R12, 2022-02-22

NOTE: Clip 'n Climb Windsor does not accept paper waivers, please submit electronically.

Covid-19 Waiver and Acknowledgment, Hold Harmless and Release Agreement

From: Clip ’n Climb Windsor

To: Patrons of Clip 'n Climb Windsor (the “Facility”)

The Guest/Patron named below acknowledges that they are aware of the national emergency caused by the COVID-19/Coronavirus pandemic and the evolving nature of the health crisis, including the danger of community spread and risks posed to the health of those who contract COVID-19 /Coronavirus

In an effort to mitigate the effects of the Coronavirus outbreak, the Guest/Patron represents and agrees to the following when on the grounds of or inside the Facility:

Guest/Patron has completed and passed the COVID-19 Screening Tool Waiver & Release Form at https:\\ewaivers.ca\pages\cpa prior to attending the facility.

Guest/Patron will use their best efforts to minimize the health risk to themselves and to others in the Facility.

Guest/Patron agrees to notify the management of the Facility if they become aware of information that poses a potential health danger previously unknown to the Facility’s operation.

Guest/Patron agrees in all respects to comply with the most current COVID-19 guidance of the Windsor-Essex County Health Unit (WECHU), the Public Health Agency of Canada (PHAC) and the Ontario Ministry of Health (OMOH) when in line, entering or within the Facility.

Guest/Patron represents that they have read this acknowledgement in its entirety.


Assumption of Risk
By signing this acknowledgment the Guest/Patron understands that Facility staff and management cannot guarantee that the Guest/Patron will not contract COVID-19/Coronavirus at the Facility, and each Guest/Patron fully assumes any and all risks posed to the Guest/Patron that may result from Guest/Patron entering the Facility.

Acceptance of Policies

Guests/Patrons not adhering to the Facility’s guidelines and policies may be expelled from the Facility and grounds at management’s discretion. The Guest/Patron signature below is given freely and voluntarily; recognizing that the Facility’s management is relying on these truthful representations in running the business of the Facility and providing the services the Guest/Patron is seeking.


For Guests/Patrons of Minority Age (Under Age 18 at Time)

This is to certify that I, as parent/guardian/adult with responsibility for this Guest/Patron, have read and explained the provisions in this Covid-19 Waiver and Acknowledgment, Hold Harmless and Release Agreement to such Guest/Patron including the risks of the activity at the Facility and his/her responsibilities for adhering to the rules and regulations. Furthermore, such Guest/Patron understands and accepts these risks and responsibilities.



Acknowledgment, Hold Harmless and Release Agreement
In consideration for the limited license allowing the below-named person who is or will be entering and using any part of, or equipment located in, Clip 'n Climb Windsor for any activity (including visiting, eating, drinking, shopping, parking, participating, or coaching in any athletic activity or practice, or attending any birthday party or other celebration (individually or collectively, an “activity”)), I agree to pay the fees determined by Clip 'n Climb Windsor when due and to abide by any and all rules and regulations established by Clip 'n Climb Windsor or otherwise applicable to the Clip 'n Climb Windsor facilities. If I observe any unusual or significant hazard during my presence at Clip 'n Climb Windsor, I will immediately bring such to the attention of the nearest Clip 'n Climb Windsor employee. To the fullest extent permitted by law, I also release and hold harmless i) Clip 'n Climb Windsor, its parent companies and affiliates and each of such entities’ respective directors, administrators, members, officers, owners, officials, coaches, employees, volunteers, agents and assigns, and ii) any other participants or attendees (collectively, the “Releasees”) from any and all known and unknown liabilities, obligations, claims, demands, losses or damages that I, or my successors-in-interest or anyone claiming under me or them, may hereinafter have for all injuries, illnesses, damages, cost or expenses sustained or incurred by me or any other person or any of my property or the property of any participants during any activity.

By signing this release, I certify that I am aware of, and know of, the risks and dangers associated with any activity, including but not limited to damage or injury from trips, falls, collisions with others or objects, and/or acts or omissions of others (intentional or negligent) and I voluntarily assume all risk and dangers associated with participation in any activity whether in Clip’n Climb Windsor or anywhere else in the facility or parking lots. The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) from attending or participating in activities at Clip’n Climb Windsor are significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist. 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.

I have read, or had explained to me, this Acknowledgment, Hold Harmless and Release Agreement, fully understand its terms, have full authority to bind the same to this agreement, understand that I accept these risks and responsibilities and have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.


For participants of minority age (under age 18 at time)

This is to certify that I, as parent/guardian with legal responsibility for this participant, have read and explained the provisions in this Covid-19 Waiver and Acknowledgment, Hold Harmless and Release Agreement to my child/ward including the risks of the activity at Clip 'n Climb Windsor and his/her responsibilities for adhering to the rules and regulations. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s /ward’s involvement or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.

By submitting this Covid-19 Waiver and Acknowledgment, Hold Harmless and Release Agreement, I understand and consent to all the conditions outlined in this Covid-19 Waiver and Acknowledgment, Hold Harmless and Release Agreement and I consent to the use of my first name and last name that I will enter below as a participant (18 years of age or older) or parent/guardian to be used as an electronic signature in lieu of an original signature on paper.

Please select who will be participating:

First Minor's Information



Second Minor's Information



Third Minor's Information



Fourth Minor's Information



Fifth Minor's Information



Sixth Minor's Information



Participant's Address

I have read Clip 'n Climb Windsor Covid-19 Waiver and Acknowledgment, Hold Harmless and Release Agreement