A.C.G. Participant Form For Adaptive Climbers/Volunteers - New York City
This is registration for Adaptive Climbing Group's indoor climbing sessions in New York City. Other sessions and Special events can be found on the calendar at www.adaptiveclimbinggroup.org

**YOU MUST SIGN UP FOR A CLIMBING SESSION AT LEAST 24 HOURS BEFORE THE START TIME.**

Cost for participants are a $10 dollars. This is a 501(c)(3) tax deductible donation to the American Alpine Club to keep climbing accessible and affordable. Payment can be made at the front desk of the facility.

__________________________________________________________________________________________________________
*** ATTENDANCE POLICY
We want to make sure that we respect the time of the volunteers, just like we respect yours, therefore 3 no shows without email communication will lead to suspension from ACG climbing sessions for one calendar month. 
__________________________________________________________________________________________________________
****ADAPTIVE CLIMBING GROUP ZERO TOLERANCE POLICY***

Adaptive Climbing Group (ACG) welcomes all people (cis and trans) and non-binary folks to join us in ACG programming. Our goal is to create and maintain a safe and diverse space where consent and respect are our first priorities. Harassment of any kind (unwanted contact, verbal or physical abuse, racism, homophobia, transphobia, body-shaming, etc.) will NOT be tolerated. As such, assigned program leaders are allowed to ask an individual(s) to leave a session if a formal complaint is made.

Harassment is defined as any unwanted physical or verbal conduct that offends or humiliates the recipient, that interferes with their ability to work and learn or leads to adverse organization-related consequences, and that any reasonable person ought to have known would be unwelcome. It does not include the legitimate exercise of supervisory authority regarding reviews, evaluations, or valid disciplinary measures.

It may include direct or implied threats of dismissal, loss of sponsorship/position, or may create an intimidating, hostile, or offensive program setting. Examples of harassment include, but are not limited to, racial or sexual slurs, name calling, racist or sexist jokes, negative stereotyping, physical assault, bullying, threats, demeaning pictures, posters and graffiti.

Harassment includes the following categories of behavior, whether the behavior occurs once or many times:

a) Discriminatory behavior. Discrimination refers to treating people differently, negatively, or adversely because of one or more of the following prohibited grounds of discrimination: race, color, ancestry, place of origin, political belief, religion, age, sex, sexual orientation, marital status, family status, physical or mental disability, or pardoned criminal conviction.

b) Personal harassment. Personal harassment includes objectionable conduct, comment, or display made on either a one-time or continuous basis that demeans, belittles, or causes personal humiliation or embarrassment on the part of the recipient. It may or may not be linked to discriminatory behavior.

c) Sexual harassment. Sexual harassment refers to any conduct, comment, gesture, or contact of a sexual nature, whether on a one-time basis or a series of incidents, that might reasonably be expected to cause offence or humiliation or that might reasonably be perceived as placing a condition of a sexual nature on employment, an opportunity for training or promotion, receipt of services, or a contract. Examples of behavior that can constitute sexual harassment include, but are not limited to:  unwanted touching, patting or leering.

If an accused violator of the above policy feels they were wrongly asked to leave/dismissed, they may appeal the temporary suspension to the ACG Program Director. The suspension will proceed pending an investigation until a final resolution is made.

By signing up for one of our sessions, you are hereby acknowledging that you have read and accepted the above policy and the consequences of violation of the Adaptive Climbing Group Zero Tolerance Policy.

Sign in to Google to save your progress. Learn more
Email *
Climber's First Name: *
Climber's Last Name: *
I  acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing. I further acknowledge that Adaptive Climbing Group, a program of the American Alpine Club has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.I further acknowledge that Adaptive Climbing Group can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, salon staff, and other salon clients and their families. I voluntarily seek services provided by Adaptive Climbing Group and acknowledge that I am increasing my risk of exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment. I attest that:* I am not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.* I have not traveled internationally within the last 14 days.* I have not traveled to a highly impacted area within the United States of America in the last 14 days.* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.* I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.* I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.I hereby release and agree to hold Adaptive Climbing Group harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of this program, or that may otherwise arise in any way in connection with any services received from Adaptive Climbing Group. I understand that this release discharges Adaptive Climbing Group from any liability or claim that I, my heirs, or any personal representatives may have against this organization with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any events attended of Adaptive Climbing Group. This liability waiver and release extends to the Adaptive Climbing Group together with the American Alpine Club, all partners, and all employees. *
Have you had any of the following new symptoms in the past 7 days? *
Required
Have you had or will you have any “high-risk” exposures in the 2 weeks leading up to the event? *
If you answer yes, please consider the effect you have by coming into contact with others and reconsider coming on a different day.
Required
Is this your first time participating in an Adaptive Climbing Group weekly session? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Adaptive Climbing Group. Report Abuse
Google Forms