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195 Adams St. Manchester, CT 06042

860-645-0015

Visitor and Participant Agreement

ENTER On-Line "Agreement" with E-mail Confirmation

This IS a Legal Document. The document must be completely & properly filled in (FULL LEGAL NAME). You must confirm by e-mail to authenticate the legal identity of the person signing the form. Under 18 – must be completed by the legal parent or legal guardian, using the parental email address (prompted at the end of the form). We may call you to confirm. EVERY PERSON MUST COMPLETE THIS FORM TO BE IN THE FACILITY, INCLUDING SPECTATORS.

You will need the latest version of abdobe reader (see link below)
We require this form to be updated yearly.

Common Mistakes

The minor completes the form or the minors e-mail is used for the confirmation/authentication.
Failure to use the participants full legal name as on a birth certificate or drivers license. 
Failure to complete all fields in the form or creating typos.
Failure to confirm via your e-mail account.

Important Notice Regarding Online Filing

In the case of a minor, it is illegal to knowingly submit a document or electronic filing on behalf of a person without having the legal authority to do so.

See Connecticut General Statutes $$33-616 and 34-109: 
Sec. 33-616. Penalty for signing false document. A person who signs or otherwise executes* a document he knows is false in any material respect with intent that the document be delivered to the recipient for filing as a legal document shall be subject to the penalty for false statement under section 53a-157b.

Sec. 34-109. Execution of documents. (d) the execution of any such document shall constitute an affirmation under the penalties of false statement by the person signing the document that the facts stated therein are true.

* Online filing requires electronic signature/execution. 

NOTE: A confirmation of every online filing is delivered to each party at its email address of record. Please monitor your emails from the Stone Age Rock Gym.

If you are looking for the Stone Age Climbing Gym - Albuquerque, New Mexico click this link. www.stoneageclimbinggym.com

* The "Stone Age Climbing Gym" waiver is not valid at the "Stone Age Rock Gym", and vise-versa.

Click here to Download Acrobat Reader
(neccessary to view and print waiver forms above)