CENTER OF GRAVITY
ROCK GYM
WAIVER (2 PAGES)
400 Bridge Street, Suite 400
Wichita Falls, TX 76306
940.235.8377-main 928.221.0063-alt
Hours: M-F 3pm-10pm S&S 10am- 6pm
Visit cogrockgym.com or find us on Facebook!
*Name: (LAST)______________________________________(FIRST)___________________(MI)____ Address:____________________________________
*Phone: (__________)___________________________ C
/H/W
*Date of Birth: ( MM)__________/(DD)__________/(YYYY)____________________
City:
State:
*Zip:______
Email:______________________________________
*Emergency Contact Information: (under 18 must have parent information) *Name:_____________________________________
*Relationship:__________________________________*Phone: (__________)_______________________ C
/H/W
CENTER OF GRAVITY ROCK GYM RULES
GENERAL:
Everyone must READ & SIGN a waiver.
Everyone that INTENDS to top rope or lead
must go through SAFETY CHECK/CERTIFICATION.
HARNESS with BELAYER required PAST RED LINE.
No FOOD or BEVERAGES allowed in climbing area.
No RUNNING or RACING.
No SMOKING, or open FLAME.
No SPITTIN or CUSSIN.
If you DON'T KNOW how to do something, DONT GUESS – ASK.
Parental SUPERVISION of MINORS required.
No one UNDER THE INFLUENCE of alcohol or drugs
allowed on premises.
DO NOT tie-into a carabiner.
Tie-in with FIGURE-EIGHT retrace/follow-through ONLY.
Do not climb above TOP ROPE BARS.
No climbing directly BELOW or above OTHER climbers.
Do not WALK in BETWEEN belayer & wall.
PERSONAL GEAR must be APPROVED by COG staff prior to USE.
BOULDERING:
Bouldering allowed everywhere, but HANDS
NOT to be past RED LINE.
Crash PADS make it SAFER, so use one.
Bouldering past YOUR HEAD height NEEDS a SPOTTER
or CRASH PAD.
Do not TAKE AWAY a PAD used by ANOTHER climber.
TOPROPEING:
Use COG ROPES & GRIGRIS (belay safety device provided) only.
CHECK that your CARABINER is LOCKED & NOT SIDE LOADED.
CHECK your CLIMBER's harness, knot and carabiner.
CHECK & RECHECK your HARNESS & tie-in KNOT.
Belayers MUST CLIP into a FLOOR ANCHOR (top rope only).
CHECK your BELAYER's carabiner, anchor points, & grigri.
LEADING:
Everyone LEADING must carry COG LEAD
TAG (pick-up & drop-off at front counter).
TAG must be worn on BACK-LEFT side of HARNESS.
CHECK & RECHECK prior to climbing, harnesses knot,
belay device, carabiner.
Connect into BOTH ANCHORS at top.
Belay device, must be a sanctioned device (Grigri, ATC, etc. NO
Munter Hitch, body belay, etc)
BELAYER must act as SPOTTER until climber has CLIPPED.
BELAYER is RESPONSIBLE for CLIMBER's ACTIONS.
CLIMBER must not BACK-clip, Z-clip, SKIP clips.
No TOPROPING on LEAD anchors, or CLEANING route.
Remember the RULES of GRAVITY are STRICTLY ENFORCED! Be SAFE. Be SMART. Be CURTIOUS. Rock on!
I have read, understand and will obey the above rules. _______ (initial)
MORE ON BACK →
PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK
In consideration of the services of Center of Gravity Rock Gym, their agents, owners, officers, volunteers, participants, employees
and all other person or entities acting in any capacity on their behalf (hereinafter collectively referred to as “COG”), I hereby agree
to release, indemnify, and discharge COG, on behalf of myself; my children, my parents, me heirs assigns, personal representatives
and estate as follows:
I acknowledge that my participation in rock climbing at an indoor artificial rock climbing wall entails known and unanticipated risk
that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand
that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. THE RISKS INCLUDE, BUT ARE
NOT LIMITED TO: falling off the wall; loose and/or damaged artificial holds; rented equipment failure; falling to the ground, on other
users, or being fallen on by other users; abrasions from the walls, ropes, pads, or the floor; equipment failure; belay and/or belayer
failure; climbing out of control or beyond one’s personal limits; the negligence of other climbers, visitors, participants, or other
persons who may be present; musculoskeletal injuries and/or over training; head injuries; or personal negligence. Furthermore,
COG employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant’s
fitness level or abilities and/or human error may occur. _____ (initial)
I expressly agree and promise to accept and assume all the risk existing in this activity. My participation in the activity is purely
voluntary, and I elect to participate in spite of the risks. _____ (initial)
I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless COG from any and all claims, demands, or
causes of action, which are in any way connected with my participation in this activity or my use of COG’s equipment or facilities,
including any such claims which allege negligent acts or omissions of COG. _____(initial)
Should COG or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to
indemnify and hold them harmless for all such fees and costs. _____(initial)
I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to
bear the costs of such injury or damage to myself. I further certify that I am willing to assume the risk of any medical or physical
condition I may have. _____(initial)
In the event that I file a lawsuit against COG, I agree to do so solely in the State of Texas, and I further agree that substantive law of
that state shall apply in that action without regard to the conflict of law or rules of that state. I agree that if any portion of this
agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. _____(initial)
I will comply and follow all Rules, Regulations and Instructions, verbal or otherwise, and have a duty to inquire or further clarify any
and all Rules, Regulations and Instructions if I do not fully understand or am unsure. _____(initial)
I will not participate in ANY activity, use any equipment or participate in any other capacity on the grounds of COG while under the
influence of drugs, alcohol or any manner of impairment. _____(initial)
I am responsible for the care and maintenance of any and all personal equipment while in use at COG regardless of where or from
whom I may have acquired said equipment. _____(initial)
I understand, acknowledge and agree that any equipment or gear rented or borrowed from COG is used at my own risk and will not
hold COG liable for any harm, loss, damage, personal injury or death resulting from the use and/or participation in activities or
events of COG facilities, or equipment. _____(initial)
By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I
may be found by a court of law to have waived my right to maintain a lawsuit against COG on the basis of any claim from which I
have released herein. _____ (initial)
Participant’s Information:
Printed Name:_________________________________________
Today’s Date: (MM)________ /(DD)____ ____ /(YYYY)_______ ______
Signature:_____________________________________________
If under 18 years of age, signature of parent or legal guardian, indicate name and relationship:
Name:______________________________________________
Relationship:____________Today's Date: ____ /____ /________