In Consideration of my being permitted by GREEN MOUNTAIN ROCK CLIMBING CENTER, and VERMONT
ADVENTURE TOURS (hereafter Center) to use its facilities, and or natural rock climbing areas, I agree to the
following waiver and release. I, the undersigned user, agree to IDEMNIFY AND HOLD HARMLESS Green Mountain
Rock Climbing Center and I make the following representations:
I understand that there are extreme risks in rock climbing activities at natural rock climbing areas and indoor
climbing facilities. I further acknowledge and agree that those risks include but are not limited to:
1. Inattentive belayers and other bad decision making, by myself or those I am climbing with.
2. All manner of injuries resulting from hitting projections, permanent or temporary, or the ground.
3. Injuries resulting from hitting falling people or other dropped items.
4. Cuts, abrasions, and other wounds resulting from skin contact with center walls and projections.
5. Rope abrasion, entanglement, and other injuries resulting from activities inside the center or at natural rock
climbing areas.
6. Rock fall, falling items, bee stings, lightning strikes, sun burn, slips, twisted ankles, and other similar injuries.
I further understand that the above in no way limits the extent or reach of this release and covenant not to sue.
I agree to assume all risk of personal injury including, but not limited to: broken bones, paralysis, and death that
may occur while I an in the center, or at natural rock climbing areas. I hereby release Green Mountain Rock
Climbing Center, its owners, officers, employees, wall builders, wall designers, hold manufacturers, lessors,
insurers, and agents harmless from all liability for any personal injury that I may incur.
I agree to pay attention to the state of the ropes in the center and that of the anchors, and to advise center staff if I
do any damage, or notice any damage. I agree to abide by all Center and staff rules and comply with any request
of Center staff. I also understand indoor climbing is not the same as outdoor climbing, and that additional skills are
necessary for outdoor climbing that cannot be acquired in the center.
I am physically fit and know of no medical or health reason why I should not participate in the activities that take
place at the Center or at natural rock climbing areas. If there is any preexisting disability, I will bring it to the
attention of the Center’s staff. (Those with disabilities will be accommodated to the best ability by the Center’s
staff.) I know of no medical health reason why any minor I am signing this release for should not participate.
Parents & Guardians:
If I am a parent or guardian of a minor climbing at the Center or at a natural rock climbing area, whether or not I am
a member myself, or am present when the minor is climbing, I agree to indemnify and hold harmless Green
Mountain Rock Climbing Center and all other parties released, in the event a minor member of my family sues them
or any one of them. I understand that this means I will pay all fees, costs, and charges incurred by the Green
Mountain Rock Climbing Center or any other parties released, including attorney fees.
This release applies to and binds my personal representatives, executors, heirs, and family. If a member of my
family under the age of 18 accompanies me to the Center, I make this release and these representations of his or
her behalf as well as my own and agree to assume responsibility for his or her safety.
This release is a binding legal contract.
I am over (18) years of age. If I am not over (18) years of age, my parent or legal guardian has also read and
signed this release. I have carefully read this agreement and fully understand its contents. I am aware that this is a
release of liability. I understand that this release is a contract. I sign it of my own free will. I also understand that
this contract is severable, in other words, that if any part of this contract is held by a court of law to be
unenforceable, the rest of the contract shall survive.
Please Print and write clearly
Signature of Participant __________________________________ Birth Date _____/________/_______
Participant’s Name Clearly Printed ____________________ Phone (____)____________________
Parent/Legal Guardian’s Signature, if participant is under 18 _________________________________
Participant’s Address___________________________________ E-Mail_________________________
City ___________________ State ________ Zip ____________ Today’s Date ____/____/____
Office use only:
Accepted by:__________________________________
On behalf of, Green Mountain Rock Climbing Center
Climber has passed belay skills test Yes No Tested by________________
Climber has passed Lead Belay skills test Yes No Tested by_________________
Card Issued [ ]