If you are under 18 years of age, your parent or legal guardian's signature is required.

In consideration for being permitted by The Rock Dump to climb or workout in its facility, I agree to the following wavier and release. I acknowledge the inherent risk in physical fitness activities and I agree to abide by all safety rules of The Rock Dump.

I acknowledge that I am physically fit and have no health, medical or physical problems that preclude me from climbing or working out. I understand climbing and working out may require conditioning and skills. I assume all risks while at the premises of The Rock Dump, including the risk of injury or illness from forces of nature, falling, equipment failure, incorrect decisions, incorrect belaying, or any other event(s) whether in or out of my control.

I understand and agree that anything I rent or borrow or use from The Rock Dump is used at my own risk. I understand and agree that The Rock Dump is not liable for any damage or injury resulting from the use of its equipment or facility. I hold harmless The Rock Dump, its officers, employees, agents, and members from any and all liability, actions, cause of action, claims and demands of any and every kind which may arise from or in connection with my release. I assume risk for any member(s) of my family and others I am signing for who accompany me at The Rock Dump including those under the age of 18 for whom I am parent, legal guardian, or agent.

I have read and fully understand the information stated above.

Print YOUR Name (clearly) _____________________________

Date _____________________________________________

Signature ________________________________________

Minor(s) you are signing for______________________