• RMEQ Broomfield Escape Room Field Trip- High School (ages 14-18)

     

  • STOP! PARENTS/GUARDIANS/ INDIVIDUALS 18+ SHOULD BE FILLING OUT THIS FORM SO THEY MAY HAVE ALL OF THE IMPORTANT DETAILS FOR THIS TRIP. 

    IF YOU ARE A MINOR FILLING OUT THIS FORM, YOU NEED TO WAIT UNTIL YOUR ADULT IS AVAILABLE TO GO THROUGH IT WITH YOU.

     Join RMEQ for an adventure to Themescape Escape Rooms in Broomfield for the chance to experience 1 of 4 rooms in a team up to 8 to try to puzzle your way out of the themed room before time runs out!

    Open to Youth 14-18 y/o MAX 20 spots- RSVP (this form) REQUIRED to attend

    Location:

    Themescape Escape Rooms, 6811 W 120th Ave, Broomfield, CO 80020

    or 

    3340 Mitchell Ln, Boulder, CO 80301 (for RMEQ transportation)

    Time:

    Meet at Themescape by 5:00p

    OR

    Meet at RMEQ by 4:20p AT THE LATEST for 4:30p departure (TRANSPORTATION RELEASE FORM AT END OF THE FORM REQUIRED FOR TRANSPORTATION!!!)

    Return Time:

    7:00p pick up at Themescape 

    OR

    7:30p at RMEQ

    Food:

    Provided at Themescape

     

    Rocky Mountain Equality programs require that parents/guardian sign and return this form to staff before your youth is allowed to participate in the field trip/activity. If you have any questions regarding this event, please contact Rouxan (they/he) at Rocky Mountain Equality, at rouxan@rmequality.org

     

  • Format: (000) 000-0000.
  • Acknowledgment of Risk, Release of Liability, & Indemnification Agreement

    Please fill out with youth and parent/guardian present
  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • This Agreement is entered into by the undersigned adult participant and/or the parent(s) or legal guardian(s) of a minor participant (“Participant” and/or “Parent/Guardian”), in favor of Rocky Mountain Equality (“RMEQ”).

    This Agreement includes a release of liability, including for ordinary negligence. Please read carefully before signing.

    1. Acknowledgment and Assumption of Risk
    I understand and acknowledge that participation in programs, services, and events organized, hosted, or sponsored by Rocky Mountain Equality (“RMEQ”) involves inherent and other risks, which may result in injury, illness, emotional distress, property damage, financial loss, permanent disability, or death. These risks may arise from, among other things, the nature of the program or event; interactions with participants, staff, volunteers, vendors, or members of the public; the condition of facilities, premises, or equipment; travel to or from the program or event; or other known or unknown circumstances.

    I understand that such risks may occur despite reasonable precautions and without fault by RMEQ. I knowingly and voluntarily assume all risks, whether known or unknown, foreseeable or unforeseeable, and accept full responsibility for any injury, damage, or loss arising out of or related to my participation.

    2. Release and Waiver of Liability
    I understand and agree that this Agreement releases RMEQ from claims based on its ordinary negligence. To the fullest extent permitted by Colorado law, I, for myself and/or for and on behalf of my minor child, hereby release, waive, and discharge Rocky Mountain Equality and its officers, directors, employees, volunteers, representatives, contractors, and agents (the “Released Parties”) from any and all claims arising out of or related to participation in the Activities or use of any equipment, facilities, or premises, including claims arising from the ordinary negligence of the Released Parties.

    This release does not apply to claims arising from gross negligence, willful and wanton misconduct, or criminal conduct, to the extent such claims cannot be waived under Colorado law.

    3. Independent Contractors and Third-Party Facilities

    RMEQ may use independent contractors to provide certain program services and may conduct Activities at facilities not owned or controlled by RMEQ. I understand that RMEQ does not control the actions of independent contractors or the conditions of third-party facilities and, to the extent permitted by law, is not responsible for their acts or omissions.


    4. Parent/Guardian Authority and Indemnification
    If Participant is a minor, I represent that I am the parent or legal guardian and have authority to sign on the minor’s behalf. I agree that this Agreement is binding on the minor and on me individually.

    I agree to defend, indemnify, and hold harmless the Released Parties from any claim brought by or on behalf of the minor, and from any third-party claim to the extent caused by Participant’s acts or omissions, except to the extent prohibited by Colorado law.

    5. Medical Authorization and Responsibility
    I authorize RMEQ to obtain or provide emergency medical care for Participant as deemed reasonably necessary, including transportation to a medical facility. I am responsible for all related medical and transportation costs.

    6. Program Removal
    RMEQ reserves the right, in its discretion, to remove any participant if RMEQ determines the participant presents a safety or medical risk, is disruptive, or otherwise engages in conduct detrimental to the program.

    7. Photo and Media Release
    I authorize RMEQ to use photographs, video, or other recordings of Participant for promotional, educational, or other lawful purposes, without compensation.

    8. Governing Law and Severability
    This Agreement shall be governed by and construed in accordance with the laws of the State of Colorado. If any provision is held unenforceable, the remaining provisions shall remain in full force and effect.

     

    For Parents/Guardians:

    I certify that I am the parent or legal guardian of the minor participant and have full legal authority to sign this Agreement on the minor’s behalf. I have read and understand this Agreement, and I knowingly and voluntarily agree to all of its terms on my own behalf and on behalf of the minor participant.

  • For youth:

    I understand that I will be participating in RMEQ programs and activities. I agree to follow all program rules, staff instructions, and safety guidelines. I understand that participation may involve risks, and I agree to notify RMEQ staff if I feel unsafe, injured, ill, or otherwise unable to participate safely.

  • Rocky Mountain Equality Photo Release

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • I hereby grant to any photographer acting on behalf of Rocky Mountain Equality, a Colorado non-profit organization ("Photographer"), the legal representatives and assigns of Photographer, and Rocky Mountain Equality, the irrevocable and unrestricted right to use and publish photographs of me and my children, if any, or in which Ior my children may be included, taken at or in connection with the above-referenced Event, for editorial, trade, advertising, and any other purpose and in any manner and medium; and to alter and composite the same without restriction and without my inspection or approval. I hereby release Photographer, Rocky Mountain Equality, and the legal representatives and assigns of Photographer and Rocky Mountain Equality, from all claims and liability relating to said photographs. I understand that Rocky Mountain Equality is an LGBTQ (Lesbian, Gay, Bisexual, Transgender, and Queer) and allies community services organization and that photographs of me and/or my children may be used in materials and in locations, including online, that are related to lesbian/gay/bisexual/transgender/queen information and services.

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Rocky Mountain Equality YOUTH Transportation Release

    (only fill out if you will be using RMEQ Transportation for your youth)
  • Rocky Mountain Equality (RMEQ) requires that parents/guardians sign and return this form to staff before a youth is allowed to participate in transportation to and from groups and events by group staff, volunteers, and interns.

    My child,has my permission to be transported to and from groups and events by adult volunteers, interns, or staff for Transportation will be provided by group interns, contract staff and volunteers who have been background checked.

    I hereby release, and agree to indemnify and hold harmless the owner and operator of the vehicle, RMEQ, RMEQ staff, volunteers or interns, and any of their respective employees or representatives and insurers from liability for any injury, loss, or damage to my child or property, whether anticipated or unanticipated, resulting from my participation in any activities contemplated by this agreement.

    | understand that transportation may involve risks and hazards, including the risk of injury to my child. I am aware of the risks and hazards inherent in my child's participation and do hereby assume sole responsibility for all such risks and waive all claims against RMEQ and their respective employees, representatives, volunteers, interns, and insurers.

  • Requesting transportation for:
  • Format: (000) 000-0000.
  • Today's Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: