• Waiver and Release of Liability:

    Outdoor, Guided Trips

    Warning: There are significant risks present in all aspects of rock climbing and wilderness travel.

    Express Assumption of Risks: I, the undersigned, am aware that there are significant risks involved in all aspects of climbing. These risks include but are not limited to: falls which can result in serious injury or death, injury or death due to negligence on the part of myself, my belayer, or other climbers (CHOOSE YOUR PARTNER[S] AT YOUR OWN RISK!), injury or death due to improper use of, or failure of equipment, and injury or death due to rock fall and other environmental, animal, and insect hazards.

    I expressly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while attending guided events operated by Pacific Edge. I, the undersigned represent that I have no physical impairments or illnesses that will endanger myself or others.

  • Initials: *

  • Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities available offered by Pacific Edge, I the undersigned, hereby release: Pacific Edge, Stoveleg Enterprises and its officers, Richard Novak, and the Seabright Station Partnership, their principals, agents, officers, employees, and volunteers, the United States Government, National Park Service, U.S. Forest Service, City of Santa Cruz, County of Santa Clara, their employees and agents 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 my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties.

    Indemnification: Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to reimburse them for such fees or costs.
    I HAVE READ AND UNDERSTOOD THE FOREGOING ASSUMPTION OF RISK, AND RELEASE OF LIABILITY.
    I UNDERSTAND THAT BY SIGNING THIS FORM I AM WAIVING VALUABLE LEGAL RIGHTS. I ALSO UNDERSTAND THAT BY SIGNING I AGREE TO ABIDE BY ALL APPLICABLE RULES AND REGULATIONS AS THEY APPLY TO SANTA CLARA COUNTY PARKS.

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  • PACIFIC EDGE Climbing Gym -104 BRONSON STREET, SUITE 12, SANTA CRUZ, CA 95062Phone (831) 454-9254 Fax 454-9269

  • Medical Information and Consent

  • I , authorize Pacific Edge to act as agents for the undersigned in the event of any medical emergency. Pacific Edge is authorized by me, to authorize any treatment that is deemed necessary in the event of such an occasion.

    I understand that the authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provide authority and power to Pacific Edge to give specific consent to any treatment which is deemed necessary.

    This authorization shall remain effective until the conclusion of the climbing course (arrival at the point of departure) for which the above is enrolled.

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  • Medical Information:
    Name:         
    Age: Date of Birth:   Pick a Date   
    Emergency Contact:         
    Emergency Phone: Medical Alert Tag:       Condition?   
    Sex: Ht:
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