza
Power Puff Code
8 Slime Wars
Bike Day *helmet
Mismatch Day
Lunch Walking FT (5)
WEEK 4:
Into the Wild
11
Upcycled
Engineering Project
Secret Life of Pets
Movie (3-5)
12 Secret Life of Pets
Movie (K-2)
Animal Encounters
Geocaching
13
Photo Scavenger
Hunt
Henry Moses
Aquatic Center (3-5)
14
Newcastle Beach
(K-2)
Master Chef Jr.
Animal Yoga
15 Ultimate Melt
Fossil Dig
Crazy Hair
Capture the Flag
WEEK 5:
Summer
Olympics
18
Opening Ceremony
Track & Field Day
Idylwood Beach
(3-5)
19
Idylwood Beach
(K-2)
Rugby
Game Day Snacks
20
Mariners Game
(K-5)
Curling
Bobsledding
21 Ninja Warrior
Bouncy Houses
Field Day
Food is Fuel
22 Ninja Warrior
Bouncy Houses
Stone Gardens
(5th only)
WEEK 6:
Get Your
Game On
25
Minute 2 Win It
Cupcake Wars
Woodland Park Zoo
(3-5)
26
Woodland Park Zoo
(K-2)
Life Sized Hungry
Hippos
27
Family Fued
Top Chef
Wild Waves (4-5)
Lunch Provided
28
Family Fun Center
(K-3)
Water Balloon
Battleship
29 Palettes & Punch
Seahawks Bingo
Hiking GR Trails
Pajama Day
WEEK 7:
Video Games
Galore
1 Zoo Tycoon
Pacific Science
Center (3-4)
Pacific Cascade
IMPACT HVZ (5th)
2
Pacific Science
Center (K-2)
Life Sized Angry
Birds
3 Interactive Mario
Kart
Bike Day *helmet
Minecraft Day
4 Bug Safari
Games 2 U
Infection Tag
Rock Band
5 Newcastle Beach
(K-5)
Neon Day
Glow Bowling
WEEK 8:
Eureka!
8
Seahawks Painting
Lynnwood Bowl &
Skate *socks (3-5)
Lunch Provided
9
Remlinger Farm
(K-2)
Seahawks Painting
Mad Science
10 Pacific Science
Center
Stop Motion
Animation
11
Vasa Beach Park
(K-5)
Lunch Provided
Bouncy Houses
12 Just Dance Off
Ice Cream Social
Science of Cooking
Color Wars
WEEK 9:
Wacky Water
15 Palettes & Punch
Central Park
Adventure
Luau
16 Drip Drip Drop
Extreme
Color Run
Bike Day *helmet
17 Water Battle
Bouncy Houses
Lunch Provided
Beach Wear
CLOSED for
School Year
Prep
CLOSED for
School Year
Prep
Participant Name: Participant Name: __________________________________________ _____________________________________
Date of Birth: Date of Birth:
___/___/___ ___/___/___ Guardian or Adult (Please print): Signature:
__________________________________________ ______________________________________
Address: ________________________________________________________________________________________
Phone: Cell or emergency contact number:
__________________________________________ __________________________________
A SIGNED WAIVER IS REQUIRED FOR ALL ACTIVITIES AT 3-2-1 BOUNCE, LLC
Date:_________________________________________Time:____________________________________
The undersigned and on behalf of the participants below, acknowledges and agrees to these conditions: I voluntarily agree to abide by the stated and customary terms, rules and conditions for participation in any party and/or program at 3-2-1 Bounce, LLC. If I witness any hazard or peril during my participation, I will immediately bring it to the attention of an employee. I understand there is a risk of injury from inflatable equipment. I ac-knowledge that while rules, equipment design, and supervision reduce the risk, the risk of possible injury does exist. I voluntarily assume all risks to include identified and unidentified, even if stemming from the negligence of other participants. I, and on behalf of my heirs, assigns, personal representatives, and next of kin, hereby hold harmless 3-2-1 Bounce, LLC employees, owners and affiliates with respect to any and all injury, disability, loss or damage to person and/or property to the fullest extent of the law.
PLEASE BRING YOUR SOCKS and wear comfortable, loose fitting garments as 3-2-1 BOUNCE parties are both fun and interactive
2029F Instruction
Student Animal Permission Form
3/21/16 A variety of petting zoo animals will be on School District property for an educational purpose on the date specified on the summer camp calendar for the site which I registered my child(ren). I give my permission for my student to be in the same environment as the animal and/or to interact with the animal. I will alert the principal or staff member overseeing the event if I have concerns about the animal posing an allergy, health, or comfort issue for my student. Site: ____________________________________________________________________ Child’s Name: ____________________________________________________________ Parent Signature: _____________________________________ Date: _______________
Please return this form by (Monday, June 20th) to the Site Coordinator
Stone Gardens, Inc.THE CLIMBERS GYM
Assumption of Risks, Release of Liability, Covenant Not to Sue, Waiver of Claims, and Indemnity Agreement (“Agreement”)
FIRST NAME DATE OF BIRTH
ADDRESS CITY STATE ZIP CODE
HOME PHONE WORK PHONE CELL PHONE
EMAIL MAY WE EMAIL YOU?
EMERGENCY CONTACT EMERGENCY PHONE
PARTICIPANT INFORMATION:
LAST NAME MIDDLE NAME
Y / N
READ CAREFULLY BEFORE SIGNING!
1. Assumption of Risks. (a) I fully understand that this Agreement describes some but not all of the risks, hazards, dangers and potential consequences of the climbing activities, which include: (i) Participants must make judgments and decisions as they participate in climbing activities and Stone Gardens staff must make judgments and decisions as they instruct or assist participants regarding climbing activities. These judgments and decisions are by their nature imprecise and subject to error. Judgments and decisions will be made in an environment that includes some routes that are designed to be challenging even to very capable and experienced climbers. Among other risks there is the risk that the Participant or a staff member may misjudge the Participant's abilities or fitness level; (ii) equipment (including, without limitation, artificial climbing walls, holds and anchor points, ropes, slings, harnesses, climbing shoes and climbing hardware whether the Participant's personal equipment or equipment rented or borrowed from Stone Gardens) may break, malfunction or be misused. Stone Gardens makes no warranties regarding any such equipment; and (iii) the Participant or others may act carelessly or recklessly or generally fail to exercise care. For example: By failing to clip into the auto-belay device before climbing, clipping the auto-belay device into the wrong part of the harness or into something other than a real harness. These and other risks, hazards and dangers may result in the Participant falling to the floor or ground, becoming entangled in ropes or other equipment or hitting artificial climbing walls, holds, anchor points or other objects or people. These and other circumstances may cause fractures, sprains, broken bones, concussions, cuts or abrasions, or other injury or illness, mental or emotional trauma, paralysis, disability or death.
(b) I also fully understand that any instruction, training, orientation or other information or assistance provided by Stone Gardens cannot eliminate such risks. In both supervised and unsupervised climbing activities, I acknowledge that I am responsible for my own safety and if I am a Parent, the safety of the Participant.
(c) Therefore, I knowingly and voluntarily assume all risks, both known and unknown, relating to the climbing activities and I accept full responsibility for those risks identified here and for those risks not identified and for injury, damage, death or other loss suffered by me and, if I am a Parent, by the Participant, resulting from those risks or resulting from my own negligence or other conduct.
2. Release of Liability, Covenant Not to Sue, Waiver of Claims, and Indemnity. For myself and on behalf of my heirs, executors, assigns, personal representatives and next of kin (and, if I am a Parent, also on behalf of my child or ward), (a) I agree to release and I covenant not to sue Stone Gardens, its officers, agents, employees, volun-teers, representatives, other participants, sponsoring agencies, sponsors, advertisers and if applicable, owners and lessors of premises used for the climbing activities (all collectively, the "releasees"), with respect to any and all claims, liabilities, suits and expenses (including attorneys fees and costs) (all collectively, "Claims"), arising out of any injury, damage, death or other loss in any way connected with my participation in the climbing activities or use of Stone Gardens equipment and facilities. I understand that I agree here to waive all claims I may have against Stone Gardens and the other releasees and agree that neither I nor anyone acting on my behalf will make a claim or file a lawsuit of any kind against Stone Gardens or the other releasees as a result of any injury, damage, death or other loss; and (b) I agree to indemnify, protect, defend and hold harmless the releasees with respect to all Claims (i) brought by me or on my behalf arising out of any injury, damage, death or other loss in any way connected with my participation in the climbing activities or use of Stone Gardens equipment and facilities; (ii) brought by a co-participant or any other person, arising out of any injury, damage, death or other loss claimed to be caused in whole or in part by my conduct in the course of partici-pating in the climbing activities or using Stone Gardens equipment and facilities; (iii) brought by or on behalf of any family member or minor accompanying me; or (iv) arising out of any breach by me of this Agreement. This release, covenant not to sue, waiver and indemnity includes any Claims caused in whole or in part by the negligence of Stone Gardens or any of the other releasees (but not gross negligence or reckless misconduct) and includes claims for personal injury, property damage, wrongful death, products liability, breach of contract or otherwise.
3. Representations, Warranties and Agreements. I represent, warrant and agree that: (a) My participation in the climbing activities is purely voluntary, and I choose to participate regardless of and with knowledge of the risks; (b) I will comply with all rules and regulations of Stone Gardens and the stated and customary terms and conditions for participation in the climbing activities; (c) I acknowledge that participating in the climbing activities requires a special degree of skill and knowledge different from other activities and that I have responsibilities as a partici-pant. I have no mental or physical problems or limitations that might compromise or affect my ability to participate in the climbing activities or to comply with my responsibilities in connection therewith. I represent that I am fully capable of participating in the climbing activities without causing harm to me or others. I acknowledge that Stone Gardens staff is, and have been available, should I have further questions about the nature and physical demands of the climbing activities and the risks, hazards and dangers associated with the climbing activities. If I observe any unusual significant hazard during my participation, I will remove myself from participation and immediately bring such hazard to the attention of Stone Gardens.
4. Transportation and Medical Care. Staff of Stone Gardens is authorized to obtain or provide medical care for Partici-pant or to transport Participant to a medical facility. Medical personnel are authorized to render such treatment as they deem necessary for Participant's health. Stone Gardens has no responsibility for medical care provided to Participant and I agree to pay all costs associated with such medical care and transportation.
5. Governing Law; Forum. This Agreement is governed by the laws of the State of Washington. Further, any proceeding arising out of or relating to Participant's participation in the climbing activities must be filed or entered into only in the State of Washington.
6. Severability. Any portion of this Agreement deemed unlawful or unenforceable shall not affect the enforceability of the remaining provisions of this Agreement and the remaining provisions shall continue in full force and effect.
7. Effectiveness. This Agreement (i) shall be effective when signed either by Participant or (if applicable) by Participant's Parent, or both, (ii) shall be valid and binding until it is cancelled or modified by written agreement and (iii) shall cancel any prior Assumption of Risks, Release of Liability and Indemnity Agreement or prior similar agreement or waiver signed by Participant or (if applicable) by Participant's Parent in favor of Stone Gardens (except any under which there is any claim or basis for any claim).
stonegardens.com
8. Mediation; Binding Arbitration. I agree to attempt to settle any dispute (that cannot be settled by discussion) through mediation before a mutually acceptable mediator. Any claim or dispute of whatever nature, including but not limited to the issue of arbitrability, arising out of or relating to this Agreement and that is not resolved through mediation shall be resolved by final and binding arbitration administered by the American Arbitration Association (“AAA”) in Seattle,Washington in accordance with the AAA commercial arbitration rules and judgment upon the award may be entered in any court having jurisdiction over the matter. NOTICE OF ARBITRATION AGREEMENT: This Agreement provides that all disputes between you and Stone Gardens will be resolved by binding arbitration. You thus give up your right to go to court to assert or defend your rights under this Agreement. Your rights will be determined by a neutral arbitrator and not a judge or jury. For more information regarding arbitration, please go to www.adr.org/
I HAVE CAREFULLY READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS AND UNDERSTAND THAT BY SIGNING IT FREELY AND VOLUNTARILY I HAVE GIVEN UP SUBSTANTIAL RIGHTS, INCLUDING WITHOUT LIMITA-TION THE RIGHT TO SUE STONE GARDENS OR ANY OF THE RELEASEES FOR CLAIMS ARISING OUT OF ANY INJURY, DAMAGE, DEATH OR OTHER LOSS RELATING TO CLIMBING ACTIVITIES.
Signature of Participant (18 years and older must sign)
Participant Name
Date
PARENT/COURT-APPOINTED LEGAL GUARDIAN OF MINORS (UNDER AGE 18 AT TIME OF REGISTRATION)As the parent or court-appointed legal guardian with legal responsibility for the Participant I consent and agree to the Participant’s assumption of risks, release of liability, covenant not to sue, waiver of claims and indemnity as provided in this Agreement. For myself, my heirs, executors, assigns, personal representatives and next of kin I release and covenant not to sue, waive and agree to indemnify, protect, defend and hold harmless the releasees from any and all Claims relating to the Participant’s participation in climbing activities in accordance with the terms of this Agreement.
Signature of Parent(s) (or Court-Appointed Legal Guardian)
Parent/Guardian Name
Date
In consideration of being allowed to participate in any way in the climbing activities of or sponsored by Stone Gardens, Inc. (”Stone Gardens”), whether such climbing activities occur at a Stone Gardens Facility or elsewhere,
I,_______________________________________________________________ [please print], the Participant identified above or if the Participant is a minor, the Participant’s Parent, acknowledge, appreciate and agree as follows. For purposes of this Agreement: “climbing activities” include without limitation bouldering, climbing, belaying and rappelling, using auto-belays, any related practice, training or team building activities (such as slack-lining), physical fitness training and recreational games, and anything incidental or related to any of the foregoing including transportation to, accessing and using any related facilities in any way; “Parent” means the Participant’s parent or court-appointed legal guardian; and “I”, “me,”myself”, “my” and any other first person references include both the Parent and the minor unless the context otherwise requires:
1. Assumption of Risks. (a) I fully understand that this Agreement describes some but not all of the risks, hazards, dangers and potential consequences of the climbing activities, which include: (i) Participants must make judgments and decisions as they participate in climbing activities and Stone Gardens staff must make judgments and decisions as they instruct or assist participants regarding climbing activities. These judgments and decisions are by their nature imprecise and subject to error. Judgments and decisions will be made in an environment that includes some routes that are designed to be challenging even to very capable and experienced climbers. Among other risks there is the risk that the Participant or a staff member may misjudge the Participant's abilities or fitness level; (ii) equipment (including, without limitation, artificial climbing walls, holds and anchor points, ropes, slings, harnesses, climbing shoes and climbing hardware whether the Participant's personal equipment or equipment rented or borrowed from Stone Gardens) may break, malfunction or be misused. Stone Gardens makes no warranties regarding any such equipment; and (iii) the Participant or others may act carelessly or recklessly or generally fail to exercise care. For example: By failing to clip into the auto-belay device before climbing, clipping the auto-belay device into the wrong part of the harness or into something other than a real harness. These and other risks, hazards and dangers may result in the Participant falling to the floor or ground, becoming entangled in ropes or other equipment or hitting artificial climbing walls, holds, anchor points or other objects or people. These and other circumstances may cause fractures, sprains, broken bones, concussions, cuts or abrasions, or other injury or illness, mental or emotional trauma, paralysis, disability or death.
(b) I also fully understand that any instruction, training, orientation or other information or assistance provided by Stone Gardens cannot eliminate such risks. In both supervised and unsupervised climbing activities, I acknowledge that I am responsible for my own safety and if I am a Parent, the safety of the Participant.
(c) Therefore, I knowingly and voluntarily assume all risks, both known and unknown, relating to the climbing activities and I accept full responsibility for those risks identified here and for those risks not identified and for injury, damage, death or other loss suffered by me and, if I am a Parent, by the Participant, resulting from those risks or resulting from my own negligence or other conduct.
2. Release of Liability, Covenant Not to Sue, Waiver of Claims, and Indemnity. For myself and on behalf of my heirs, executors, assigns, personal representatives and next of kin (and, if I am a Parent, also on behalf of my child or ward), (a) I agree to release and I covenant not to sue Stone Gardens, its officers, agents, employees, volun-teers, representatives, other participants, sponsoring agencies, sponsors, advertisers and if applicable, owners and lessors of premises used for the climbing activities (all collectively, the "releasees"), with respect to any and all claims, liabilities, suits and expenses (including attorneys fees and costs) (all collectively, "Claims"), arising out of any injury, damage, death or other loss in any way connected with my participation in the climbing activities or use of Stone Gardens equipment and facilities. I understand that I agree here to waive all claims I may have against Stone Gardens and the other releasees and agree that neither I nor anyone acting on my behalf will make a claim or file a lawsuit of any kind against Stone Gardens or the other releasees as a result of any injury, damage, death or other loss; and (b) I agree to indemnify, protect, defend and hold harmless the releasees with respect to all Claims (i) brought by me or on my behalf arising out of any injury, damage, death or other loss in any way connected with my participation in the climbing activities or use of Stone Gardens equipment and facilities; (ii) brought by a co-participant or any other person, arising out of any injury, damage, death or other loss claimed to be caused in whole or in part by my conduct in the course of partici-pating in the climbing activities or using Stone Gardens equipment and facilities; (iii) brought by or on behalf of any family member or minor accompanying me; or (iv) arising out of any breach by me of this Agreement. This release, covenant not to sue, waiver and indemnity includes any Claims caused in whole or in part by the negligence of Stone Gardens or any of the other releasees (but not gross negligence or reckless misconduct) and includes claims for personal injury, property damage, wrongful death, products liability, breach of contract or otherwise.
3. Representations, Warranties and Agreements. I represent, warrant and agree that: (a) My participation in the climbing activities is purely voluntary, and I choose to participate regardless of and with knowledge of the risks; (b) I will comply with all rules and regulations of Stone Gardens and the stated and customary terms and conditions for participation in the climbing activities; (c) I acknowledge that participating in the climbing activities requires a special degree of skill and knowledge different from other activities and that I have responsibilities as a partici-pant. I have no mental or physical problems or limitations that might compromise or affect my ability to participate in the climbing activities or to comply with my responsibilities in connection therewith. I represent that I am fully capable of participating in the climbing activities without causing harm to me or others. I acknowledge that Stone Gardens staff is, and have been available, should I have further questions about the nature and physical demands of the climbing activities and the risks, hazards and dangers associated with the climbing activities. If I observe any unusual significant hazard during my participation, I will remove myself from participation and immediately bring such hazard to the attention of Stone Gardens.
4. Transportation and Medical Care. Staff of Stone Gardens is authorized to obtain or provide medical care for Partici-pant or to transport Participant to a medical facility. Medical personnel are authorized to render such treatment as they deem necessary for Participant's health. Stone Gardens has no responsibility for medical care provided to Participant and I agree to pay all costs associated with such medical care and transportation.
5. Governing Law; Forum. This Agreement is governed by the laws of the State of Washington. Further, any proceeding arising out of or relating to Participant's participation in the climbing activities must be filed or entered into only in the State of Washington.
6. Severability. Any portion of this Agreement deemed unlawful or unenforceable shall not affect the enforceability of the remaining provisions of this Agreement and the remaining provisions shall continue in full force and effect.
7. Effectiveness. This Agreement (i) shall be effective when signed either by Participant or (if applicable) by Participant's Parent, or both, (ii) shall be valid and binding until it is cancelled or modified by written agreement and (iii) shall cancel any prior Assumption of Risks, Release of Liability and Indemnity Agreement or prior similar agreement or waiver signed by Participant or (if applicable) by Participant's Parent in favor of Stone Gardens (except any under which there is any claim or basis for any claim).
Stone Gardens, Inc.THE CLIMBERS GYM
8. Mediation; Binding Arbitration. I agree to attempt to settle any dispute (that cannot be settled by discussion) through mediation before a mutually acceptable mediator. Any claim or dispute of whatever nature, including but not limited to the issue of arbitrability, arising out of or relating to this Agreement and that is not resolved through mediation shall be resolved by final and binding arbitration administered by the American Arbitration Association (“AAA”) in Seattle,Washington in accordance with the AAA commercial arbitration rules and judgment upon the award may be entered in any court having jurisdiction over the matter. NOTICE OF ARBITRATION AGREEMENT: This Agreement provides that all disputes between you and Stone Gardens will be resolved by binding arbitration. You thus give up your right to go to court to assert or defend your rights under this Agreement. Your rights will be determined by a neutral arbitrator and not a judge or jury. For more information regarding arbitration, please go to www.adr.org/
I HAVE CAREFULLY READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS AND UNDERSTAND THAT BY SIGNING IT FREELY AND VOLUNTARILY I HAVE GIVEN UP SUBSTANTIAL RIGHTS, INCLUDING WITHOUT LIMITA-TION THE RIGHT TO SUE STONE GARDENS OR ANY OF THE RELEASEES FOR CLAIMS ARISING OUT OF ANY INJURY, DAMAGE, DEATH OR OTHER LOSS RELATING TO CLIMBING ACTIVITIES.
Signature of Participant (18 years and older must sign)
Participant Name
Date
PARENT/COURT-APPOINTED LEGAL GUARDIAN OF MINORS (UNDER AGE 18 AT TIME OF REGISTRATION)As the parent or court-appointed legal guardian with legal responsibility for the Participant I consent and agree to the Participant’s assumption of risks, release of liability, covenant not to sue, waiver of claims and indemnity as provided in this Agreement. For myself, my heirs, executors, assigns, personal representatives and next of kin I release and covenant not to sue, waive and agree to indemnify, protect, defend and hold harmless the releasees from any and all Claims relating to the Participant’s participation in climbing activities in accordance with the terms of this Agreement.
Signature of Parent(s) (or Court-Appointed Legal Guardian)
Parent/Guardian Name
Date
stonegardens.com
page 2
1. Assumption of Risks. (a) I fully understand that this Agreement describes some but not all of the risks, hazards, dangers and potential consequences of the climbing activities, which include: (i) Participants must make judgments and decisions as they participate in climbing activities and Stone Gardens staff must make judgments and decisions as they instruct or assist participants regarding climbing activities. These judgments and decisions are by their nature imprecise and subject to error. Judgments and decisions will be made in an environment that includes some routes that are designed to be challenging even to very capable and experienced climbers. Among other risks there is the risk that the Participant or a staff member may misjudge the Participant's abilities or fitness level; (ii) equipment (including, without limitation, artificial climbing walls, holds and anchor points, ropes, slings, harnesses, climbing shoes and climbing hardware whether the Participant's personal equipment or equipment rented or borrowed from Stone Gardens) may break, malfunction or be misused. Stone Gardens makes no warranties regarding any such equipment; and (iii) the Participant or others may act carelessly or recklessly or generally fail to exercise care. For example: By failing to clip into the auto-belay device before climbing, clipping the auto-belay device into the wrong part of the harness or into something other than a real harness. These and other risks, hazards and dangers may result in the Participant falling to the floor or ground, becoming entangled in ropes or other equipment or hitting artificial climbing walls, holds, anchor points or other objects or people. These and other circumstances may cause fractures, sprains, broken bones, concussions, cuts or abrasions, or other injury or illness, mental or emotional trauma, paralysis, disability or death.
(b) I also fully understand that any instruction, training, orientation or other information or assistance provided by Stone Gardens cannot eliminate such risks. In both supervised and unsupervised climbing activities, I acknowledge that I am responsible for my own safety and if I am a Parent, the safety of the Participant.
(c) Therefore, I knowingly and voluntarily assume all risks, both known and unknown, relating to the climbing activities and I accept full responsibility for those risks identified here and for those risks not identified and for injury, damage, death or other loss suffered by me and, if I am a Parent, by the Participant, resulting from those risks or resulting from my own negligence or other conduct.
2. Release of Liability, Covenant Not to Sue, Waiver of Claims, and Indemnity. For myself and on behalf of my heirs, executors, assigns, personal representatives and next of kin (and, if I am a Parent, also on behalf of my child or ward), (a) I agree to release and I covenant not to sue Stone Gardens, its officers, agents, employees, volun-teers, representatives, other participants, sponsoring agencies, sponsors, advertisers and if applicable, owners and lessors of premises used for the climbing activities (all collectively, the "releasees"), with respect to any and all claims, liabilities, suits and expenses (including attorneys fees and costs) (all collectively, "Claims"), arising out of any injury, damage, death or other loss in any way connected with my participation in the climbing activities or use of Stone Gardens equipment and facilities. I understand that I agree here to waive all claims I may have against Stone Gardens and the other releasees and agree that neither I nor anyone acting on my behalf will make a claim or file a lawsuit of any kind against Stone Gardens or the other releasees as a result of any injury, damage, death or other loss; and (b) I agree to indemnify, protect, defend and hold harmless the releasees with respect to all Claims (i) brought by me or on my behalf arising out of any injury, damage, death or other loss in any way connected with my participation in the climbing activities or use of Stone Gardens equipment and facilities; (ii) brought by a co-participant or any other person, arising out of any injury, damage, death or other loss claimed to be caused in whole or in part by my conduct in the course of partici-pating in the climbing activities or using Stone Gardens equipment and facilities; (iii) brought by or on behalf of any family member or minor accompanying me; or (iv) arising out of any breach by me of this Agreement. This release, covenant not to sue, waiver and indemnity includes any Claims caused in whole or in part by the negligence of Stone Gardens or any of the other releasees (but not gross negligence or reckless misconduct) and includes claims for personal injury, property damage, wrongful death, products liability, breach of contract or otherwise.
3. Representations, Warranties and Agreements. I represent, warrant and agree that: (a) My participation in the climbing activities is purely voluntary, and I choose to participate regardless of and with knowledge of the risks; (b) I will comply with all rules and regulations of Stone Gardens and the stated and customary terms and conditions for participation in the climbing activities; (c) I acknowledge that participating in the climbing activities requires a special degree of skill and knowledge different from other activities and that I have responsibilities as a partici-pant. I have no mental or physical problems or limitations that might compromise or affect my ability to participate in the climbing activities or to comply with my responsibilities in connection therewith. I represent that I am fully capable of participating in the climbing activities without causing harm to me or others. I acknowledge that Stone Gardens staff is, and have been available, should I have further questions about the nature and physical demands of the climbing activities and the risks, hazards and dangers associated with the climbing activities. If I observe any unusual significant hazard during my participation, I will remove myself from participation and immediately bring such hazard to the attention of Stone Gardens.
4. Transportation and Medical Care. Staff of Stone Gardens is authorized to obtain or provide medical care for Partici-pant or to transport Participant to a medical facility. Medical personnel are authorized to render such treatment as they deem necessary for Participant's health. Stone Gardens has no responsibility for medical care provided to Participant and I agree to pay all costs associated with such medical care and transportation.
5. Governing Law; Forum. This Agreement is governed by the laws of the State of Washington. Further, any proceeding arising out of or relating to Participant's participation in the climbing activities must be filed or entered into only in the State of Washington.
6. Severability. Any portion of this Agreement deemed unlawful or unenforceable shall not affect the enforceability of the remaining provisions of this Agreement and the remaining provisions shall continue in full force and effect.
7. Effectiveness. This Agreement (i) shall be effective when signed either by Participant or (if applicable) by Participant's Parent, or both, (ii) shall be valid and binding until it is cancelled or modified by written agreement and (iii) shall cancel any prior Assumption of Risks, Release of Liability and Indemnity Agreement or prior similar agreement or waiver signed by Participant or (if applicable) by Participant's Parent in favor of Stone Gardens (except any under which there is any claim or basis for any claim).
8. Mediation; Binding Arbitration. I agree to attempt to settle any dispute (that cannot be settled by discussion) through mediation before a mutually acceptable mediator. Any claim or dispute of whatever nature, including but not limited to the issue of arbitrability, arising out of or relating to this Agreement and that is not resolved through mediation shall be resolved by final and binding arbitration administered by the American Arbitration Association (“AAA”) in Seattle,Washington in accordance with the AAA commercial arbitration rules and judgment upon the award may be entered in any court having jurisdiction over the matter. NOTICE OF ARBITRATION AGREEMENT: This Agreement provides that all disputes between you and Stone Gardens will be resolved by binding arbitration. You thus give up your right to go to court to assert or defend your rights under this Agreement. Your rights will be determined by a neutral arbitrator and not a judge or jury. For more information regarding arbitration, please go to www.adr.org/
I HAVE CAREFULLY READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS AND UNDERSTAND THAT BY SIGNING IT FREELY AND VOLUNTARILY I HAVE GIVEN UP SUBSTANTIAL RIGHTS, INCLUDING WITHOUT LIMITA-TION THE RIGHT TO SUE STONE GARDENS OR ANY OF THE RELEASEES FOR CLAIMS ARISING OUT OF ANY INJURY, DAMAGE, DEATH OR OTHER LOSS RELATING TO CLIMBING ACTIVITIES.
Signature of Participant (18 years and older must sign)
Participant Name
Date
PARENT/COURT-APPOINTED LEGAL GUARDIAN OF MINORS (UNDER AGE 18 AT TIME OF REGISTRATION)As the parent or court-appointed legal guardian with legal responsibility for the Participant I consent and agree to the Participant’s assumption of risks, release of liability, covenant not to sue, waiver of claims and indemnity as provided in this Agreement. For myself, my heirs, executors, assigns, personal representatives and next of kin I release and covenant not to sue, waive and agree to indemnify, protect, defend and hold harmless the releasees from any and all Claims relating to the Participant’s participation in climbing activities in accordance with the terms of this Agreement.
Signature of Parent(s) (or Court-Appointed Legal Guardian)
Parent/Guardian Name
Date
stonegardens.com
Stone Gardens, Inc.THE CLIMBERS GYM
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