• LA VIDA CONFIDENTIAL MEDICAL AND EMERGENCY FORM

    This form must be completed by the La Vida participant or a parent/legal guardian if participant is under the age of 18. For your safety and our records, answer the following questions in detail and sign the bottom of the page. La Vida carries limited accident and illness insurance.
  • Participant Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
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  • Photo Release Statement: The La Vida Center may use any photograph or video footage of me or my child for advertising, art, or promotional purposes. I waive my right to inspect or approve the finished product, and know that I will not receive any compensation for any products used by La Vida.

  • Photo Release*
  • Date
     - -

  • CONFIDENTIAL MEDICAL HISTORY AND PHYSICAL CONDITION

    Do you have (or have had in the past) any health conditions that you or your doctor feel would limit your participation in any of La Vida’s activities? If yes, please identify and explain in detail to the best of your ability.
  • Rows
  • If you answered YES to any of the above questions, have you consulted your physician about your participation? Check below:

  • The La Vida staff reserve the right to limit participants activities based on the information provided above.

  • La Vida Rock Gym Policies Form

    These policies have been developed to ensure the health and safety of the rock gym users as well as a positive atmosphere in the rock gym area. Please read and ask a staff member for any clarification of anything you don’t understand. Once you understand these policies, please sign and date the bottom of the page.

  • Conduct

    The following will not be tolerated and will be confronted by facility staff. Rock Gym and Bennett Center staff reserve the right to suspend or revoke privileges for any of the following:

    Misconduct
    Misuse of equipment
    Willful destruction of property
    Harassment, profane or abusive language
    Disrespect of staff or other climbers
    Disregard of operational policies and procedures

    Attire & Shoe Policy

    Climbers are required to wear appropriate athletic clothing while using the rock gym.
    Shoes must be clean and close-toed. If the climber does not have clean, close-toed personal shoes, they will need to pay the $1 rental fee and use the Rock Gym rental climbing shoes.

    Rock Gym and Bennett Center Access 

    All Rock Gym users must enter and exit through the main lobby area. Upon entering, rock gym users should be prepared to inform Bennet Center front desk attendant that they are entering the Bennet Center for the purpose of using the Rock Gym.
    Entrance will be on a first come first served basis due to the possibility of overcrowding. Our space limit is 15 climbers.
    Bennett Center use is restricted to the Rock Gym, concession area and bathroom. 

    Signing Forms

    Medical Forms, Rock Gym Policies Forms, Waiver and Release of Liability Forms all need to be read and signed by climbers before they can climb.

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    General Policies:

    • Personal climbing harnesses may be used in the rock gym but must be deamed safe by a rock gym staff member before use.
    • Only Rock Gym staff are allowed: to be behind the desk, access storage closets, go behind the climbing walls and adjust, remove or add holds on the walls.
    • Socks are recommended to be worn with all rental shoes.(Note: shoes are sprayed after each use).
    • No activity other than climbing should be performed in the rock gym unless explicitly instructed by a Rock Gym staff member (ie. gymnastics, tumbling, running, wrestling).
    • No improper use of climbing equipment (i.e. hanging or swinging on ropes).
    • No rock climbing shoes may be worn outside of the rock gym area except to the bathroom and water fountain (unless it is during a fire drill/ alarm).
    • Food and drink other than water must be consumed outside of the Rock Gym.

    Climbing/Belaying Policies 

    • Climbers are not allowed to climb higher than the red line without being belayed (green line for climbers that are shorter than the green line), unless they are properly utilizing the crash pads.
    • Proper commands must be used by all climbers and belayers.
    • Climbers must stay in route to prevent an unsafe pendulum swing in the event of a fall.
    • Do not stand or climb under another climber’s fall line.
    • The Retrace Figure 8 knot is the only knot allowed in the rock gym to attach the belay rope to a harness.
    • No one is allowed to belay until they have passed the "Belay Test" or have been visually checked by a senior staff.
    • Belayers must unerstand the 'brake position'.
    • Belayers must be anchored into the floor properly and standing in such a way that keeps the anchor tight.
    • Belayers must keep their brake hand on the belay rope at all times.
    • Belayers should make sure the rope is weighted before lowering a climber to ensure slow and controlled lower. 

  • La Vida Risk Release Waiver

  • The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. As well, the Governor of the Commonwealth of Massachusetts declared a state of emergency as a result of the pandemic. COVID-19 is reported to be extremely contagious. The state of medical knowledge is evolving, but the virus is believed to spread from close person-to-person contact, through respiratory droplets, and may be spread from contact with contaminated surfaces and objects. COVID-19 may also be spread by people who do not show and are not experiencing any symptoms. The exact methods of spread and contraction are unknown, and there is no known treatment, cure, or vaccine for COVID-19. Evidence has shown that COVID-19 can cause serious and potentially life-threatening illness and even death. Gordon College cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while utilizing Gordon College’s campus and participating in the Activity. It is not possible to prevent against the presence of the disease. Therefore, if you choose to engage in the Activity and/or enter onto Gordon College’s campus you may be exposing yourself to and/or increasing your risk of contracting COVID-19 onsite from a Gordon College employee, student, Bennett Athletic Center member, guest/visitor, or any other person present on campus, and/or increasing your risk of spreading COVID-19 to others.

    Therefore, by participating in this Activity, I VOLUNTARILY ASSUME ALL RISKS RELATED TO COVID-19. I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of becoming exposed to or contracting COVID-19 for myself and/or my children in order to participate in the Activity and enter Gordon College’s campus. The Activity is of such value to me [and/or my child(ren)] that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize Gordon College’s campus in person.

  • This is a legal and binding agreement which, when signed, will permanently limit your ability to recover from the parties indicated below for illness, disease or even death you may sustain as a result of participating in any trip and/or activity on or off campus.

    Gordon College is a non-profit educational institution. References to Gordon College include its trustees, employees, volunteers, students, Student Organizations, programs, events, participating organizations, sponsors, agents and assigns.

    ASSUMPTION OF RISK
    I, the undersigned, in consideration of the right to participate in the on-campus activity/ies, agree as follows:

  • Name of Activity

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    RELEASE AND WAIVER
    In consideration of the right to participate in the Activity, I the undersigned, on behalf of myself, my spouse, heirs, representatives, executors, administrators and assigns, and to the fullest extent permitted by law, agree to and hereby do forever:

    (a) Release Gordon College from any cause of action, claims, or demands of any nature whatsoever, including but not limited to a claim of negligence which I or my spouse, heirs, representatives, executors, administrators and assigns may now have, or have in the future against Gordon College in connection with exposure, infection, and/or spread of COVID-19 related to utilizing Gordon College’s campus and participating in the Activity. I understand that this waiver means I give up my right to bring any claims including for personal injuries, illness, permanent disability, death, property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen; and
    (b) Covenant not to sue and agree to hold harmless Gordon College from any and all causes of action, claims, demands, losses or costs of any nature whatsoever arising out of or in any way relating to COVID-19 in conjunction with my participation in La Vida.

    This agreement shall be construed and enforced in accordance with Massachusetts law and I consent to the jurisdiction of said state. I expressly agree that this waiver and release is intended to be as broad and inclusive as permitted under Massachusetts law and that if any portion hereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

    My signature below indicates that I have fully read and freely signed this agreement and I understand that by signing this form, I am giving up legal rights and/or remedies which may be available to me with respect to Gordon College and any parties listed above. I further certify that I am legally competent to sign this agreement. I further understand that the terms of this agreement are legally binding and I certify that I am signing this agreement after having carefully read and understood the same, of my own free will. This agreement is made in sole consideration of Gordon College permitting my use of the campus and facilities and my use of facilities, equipment, or services associated with the Activity.

  • FOR MINORS: The following shall apply to participation by minors: My child is voluntarily participating in this Activity with knowledge of the danger involved and hereby agrees to accept any and all inherent risks listed above. I, as a parent or legal guardian of the above minor under 18 years of age, hereby consent to the terms and conditions set forth in this release form.

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