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Consent to Treatment and Model Release Form

I,

, hereby consent to any hospital

care or medical or surgical diagnosis or first aid activities with a Mountain Skills Climbing Guides, Inc. and its agents, if I am not able at that time to give my written consent due to unconsciousness, disorientation or other mental incapacity. I also understand and agree that I am solely responsible for all appropriate charges for such services and that Mountain Skills Climbing Guides, Inc. and its agents are under no duty to provide any first aid or medical treatment in any event.



Consent to Treatment (Minors)

I authorize Mountain Skills Climbing Guides, Inc. personnel to call for medical care for the minor or to transport the minor to a medical facility or hospital if, in the opinion of such personnel, the minor needs medical attention. I further authorize appropriate personnel to render such medical treatment as is necessary for the health of the minor, in their professional opinion. I agree that once the minor is in the care of medical personnel or a medical facility, Mountain Skills Climbing Guides, Inc. shall have no further responsibility for the minor and I agree to pay all costs associated with such medical care and transportation.



Model Release

I authorize and release to Mountain Skills Climbing Guides, Inc. the use of my image in any photograph or video recording for any purpose of Mountain Skills Climbing Guides, Inc.



Rental Equipment Release of Liability

I accept for use as is the equipment listed on this form. I realize that the listed equipment can fail and can be used for activities which can cause injury or death, and agree not to hold Mountain Skills Climbing Guides, Inc. or its guides liable if such an accident involves the use of the rented equipment.



Rock climbing involves risk of serious injury and/or death!

Make sure you prepare yourself and that you are in shape for the course or trip you sign up for.