Parent/Caregiver Acknowledgement and Signature
I understand there are numerous risks associated with participation in bouldering, including slips, scrapes, bruises, broken bones, falls from a height, and mental trauma. Many, but not all these risks are inherent in bouldering offered through Girl Scouts Spirit of Nebraska.
Equipment used in the activity may break, fail, or malfunction, or be improperly placed, despite reasonable maintenance and use. Persons using equipment may lose control of such equipment and cause injury to themselves and to others. Completely enclosed flat shoes, defined as without any toe or heel holes and no high heel or wedge, are required while climbing on the bouldering wall at the Girl Scout DreamLab.
Staff and volunteers use their best judgment in determining how to react to circumstances including, but not limited to, injury. The staff and volunteers may misjudge such circumstances, an individual's capabilities, and the like.
These are some, but not all, of the risks inherent in bouldering; a complete listing of inherent and other risks is not possible. There are also risks which cannot be anticipated. I give my permission for my child to participate in bouldering activities. I acknowledge and assume the risks involved in these activities, and for any damages, illness, or injury resulting from such risks for myself and my child.
I agree to indemnify and hold harmless Girl Scouts Spirit of Nebraska, its employees, representatives, and agents from any claims, actions, or liabilities (including reasonable attorney fees), for any occurrences which result in any injury, illness, accident, or harm of any kind to Participant while participating in the bouldering event or activity.
I also expressly agree to release and discharge Girl Scouts Spirit of Nebraska, its employees, representatives, and agents from any act or omission of negligence in rendering or failing to render any type of emergency or medical service.
In signing this document, I fully recognize and understand that I am giving up my right and participant's right to make a claim or file a lawsuit against Girl Scouts Spirit of Nebraksa even if they negligently or by some other act or omission cause injury or damage to a participant.
I agree that this Release of Liability is intended to be as broad and inclusive as is permitted by the law of the State of Nebraska and that if any portion thereof is held to be invalid, the balance of the agreement shall continue in full legal force and effect.
As parent/caregiver of a participant under 18 years of age, I voluntarily agree that said minor may participate in the above referenced event or activity and I sign this release on their behalf. I understand that this is a release of all claims that is binding on myself, my heirs, members of my family, personal representatives and assigns. I understand that I am assuming all risk inherent in the above referenced event or activity. I voluntarily sign my name as evidence of my acceptance of the above provisions.
I have read and understand this document, and agree to the terms and conditions above.