Registration – Hard Warrior

Personal Information #1

Name *

Email Address *

Phone *

Street Address *

Apartment, suite, etc

City *

State/Province

ZIP / Postal Code

Country *

Date of Birth *

Day

Month

Year

Gender at Birth *MaleFemale

Meal Preference *

AllergiesState any allergies and the reaction

Other Medical InformationAdd any other medical information

Swimming Ability *Non Swimmer: Cannot stay afloat in Water. Need a floating aid.Moderate: Can move around in water but cannot stay afloat for long. Do not need a floating aid.Good: Can swim 50m under 1 min and retrieve an object 3m under water. Do not need a floating aid.

In consideration of the services of Vertical World Ltd, its agents, employees, trustees, officers, contractors and all other persons or entities associated with it (referred to below as ‘VW’), I agree and acknowledge as follows:

Although VW has taken reasonable steps to provide me with appropriate equipment and skilled staff for the activity for which I have applied, I acknowledge that the activities of the program have risks, including certain risks that cannot be eliminated without destroying their unique character.
Those same elements can cause loss or damage to my equipment, accidental injury, illness, or in extreme cases, permanent trauma, disability or death.
I understand that VW thinks it is important for me to know in advance what to expect and to be informed of the activities’ inherent risks. I have been informed in the briefing about the risks involved in the activities and I agree to assume responsibility for the inherent risks of the activities for which I have chosen to participate in.
My participation in this activity is purely voluntary, no one is forcing me to participate, and I elect to participate in spite of and with the knowledge of the inherent risks.
I agree to take full responsibility for all equipment entrusted to me. I understand that I may be charged for all equipment lost or damaged through my negligence. This excludes any normal wear and tear through normal usage of the equipment.
In the event of injury or illness during the Activity, you authorise VW to obtain and administer first and and emergency medical treatment on your behalf, if necessary.

AGREEMENT OF INDEMNITY AND RELEASE

I (referred to as “I” or “me” in the paragraphs which follow), or, if I am under the age of 18, my parents or guardian (referred to as “we”), for themselves and on my behalf, agree as follows:

To release and discharge VW, from all claims, liabilities and losses whatsoever asserted by or on behalf of me, or by my parents or guardian, in any way arising from or connected with my enrolment or participation in an activity of VW (including transportation and occurrences to and from the activity).
I (or we) understand that in signing this document, I (or we) surrender our rights to make a claim or file a lawsuit against VW for personal injury, property damage, wrongful death, products liability (including strict liability), or under any other legal theory, except in cases of intentional wrongs or the gross negligence of VW.
To defend, hold harmless and indemnify VW from any claim, and from any liability, loss, damages or expenses (including attorney’s fees) resulting from a claim, brought by a fellow participant, rescuer or any other person for loss or damage caused in whole or in part by my conduct.

Emergency Contact Name *

Emergency Contact – Phone Number *