WAIVER OF LIABILITY, ASSUMPTION OF RISK & INDEMNITY AGREEMENT

MARYLAND MOBILE ROCKWALL RENTALS

443-244-4089 | MarylandMobileRockwallRentals@yahoo.com

www.MarylandMobileRockwallRentals.com
WAIVER OF LIABILITY, ASSUMPTION OF RISK & INDEMNITY AGREEMENT
PARTICIPANT / CLIMBER INFORMATION
PRINT PARTICIPANT NAME

First NameLast Name
BIRTH DATE

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
GENDER: M / F
ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
CITY / STATE / ZIP

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PHONE (WITH AREA CODE)
Format: (000) 000-0000.
EMERGENCY CONTACT & PHONE
Format: (000) 000-0000.
WARNING — THIS IS A LEGALLY BINDING AGREEMENT
If you do not understand any part of this agreement, ask a Maryland Mobile Rockwall Rentals employee to explain it before signing. By signing, you and the participant named above waive the right to bring a court action to recover compensation or any other remedy for personal injuries, property damage, accident of any kind, or death arising out of use of the mobile climbing wall.
Initials:
ASSUMPTION OF RISK
Participation in Rock Wall activities carries inherent risks that cannot be eliminated no matter how much care is taken. Risks range from (1) minor injuries such as scratches, bruises, and sprains; (2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions; to (3) catastrophic injuries including paralysis and death. I have read this section and I know, understand, and appreciate these and other risks inherent in activities made possible by Maryland Mobile Rockwall Rentals. I assert that my participation is voluntary and that I knowingly assume all such risks.
INDEMNIFICATION & HOLD HARMLESS
I agree to INDEMNIFY AND HOLD Maryland Mobile Rockwall Rentals, LLC HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages, and liabilities, including attorney's fees, arising as a result of my (or the participant's) involvement in Rock Wall activities, and to reimburse them for any such expenses incurred.
SEVERABILITY
This waiver and assumption of risk agreement is intended to be as broad and inclusive as permitted by law. If any portion is held invalid, the balance shall nonetheless continue in full legal force and effect.
ACKNOWLEDGMENT OF UNDERSTANDING
I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.
Signature of Parent / Guardian (if participant is a minor)
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature of Participant
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
MARYLAND MOBILE ROCKWALL RENTALS, LLC • 443-244-4089 • www.MarylandMobileRockwallRentals.com
Should be Empty:

WAIVER OF LIABILITY, ASSUMPTION OF RISK & INDEMNITY AGREEMENT

PARTICIPANT / CLIMBER INFORMATION