Climbing Club Registration

The climbing club's gear has been ordered and is on its way. We are getting enough gear to be able to go out and do some awesome sport climbing in our local area.
We had our first meeting on Sunday, and had a good turn out. We also had leftover pizza, so we could stand to have more people at our next meeting, so don't forget to spread the good word about the climbing club.
We are going to be offering the first club only climbing clinic this Friday. The clinic is going to be an introduction to lead climbing and lead belaying, and the clinic is going to start at 6:30pm. Hopefully everyone can make it down to the SOU climbing gym to participate. In order to participate we need to have your registration information completed. If you did not get the email that we sent out last night then tuff! Actually the registration info will be at the bottom of this page, so you will be able to copy and past it into word and then print it off, fill it out, and bring it in on Friday night. We will also have a couple copies with us down there for people who forget or are just lazy like me. If you cannot figure out the copy and paste email sourockclub@gmail.com and we will send you the packet via email.
The design for the club shirts is just about completed, which mean you will be getting that soon. Also, Rogue Rock Gym has agreed to give club members a discount and we will tell you all about on Friday. We are still waiting to hear back from The Ashland Outdoor Store, Mckenzie Outfitters, Great American, and Northwest Pizza.

Enjoy the rain and we will see you at open climb today from 11 - 2!



Southern Oregon University
Rock Climbing Club
sourockclimbing@gmail.com
sourockclimbing.blogspot.com


Rock Climbing Club Registration Form

 $20 – Club Member (By checking this box you are committing to pay $20 for the club membership fee and volunteer for 10 hours during the current term)

Pay by(circle one): Cash / Student Account

*we are currently set up to bill your student account or take cash

Participants of the Rock Climbing Club will meet at the Outdoor Program Office during the first week of each term to renew their memberships and plan the terms trips.


Southern Oregon University Rock Climbing Club
Participants Name: __________________________ Phone: _______________________

Email: ______________________________ Student ID#: ________________________
(not ss #)

Emergency Contact info:___________________________________________________
name relationship phone

Doctor medical provider: ___________________________________________________
name phone

Insurance: _______________________________________________________________
provider policy #
Medical history and/or special instructions (known allergies, asthma, special medical conditions):
________________________________________________________________________________________________________________________________________________




Hold Harmless and Assumption of Liability Agreement
Notice: This is a legally binding contract between myself and the SOU Rock Climbing Club.
To the fullest extent allowed by law, I, ________________________, release from liability and agree to hold harmless the Southern Oregon University Rock Climbing Club and any of its officers, employee’s, and agents, for any injury’s I sustained or incurred, during the course of traveling to or from any SOU Rock Climbing Club sponsored club sport activity in any a motorized vehicle that is operated by another student, officer, employee or agent. This Hold Harmless Agreement covers and applies to all SOU Rock Climbing Club sponsored events and shall remain in affect as long as the above named is a part of the SOU Rock Climbing Club.
I understand that the SOU Rock Climbing Club requires all student drivers who transport other students to or from club sport activities to carry car insurance in accordance with state law.
Rock Climbing has inherent extreme risks and I, _______________________, herby acknowledge those risks including, but not limited to, falls from contact with walls and equipment, bad decision making, inattention of belayers or actions of other climbers, misuse or failure of equipment, holds which may have become loose or damaged, and other accidents. I acknowledge that the above list does not include all possible risks associated with rock climbing and participating in events sponsored by the SOU Rock Climbing Club. I,__________________, voluntarily except those risks and assume responsibility associated with those risks.
I voluntarily agree to assume all risk of injury or death that may occur while participating in SOU Rock Climbing Club events or climbing whether or not I am under supervision of the SOU Rock Climbing Club. From this date forth I waive, release, indemnify, and hold harmless the SOU Rock Climbing Club, its officers, members, and all other related persons from any and all claims, known or unknown, which I have or may have in the future, which is in any way connect to participating in SOU Rock Climbing Club sponsored activities. _______ (Initial)
I maintain that I am in good health and have no physical limitations that would prevent me from participating safely in SOU Rock Climbing Club sponsored events. I am committed to paying attention to the quality of all equipment I use with SOU Rock Climbing Club, and notifying its officers of any damage I do or notice in connection to the SOU Rock Climbing Club’s equipment or training facilities. I agree to comply with any specific request given to me by the SOU Rock Climbing Club officers, and I agree to receive additional instruction before attempting to climb outside because it requires additional skills and knowledge. _______ (Initial)
I have read the above Hold Harmless and Assumption of Liability Agreement and I agree to the above terms, conditions, and agree to comply with said terms and represent that by signing below.
Signature __________________________________ Date ________________________



VOLUNTEER DRIVER INFORMATION FORM

ONE DRIVER PER FORM

Please complete this form and return it to the Southern Oregon University Rock Climbing Club Coordinators. We appreciate your interest and the time it take to complete this application.


Print Driver’s Full Name ___________________________________________________
Address __________________________________________
Phone Number __________________ Driver License Number _____________ State___ Issued _________________ Expires ________________ Date of Birth ______________
Name of Insurance Provider ________________________________________________
Insurance Policy Number ___________________________________________________
License Plate Number _________________ Number of Seat Belts in Vehicle _________

I authorize a background check of my driving history.

Driver’s Signature ________________________________________ Date ___________