Waiver for Fit Rocks Climbing Gym Inc.

Acknowledgment and Assumption of Risks

Participant Last Name Participant First Name Participant Middle Name Date of Birth
Ruiz Macias Valeria February 14, 2007
Address
40 Chemin Saint-Andre
City State Postal Country
Cap-Pele New Brunswick E4N1Z7 Canada
Home Phone Work Phone Cell Phone
(506) 577-4636 (506) 866-0861
Email Address Can we email
renato379@yahoo.com.mx No, only contact me regarding billing issues!
Emergency Contact Emergency Phone
Renato Ruiz De Lara (506) 866-0861

WARNING: There are significant elements of risk in any sport or activity associated with a "rock gym" bouldering area, incidental fitness
training regimens and equipment (referred to herein as 'Activity'). We wish to remind you this Activity is not without risk. Certain risks
cannot be eliminated without destroying the unique character of the activity. The same elements that contribute to the unique character of
the activity can be causes of loss or damage to your equipment, or accidental injury, illness, or in extreme cases, permanent trauma or
death. We do not want to frighten you or reduce your enthusiasm for the activity, but we do think it is important for you to know in
advance what to expect and be informed of the inherent risks.

ACKNOWLEDGEMENT OF RISKS: I ACKNOWLEDGE THAT THE FOLLOWING DESCRIBES SOME, BUT NOT
ALL THE RISKS OF INDOOR ROCK CLIMBING:
1. Slips, trips, falls or painful crashes while using the facilities or equipment, climbing walls, bouldering areas, landing pits, floors below
climbing areas, work-out areas, bathroom facilities, or stairs;
2. Risk associated with crossing, climbing, or down-climbing;
3. Misuse of equipment or facilities, or failure of equipment;
4. The risk that my health and physical strength, coordination, sense of balance, and ability to follow or give directions while climbing,
belaying, or working out may not be sufficient to practice safely the sport of indoor rock climbing;
5. Fatigue, chill and/or dizziness, which may diminish my/our reaction time and increase the risk of accident;
6. Abrasion with bouldering wall texture and hold's texture;
7. The presence, actions, or falls of other participants.

I understand the description of these risks is not complete and that other unknown or unanticipated risks may result in injury, illness, or
death.

HEALTH AND PHYSICAL CONDITION

I confirm that I am in proper physical condition and I suffer from no personal health issues nor am I taking any medication, vitamins or
supplements that prevent me from participating in the activities of FIT ROCKS CLIMBING GYM INC.

ASSUMPTION OF RISK
I assume the risk(s) of personal injury, accidents and/or illness, including but not limited to: sprains, torn muscles and/or ligaments;
fractured or broken bones; eye damage; cuts, wounds, scrapes, abrasions, and/or contusions; dehydration, oxygen shortage (anoxia),
exposure and/or altitude sickness; head, neck, and/or spinal injuries; shock, paralysis, and/or death.

AGREEMENT TO ABIDE BY THE RULES AND REGULATIONS

I agree to abide by the rules and regulations of FIT ROCKS CLIMBING GYM INC., which are posted on the gym floor and on our
website, and I acknowledge having red and understood the rules and regulations. A written copy of the rules and regulations will be made
available upon request.

FIT ROCKS CLIMBING GYM INC. reserves the right to refuse access to any climber who does not conform with our rules and
regulations or who demonstrates an unsafe attitude toward safety in indoor climbing while at FIT ROCKS CLIMBING GYM INC.

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Please read the citations below and sign your initials in the space provided to indicate that you have read and accepted
the statements.
* "I have read and understood the foregoing acknowledgment of risks and assumption of risk and responsibility and that I will abide by
the rules and regulations of FIT ROCKS CLIMBING GYM INC."

* "I hereby acknowledge and agree that I will indemnify and save harmless FIT ROCKS CLIMBING GYM INC., it's directors, officers,
employees and agents from any and all liability for any injuries I may suffer as a result of any negligence or error on my part."

* "I hereby acknowledge and agree that I have viewed the Mandatory Safety Video of FIT ROCKS CLIMBING GYM INC., that is
provided on their website at "www.fitrocks.ca/waiver" and understand my responsibility to maintain safety while at Fit Rocks Climbing
Gym."

Please sign on the bottom of this page to indicate your acknoledgment and acceptance of the risks as stated in this document.
I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT,
AND I AGREE TO BE BOUND BY ITS TERMS.

Parent(s) or Court-Appointed Legal Guardian(s) must sign below for any Valeria Ruiz Macias and
agree that they and the minor are subject to all the terms of this document, as set forth above.

Signature of Parent(s)
(or Legal Court Appointed Guardian)
Parent/Guardian Name Renato Ruiz De Lara
Date November 18, 2023

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