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Free Adaptive Climbing · 501(c)(3) Nonprofit
Courageous Kids Climbing
Participant Application

Participant Application

Apply to Participate

Complete this application and liability release to register for any Courageous Kids Climbing event. There is no cost to participate — just fill out the form below and our team will follow up with next steps.

Please note: this online form does not replace the paperwork required by the host climbing gym. Families will still need to sign a separate liability waiver provided by the climbing facility on the day of the event.

Participant Information
Gender
Event Information
Session
May we take photos of the participant? (Photos may be shared on social media.)
Emergency Contact
Medical Information
Liability Release & Signature

Indoor and Outdoor Rock-Climbing Participants Hold Harmless and Acknowledgement of Risk Agreement

There are risks associated with rock wall climbing, but we will make every effort to eliminate those risks. You understand that your climber will be required to wear a climbing harness that fits snuggly around the waist and the upper thighs and may be required to wear a chest harness. A limited supply of climbing shoes may be available. Not all climbers will be able to borrow a pair. If the climber should be allowed to wear a pair, you understand that these are designed to be worn tight on the feet. You understand that one care-giver shall remain on site during the entire event to assist with the climber's needs as they arise. You understand that if at any time the staff of this event feel that it is in your climber's best interest that the climber not climb, they will not be allowed to climb. The safety of your climber is our number one priority. You will be required to sign a waiver for your climber for the hosting climbing gym and CKC. If either waiver is not signed, your climber will not be allowed to participate in the event. Friends and family attending will also be required to complete a waiver(s). After the event is over, should your climber want to continue to climb, you will need to pay regular admission and equipment rental fees to the climbing gym. You are encouraged to watch and encourage your climber and feel free to ask questions. No food or drink is allowed in the climbing area. Due to limited space, the first priority is to accept climber's with a disability. Open slots may be made available to siblings the day of the event.

1. Courageous Kids Climbing (CKC) participants understand that recreational activities, to include but not limited to indoor / outdoor rock climbing, slacklining and ice skating, do have inherent risks which are beyond the control of CKC and its staff including Jeff Riechmann, volunteers, members and the hosting facility. We, the undersigned, do understand that upon participating in any CKC-sanctioned event, that we hereby assume all risks for the behavior, actions, and safety of myself, my minor child or children while involved in the activities. 2. In consideration for being permitted to participate in a CKC-sanctioned event, I acknowledge that I assume full responsibility for my safety. I further understand that I participate at my own risk, and I agree to hold CKC, its officers, employees, etc., harmless from every and all claim which may arise from injury, which might occur from my participation in a CKC-sanctioned event in favor of myself, my heirs, representatives or dependents. I understand that CKC does not represent or warrant the quality or character of any equipment or services provided. 3. I have read and understand this agreement and release of liability and do voluntarily agree to sign. While on the premises of any CKC-sanctioned event, my family and I agree to act with Caring, Honesty, Respect and Responsibility. 4. CKC reserves the right to use photographs and flash video taken during CKC-sanctioned events and activities for marketing and promotional purposes, including social media, unless noted otherwise above. 5. I HAVE CAREFULLY READ THIS AGREEMENT. I FULLY UNDERSTAND ITS CONTENTS AND SIGN IT OF MY OWN FREE WILL. THIS IS A RELEASE OF LIABILITY. DO NOT SIGN THIS AGREEMENT IF YOU DO NOT UNDERSTAND OR DO NOT AGREE WITH ITS TERMS.