Speak Your Mind Participant Info & Liability Waiver Logo

  • Welcome to Speak Your Mind Activities

  • Participant Information

  • Demographic Info

    Why we ask: Collecting this information helps us determine and maintain our charitable organization status. They are not required but do help us a lot if you have an extra minute to answer them. 

  • Emergency Contact

  • Speak Your Mind Liability Waiver

    Monthly Meetups (EIN 99-2068734)

  • Release of Liability, Assumption of Risk, and Indemnification Agreement

    In consideration of being permitted to participate in any and all formalized or informal group meetups sponsored by Speak Your Mind, I hereby agree to the following:

    1. Release and Hold Harmless

    I,   **  (the "Participant"), hereby release, discharge, and covenant not to sue Speak Your Mind (the "Releasee"), its officers, directors, employees, volunteers, agents, representatives, successors, and assigns (collectively, the "Released Parties"), from any and all claims, losses, damages, suits, actions, liabilities, expenses (including attorney's fees), or causes of action of any kind, known or unknown, arising out of, relating to, or in any way connected with my participation in the Activity, including, but not limited to, personal injury, death, property damage, or any other loss sustained by me, even if such loss is caused in whole or in part by the negligence of the Released Parties.

  • 2. Assumption of Risk

    I understand that rock climbing is an inherently dangerous activity with risks that cannot be eliminated entirely.

    These risks include, but are not limited to:

    • Falling
    • Equipment failure
    • Improper belaying
    • Slips, trips, and strains
    • Cuts, scrapes, and bruises
    • Head injuries
    • Spinal cord injuries
    • Broken bones
    • Hypothermia
    • Death

    I freely and voluntarily assume all risks of participation in the Activity, whether such risks are known or unknown, foreseen or unforeseen.

    3. Medical Fitness

    I represent and warrant that I am in good health and physically fit to participate in the Activity. I acknowledge that I have no medical or physical conditions that would preclude my safe participation in the Activity. If I have any concerns about my fitness, I will consult with a physician before participating.

    4. Medical Treatment Authorization

    In the event of an injury or emergency during the Activity, I authorize the Released Parties to secure medical treatment for me. I understand that I will be responsible for all costs associated with such treatment. It is recommended that participants have their own health insurance.

    5. Rules and Instructions

    I agree to follow all rules and instructions provided by the Released Parties regarding the Activity. I further agree to use all safety equipment provided in a proper manner.

    6. Binding Agreement

    This Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective successors and assigns.

    7. Governing Law

    This Agreement shall be governed by and construed in accordance with the laws of the State in which services are provided.

    8. Severability

    If any provision of this Agreement is held to be invalid or unenforceable, such provision shall be struck and the remaining provisions shall remain in full force and effect.

    9. Entire Agreement

    This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior or contemporaneous communications, representations, or agreements, whether oral or written.

    10. Age Requirement

    I understand that participants must be at least 8 years old to participate in the Activity.

    11. Minor Participants

    If I am the parent or legal guardian of a minor participant (the "Minor"), I hereby agree to this Agreement on behalf of the Minor and myself. I further agree to assume all risks associated with the Minor's participation in the Activity and to indemnify and hold harmless the Released Parties from any and all claims arising out of the Minor's participation.

    12. Image Release

    In addition to the above, I grant Speak Your Mind a non-exclusive, irrevocable, royalty-free worldwide license to use, reproduce, modify, publish, distribute, and create derivative works of my photographic image, likeness, and voice, as captured during any events organized and/or sponsored by Speak Your Mind, in perpetuity, in connection with the promotion and marketing of said Organization's programs and services.

  • I acknowledge that I have carefully read this form and fully understand that my e-signature (below) is a legally binding release of liability. I expressly agree to release and discharge the Speak Your Mind organization, group leader, sponsor, fellow participants, and any other affiliated party from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I may otherwise have to bring a legal action for personal injury or property damage. 

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