PARTICIPANT AGREEMENT, RELEASE OF LIABILITY and ASSUMPTION OF RISK
Please read through carefully before signing. If you have any questions about this document please call, email or write to the address at the bottom of each page or talk to your guide on the day before signing or taking part in the activity.
Name: (Last, First, MI)
Date:
Email:
Home Phone:
Cell Phone:
Address, Line 1:
Address, Line 2:
City:
Zip Code:
In consideration of being allowed to participate in any way in the FOX MOUNTAIN GUIDES AND CLIMBING SCHOOL (Fox Mountain Guides, LLC) program, (hereinafter collectively referred to as “FMG”) its related events and activities, I, , the undersigned, acknowledge, appreciate, and agree that:
The risk of injury from the activities involved in this program is significant, including the potential for
permanent paralysis and death, and while particular skills, equipment, and personal disciple may reduce
this risk, the risk of serious injury does exist; and,
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF
ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full
responsibility for my participation, the following describes some, BUT NOT ALL, of the Risks: Rock fall;
Icefall; Avalanches; Electrical Storms; Mountain Storms; Snow; Ice; Rain; Hail; Sleet; Lightning; Falling;
Objects falling from above; Unstable or Loose Rock, Snow, Ice, Talus, Scree, Boulders, and/or other
Terrain; Slippery Terrain; Extreme Cold and Hot Temperatures; Dehydration; Wind; Failure of
Mountaineering Equipment despite reasonable care and use; Injury from Mountaineering Equipment
despite reasonable care and use; Careless or Reckless Behavior on the part of other members of the
group despite reasonable supervision; Guide Error; and Careless or Reckless behavior on the part of
third parties; and,
I willingly agree to comply with the stated and customary terms and conditions for participation. If,
however, I observe any unusual significant hazard during my presence or participation, I will remove
myself from participation and bring such to the attention of the Company immediately; and,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HERBY
RELEASE, INDEMNIFY, AND HOLD HARMLESS FMG, their officers, officials, agents and/or
employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners
and lessors of premises used for the activity (“Releasees”), WITH RESPECT TO ANY AND ALL
INJURY, DISABILITY, DEATH, or loss or damage to person or property associated with my presence or
participation, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR
OTHERWISE, to the fullest extent permitted by law.
Are there and physical or mental conditions for which you have received medical treatment or for which
you are currently receiving medical treatment? Please include RECENT SURGERIES, PROBLEMATIC
OLD INJURIES, and any MEDICATIONS you are currently taking and all ALLERGIES.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT,
FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP
SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY
WITHOUT ANY INDUCEMENT.
______________________________________
______________________
________________
(Participant's Signature)
(Date)
(Age)
FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that, I as a parent/guardian with legal responsibility for this participant, do consent and agree to
his/her release as provided above of all the Releasees, and, for myself, my child, and our heirs, assigns, and
next of kin, I release and agree to indemnify and hold harmless the releasees from any and all liabilities incident
to minor child’s involvement of participation in these programs as provided above, EVEN IF ARISING FROM
THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.