I recognize that there is an element of risk involved in any adventure, sport, or activity associated with the outdoors. I am also fully cognizant of all the risks and dangers inherent in rock-climbing (bouldering and top-roping) and adventure competitions. Knowing of the inherent risks (specifically risk of loss, damage, injury, and/or death in any and all activities associated with the Phoenix Bouldering Contest ), dangers and rigors required of said activities. I certify that I or any person for whom I am signing, including minor children, is fully capable of participating in the said activities. Therefore, I assume full responsibility for the personal injury to myself or any person for whom I am signing, including minor children, for loss or damage to person and personal property and any expenses thereof as a result of my or their negligence with respect to said activities except to the extent such damage or injury may be due to the negligence of Phoenix Climbing Competitions, Inc. I further understand that Phoenix Climbing Competitions, Inc. reserves the right to refuse participation for any person it judges to be incapable of meeting the rigors and requirements of participating in either the rock-climbing (bouldering and top-roping) and adventure competitions.

Name (please print): _______________________________________________________

Signature: _______________________________________________________________ 

Date:____________________________________.

Name (please print):_______________________________________________________

Relationship: _______________________________________________________________ 

Signature: _______________________________________________________________ 

Date ___________________________________.

Subscribed and sworn to before me by __________________________________, 

this _____ day of ___________________, 2001.

___________________________________ My Commission Expires: