Xtreeme Challenge LLC
Participant Agreement, Release and Acknowledgement
of Risk Form
consideration of the services at Xtreeme Challenge LLC, their agents,
officers, volunteers, participants, employees,
I acknowledge that participation in Adventure Learning
activities, and/or the use of Challenge Course Activities
I expressly agree and promise to accept
and assume all of the risks existing in this activity.
My participation in this
of "Challenge By
Choice" and that I have the right to not participate in any
activity during the event.
hereby voluntarily release, forever discharge, and agree to indemnify
and hold harmless the XC from any and all claims, demands, or causes of
action, which are in any way connected with my participation in this
activity, or my use of XC equipment or facilities.
Should the XC, or anyone acting on their behalf, be required to
incur attorney’s fees and costs to enforce this agreement, I agree to
indemnify and hold them harmless for all such fees and costs.
I certify that I have adequate insurance to cover any injury or
damage I may cause or suffer while participating, or else I agree to
bear the costs of such damage or injury myself.
I further certify that I have no medical or physical conditions,
which could interfere with my safety in this activity, or else I am
willing to assume - and bear the costs of - all risks that may be
created, directly or indirectly, by any such condition.
In the event that I file a lawsuit against the XC, I agree to do
so only in the state of NC, and I further agree that the substantive law
of that state shall apply in that action without regard to the conflict
of law rules of that state. I agree that
I am aware that the XC requires st
By signing this document, I acknowledge
that if anyone is hurt or property is damaged during my participation in
this activity, I may be found by a court of law to have waived my right
to maintain a lawsuit against the XC on the basis of
OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (if under 18)
consideration of ____________________________(print minor’s name)
(“Minor”) being permitted by the XC to participate in it’s
activities and to use it’s equipment and facilities, I further agree
to indemnify and hold harmless the XC from any and all Claims which are
brought by, or on behalf of Minor, and which are in any way connected
with such use or participation by Minor.
Parent or Guardian Signature
if different:_______________________________ Phone if