MEMBERSHIP AGREEMENT MEMBER INFORMATION

MEMBERSHIP AGREEMENT
OFFICE USE ONLY
MEMBER INFORMATION
Payment
First Name
Last Name
Address
City
Primary/Cell/Home Phone
Work Phone
Setup
Approval
MI
State
Date of Birth
Zip
Member Email (email addresses are not shared/sold)
Emergency Contact
Emergency Phone
Gender
Relation
MEMBERSHIP DETAILS
Individual Membership:
Type:
__
Family
Membership:
_ Price________
Family*:
Member Name ______
o Individual First Up Annual
$400
o
1st Family
o Student First Up Annual
$350
o
2nd Family
o Family First Up Annual
$700
o
3rd Family
o Individual VIP Lifetime
$2500
o
4th Family
o Family VIP Lifetime
$5000
(primary listed above)
MEMBERSHIP TERMS
This is a special promotion, pay-in-full membership. Members receive unlimited visits for yoga and climbing*. All memberships officially
begin on opening day. Members may receive special invites to pre-opening events or tours. First Up annual memberships expire one-year
from opening day.
First Up annual memberships are renewable at this special “First Up” rate as long the membership is renewed consecutively each year and
remains in good standing. VIP Lifetime memberships do not expire.
All memberships are non-transferable and non-refundable.
Climb UP, LLC has the right to revise membership terms, rules, hours, and programs. Reservations are required for yoga sessions and
other classes.
Annual memberships may be placed on hold for up to 3-months with prior notification given. Members must complete a Membership Hold
Request form.
See Appendix A (attached) for complete list of benefits and inclusions.
All participants are required to have a valid Assumption of Risk / Waiver of Liability on file. All participants are required to abide by the Climb
Up Rules (document on file and posted in gym).
*Not included in these memberships are kids’ programs/yoga, rental equipment, other specialized training sessions.
AUTHORIZATION FOR PAYMENT
I hereby authorize Climb UP, LLC. to charge the Credit Card, Checking or Savings Account named below, and/or adjustments for
entries made in error. I hereby authorize the financial institution named below to credit and/or debit the same to such account.
Name on Card/Account
BILLING Address on Card/Account (if different)
Credit Card Number
Credit Card Expiration Date
any debit
BILLING Phone on Card/Account (if different)
OR INCLUDE CHECK OR MONEY ORDER made out to
Climb UP, LLC
CCV Code
SIGNATURE
I have been advised of the Terms and Conditions of Membership and fully understand the Membership Agreement.
Member Signature
Date
Parent/Guardian Signature
CLIMB UP, LLC. • 2701 WASHINGTON DR • NORMAN, OK • 73069
Phone: 405-310-4648 • http://climbupgym.com
Date
v100314
MEMBERSHIP DETAILS – APPENDIX A
VIP Lifetime Member benefits include:
o Bring a guest for free EVERY visit – All participants must have a valid waiver on file. Rental gear is not included.
o 15% off pro-shop gear
o Early enrollment in classes and programs - Reservations are required. Ages: walking toddler and up.
o Free while-you-climb child care for one year - Reservations are required. Ages: walking toddler and up.
o Discounted group/party rates – Standard member rates apply.
o Free locker usage – Permanent locker.
o VIP opening party invitation
o Exclusive invitations to pre-opening tours and events
With your VIP Lifetime Membership you will receive:
o Limited edition metal membership card
o Climb UP “First Up” Member shirt
o Custom Climb Up chalkbag
VIP Family Lifetime Member benefits include:
o This membership is good for up to 4 related household family members! - All participants must have a valid waiver on file.
Rental gear is not included.
o Family can bring one guest for free EVERY visit (this is one guest per family, not per family member)
o 15% off pro-shop gear
o Early enrollment in classes and programs - Reservations are required.
o Free while-you-climb child care for one year - Reservations are required. Ages: walking toddler and up.
o Discounted group/party rates - Standard member rates apply.
o Free locker usage – Permanent locker (one locker per family).
o VIP opening party invitation
o Exclusive invitations to pre-opening tours and events
With your VIP Lifetime Family Membership each member will receive:
o Limited edition metal membership card
o Climb UP “First Up” Member shirt
o Custom Climb Up chalkbag
First Up Annual and Student Member benefits include:
o Keep this same rate for membership renewal as long as you maintain your membership! – Must renew by expiration date.
o Purchase today, your annual membership term begins opening day – Currently slated for end Nov/early Dec.
o Bring one guest for free each month - All participants must have a valid waiver on file. Use it or lose it.
o 10% off pro-shop gear
o Early enrollment in classes and programs - Reservations are required.
o Discounted group/party rates - Standard member rates apply.
o Free locker usage – Daily usage
o Opening party invitation
o Exclusive invitations to pre-opening tours and events
With your Annual Membership you will receive:
o Wood membership card
o Climb UP “First Up” Member shirt
First Up Annual Family Member benefits include:
o Keep this same rate for membership renewal as long as you maintain your membership! – Must renew by expiration date.
o Purchase toady, your annual membership term begins opening day – Currently slated for end Nov/early Dec.
o Bring one guest for free each month (per family) - All participants must have a valid waiver on file. Use it or lose it.
o 10% off pro-shop gear
o Early enrollment in classes and programs - Reservations are required.
o Discounted group/party rates - Standard member rates apply.
o Free locker usage – Daily usage
o Opening party invitation
o Exclusive invitations to pre-opening tours and events
With your Annual Family Membership you will receive:
o Wood membership cards
o Climb UP “First Up” Member shirt
* These benefits are exclusive to the VIP Lifetime and First UP Annual members and not transferrable to other individuals. Climb UP,
LLC has the right to revise membership terms, rules, hours, and programs.
Climb UP Rules
Please read the following rules of the gym. You are responsible for understanding and abiding by
these rules. Please ask a member of Climb Up’s staff if you do not understand something.
• For each visit, all climbers will check in at the front desk upon arrival. If you have an address
change, please let us know.
• All climbers and belayers must sign all parts of the release before participating and complete a
gym orientation.
• Before being allowed to belay, individuals will be tested for proficiency by Climb UP staff for
knowledge of the following: proper belaying (managing the rope for a climber), knot tying,
climbing commands and equipment checks. Belaying without being tested will result in loss of
climbing privileges. The minimum age for belaying at Climb UP is 13.
• Climb UP staff must test all lead climbers and lead belayers for proficiency. Lead climbing
ropes may be rented. If you wish to use your own, a separate waiver must be signed.
• Boulderers are responsible for providing their own spotter. It is recommended that climbers 13
and under only boulder as high as they are tall.
• Only climbing equipment approved by Climb UP staff is to be used in the climbing facility. All
belayers must belay directly off of their harness.
•
Loose chalk is not allowed in the gym. Chalk balls only!
•
For insurance purposes, no instruction is allowed except by a member of Climb UP.
• Climber and belayer must always double-check each other’s systems before each and every
climb.
• When using the auto belays you may only climb an arms width to either side of the point where
the auto belay is anchored at the top of the wall.
• A parent or adult guardian must accompany climbers 13 years old or younger at all times unless
lessons are scheduled.
•
No horseplay! No running, yelling, jumping or swinging on ropes.
• No alcohol, drugs, or tobacco allowed. Anyone suspected of being under the influence will not be
permitted in the gym. No foul language on Climb UP premises. No chewing gum for safety reasons.
Food and open drinks are not allowed on padded surfaces.
• Personal items are not allowed on padded surfaces. Water bottles, bags, etc., should be stored in
cubbies or lockers.
• Management has the right to suspend or terminate any participant’s membership for violation of
the gym policies and/or rules. In such a case, there will be no refund of any fees. Rules are subject to
change and will be enforced by Climb UP staff.
•
Any injuries or damaged equipment must be reported to Climb UP staff.
• These are not all of the gym’s policies. Participants are responsible for reading additional policy
information posted in the gym.
.
2701 Washington Drive, Norman, OK 73069 http://climbupgym.com EXPRESS ASSUMPTION OF RISK, WAIVER OF LIABILITY, RELEASE,
COVENANT NOT TO SUE AND INDEMNITY AGREEMENT
NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. PLEASE READ CAREFULLY.
I desire to participate in one or more activities or programs (each individually an “Activity”; collectively, “Activities”) offered, operated,
sponsored or directed by, or otherwise involving, Climb UP, LLC d/b/a Climb Up Fitness & Yoga (“Climb UP”). The Activities may occur in
whole or in part at the climbing and recreation facility (the “Facility”) located at 2701 Washington Drive, Norman, OK 73069 operated by Climb
UP. The Activities may involve, without limitation, rock climbing (including but not limited to climbing on artificial surfaces, outdoor instruction,
and expeditions) and other recreational activities, programs, events, instruction, and classes both inside and outside the Facility and with or
without supervision of Climb UP or any of its employees, contractors or personnel (collectively, “Personnel”). I understand that each Activity
poses inherent and extreme risks. With full knowledge and understanding of these risks, and in consideration of my use of the Facility and
participation in Activities, I acknowledge and agree as follows:
1. Acknowledgement and Assumption of the Risk
I acknowledge that participation in Activities, use of the Facility and any services provided by the Facility or Personnel subjects me to risks of
personal injury (including but not limited to death or paralysis) from various causes, including but not limited to falling from climbing walls or gym
apparatus; contact with walls, equipment, landing areas and other climbers, belayers, or objects; rope abrasion; rope entanglement; falling climbers;
dropped items; cuts and abrasions resulting from skin contact with ropes, climbing hardware and climbing walls; loose or damaged holds; failure of
ropes, slings, helmets, harnesses, shoes, climbing hardware, anchor points, belay devices, or any part of climbing wall or gym apparatus structures;
the use of exercise equipment and free weights; participation in group exercise classes; negligence of others, such as failure to maintain control over
climbing equipment or other climbers or to act within their ability; or other causes and accidents not specified herein, whether or not foreseeable. I
also acknowledge the risk that my personal property (including but not limited to vehicles or their contents or personal property placed in lockers)
may be damaged, lost or stolen while I am at the Facility or participating in Activities.
I understand and acknowledge that:
A.
B.
C.
D.
The above list is not inclusive of all the possible risks to which I will be subject during Activities and in using the Facility and that the list in
no way limits the extent or reach of this Waiver of Liability and Covenant Not to Sue (this “Agreement”) or any provision of this
Agreement.
Climbing at the Facility is not the same as climbing outdoors or on other artificial rock surfaces. I understand that any instruction I may
receive at the Facility or in connection with any Activity is not necessarily applicable to other real or artificial rock climbing and that such
instruction does not prepare me to climb without supervision.
While wearing a helmet while climbing in the Facility is not required, I assume additional risks of possible injury and death by not wearing a
helmet. I understand that I may request a helmet from the Facility and the Facility will provide one for my use. Gym users are encouraged
to use helmets at all times when climbing or belaying other climbers. I understand that helmets may reduce or mitigate the severity of head
injuries but are in no way a guarantee of safety. I further recognize that helmets have limited capability as far as shock absorption and that
serious injury or death can result from both low and high-energy impacts, even when a helmet is worn.
If I rent equipment through the Facility, I accept the equipment rented “AS IS”, I accept responsibility for the care of the equipment during
the rental period and agree to be responsible for the replacement at full value of any equipment that I do not return or that I return in
damaged condition. I understand that climbing gear could become damaged or defective. I am capable of examining and assessing all
equipment that I use. If damage occurs to equipment belonging to Climb UP while I am using it, I will promptly bring it to the attention of
appropriate Personnel so they can evaluate the equipment.
I VOLUNTARILY ASSUME ALL OF THE RISKS ASSOCIATED WITH PARTICIPATION IN ANY ACTIVITY OR USE OF THE FACILITY,
INCLUDING BUT NOT LIMITED TO RISK OF INJURY, PARALYSIS AND DEATH. I VOLUNTARILY ASSUME ALL SUCH RISKS WITH
FULL KNOWLEDGE, UNDERSTANDING AND APPRECIATION OF THE RISKS INVOLVED.
2. Waiver of Liability, Release and Covenant Not to Sue
I, on behalf of myself, my heirs, representatives, executors, administrators and assigns, hereby knowingly and intentionally (A) waive any and all
liability of Climb UP and its successors, assigns, affiliates, owners, shareholders, officers, directors, landlords, members and Personnel (each
individually, a “Released Party”; collectively, “Released Parties”) for, (B) release Released Parties from, and (C) covenant not to sue Released
Parties for, any and all causes of action, claims, injuries, liabilities, damages or demands of any nature whatsoever, whether known or unknown,
anticipated or unanticipated, which I, my heirs, representatives, executors, administrators and assigns may now have, or may have in the future,
against any Released Party on account of any and all known and unknown, foreseen and unforeseen personal injuries, property damage, death,
paralysis or accident of any kind and whenever occurring, arising out of or in any way related to any Activity, any occurrence or event involving
the Facility, any Released Party or any service or program related to any thereof, whether such Activity, occurrence or event is supervised or
unsupervised and however and whenever any injury, property damage, death, paralysis or accident is caused (collectively, “Claims”). THIS
WAIVER OF LIABILITY, RELEASE AND COVENANT NOT TO SUE SHALL BE EFFECTIVE EVEN THOUGH SAID LOSS, DAMAGE, OR
INJURY RESULTS OR HAS RESULTED, OR ANY CLAIMS ARISE FROM, THE NEGLIGENCE, WRONGFUL ACTS, OMISSIONS,
BREACH OF WARRANTY, OR STRICT TORT LIABILITY OF ANY RELEASED PARTY. NOTWITHSTANDING THE IMMEDIATELY
PRECEDING SENTENCE, THIS WAIVER OF LIABILITY, RELEASE AND COVENANT NOT TO SUE SHALL NOT BE EFFECTIVE IN
REGARD TO LOSS, DAMAGE OR INJURY RESULTING FROM, OR ANY CLAIMS ARISING FROM, THE GROSS NEGLIGENCE OR
WILLFUL OR WANTON MISCONDUCT OF ANY OF THE RELEASED PARTIES.
3. Indemnification Agreement
I hereby agree to INDEMNIFY, HOLD HARMLESS AND DEFEND the Released Parties from and against any and all Claims and costs (including
but not limited to attorneys’ fees and costs incurred by Released Parties or any thereof) of any nature whatsoever, including but not limited to those
caused by the negligence, wrongful acts, omissions, breach of warranty or strict tort liability of any Released Party (except for those resulting from
the gross negligence or willful or wanton misconduct of any Released Party), arising out of or in any way relating to my use of the Facility or the
services provided thereby or my participation in any Activity.
____Initials_ _ 4. Miscellaneous
I certify that I am in proper physical and mental condition to participate in Activities and that I have no physical limitations that would preclude my
safely using the Facility and participating in Activities with the risks assumed. I agree to read and abide by all rules from time to time posted in the
Facility or otherwise communicated to me. I agree to comply with requests and instructions of all Personnel. In the event of an accident, if I
should be unconscious or otherwise unable to make medical decisions for myself, I hereby grant the Released Parties permission to administer
necessary first aid, and/or to solicit emergency medical services as deemed necessary. This authorization includes permission for emergency
medical transportation to the nearest medical facility for additional medical treatment.
I hereby voluntarily waive any right I may have to a trial by jury in any action, proceeding or litigation involving any Released Party. The laws of
the State of Oklahoma shall govern the rights and obligations of the parties to this Agreement and the interpretation, construction and
enforceability thereof. I agree that any lawsuit brought against any Released Party shall be brought solely in Cleveland County, Oklahoma. If
any portion of this Agreement is held invalid, the remainder shall remain in full force and effect.
I hereby grant to Climb UP, and Climb UP reserves, the right to use for promotional purposes any photographs taken at the Facility or during
any Activity. Such images may be used in Climb UP’s brochures, posters, website or other promotional materials without liability or payment.
I ACKNOWLEDGE AND AGREE THAT BY SIGNING THIS AGREEMENT I AM RELIEVING THE FACILITY AND ALL RELEASED
PARTIES OF ANY AND ALL LIABILITY FOR ANY LOSS, DAMAGE, INJURY OR DEATH RESULTING FROM ANY ACTIVITY AND
WAIVING MY RIGHT TO MAINTAIN A LAWSUIT AGAINST ANY OF THE RELEASED PARTIES, EXCEPT FOR ANY LIABILITY
BASED UPON THEIR GROSS NEGLIGENCE OR WANTON AND WILFULL MISCONDUCT. I CERTIFY THAT MY AGE IS
ACCURATELY SET FORTH BELOW; THAT, IF I AM AT LEAST 18 YEARS OF AGE, I AM LEGALLY COMPETENT TO SIGN THIS
AGREEMENT; I HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTAND THAT THE TERMS OF THIS AGREEMENT ARE
LEGALLY BINDING UPON ME AND UPON MY ASSIGNS, HEIRS, REPRESENTATIVES, EXECUTORS AND ADMINISTRATORS; AND
THAT I AM SIGNING THIS AGREEMENT, AFTER HAVING CAREFULLY READ IT, OF MY OWN FREE WILL.
IF PARTICIPANT IS UNDER 18 YEARS OLD –UNDERSIGNED PARENT/GUARDIAN CONSENT: I am the parent or legal guardian of the
undersigned one or more minors (whether one or more, the “Minor”) under 18 years of age and hereby consent to the Minor’s using the Facility or
participating in Activities, all as defined above. In consideration of permission to the Minor to use the Facility and participate in one or more
Activities, I agree, personally and on behalf of the Minor and any other parent or legal guardian of the Minor, to be bound by the terms and
conditions set forth in this Agreement. Without limiting the immediately preceding sentence, I expressly, personally and on behalf of the Minor and
any other parent or legal guardian of the Minor, (a) acknowledge and consent to the Minor’s assumption of the risks described above, (b) make and
enter into for the benefit of the Released Parties the agreements set forth above in Paragraph 2, entitled “ Waiver of Liability, Release and
Covenant Not to Sue” and (c) agree to indemnify, hold harmless and defend all Released Parties from and against any loss, damage, liability and
expense, including but not limited to costs and attorneys’ fees, incurred by any Released Party, as a result of the Minor’s using the Facility or
participating in any Activity. I represent that I am at least eighteen (18) years of age and legally competent to sign this Agreement.
A photocopy hereof, or a record of this Agreement sent and received by facsimile, email or other electronic transmission, shall be enforceable and
shall have full legal effect as an original.
IN WITNESS WHEREOF, this Agreement is duly executed this
day of
_,
.
ADULT PARTICIPANT AND SIGNATURE OF PARENT/LEGAL GUARDIAN
I AM AWARE THAT I AM RELEASING CERTAIN LEGAL RIGHTS THAT I OR MY CHILD(REN) OTHERWISE MAY HAVE.
ADULT PARTICIPANT /PARENT OR GUARDIAN – Print First Name, Last Name
x SIGNATURE
_
ADDRESS – Street Address/Mailing Address (please print)
City, State
Zip Code
_
DATE OF BIRTH (MM-DD-YYYY)
Phone Number
EMERGENCY CONTACT (other than the above signed)
E-Mail Address
RELATION
PHONE NUMBER
MINOR PARTICIPANT (UNDER 18) INFORMATION
*Requires signature of Parent or Legal Guardian in the Box Above
_____________________________________________________________________________________________________
MINOR PARTICIPANT #1 – First Name, Last Name (please print)
Date of Birth
______________________________________________________________________________________________________
MINOR PARTICIPANT #2 – First Name, Last Name (please print)
Date of Birth
The Minor Participant fields must be completed for the on-­‐line form. If you are not signing for a minor, please enter N/A in the fields. ______________________________________________________________________________________________________
MINOR PARTICIPANT #3 – First Name, Last Name (please print)
Date of Birth
Bolded Fields MUST be fully and legibly completed. Bolded Fields are NOT optional, even if adult or guardian is not participating.
Liability Waiver Climb UP ver.01 07/23/2014