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We opted for a day trip out on one of our days at Hedonism III. I'd imagine most other resorts have something similar. I think our driver was permanently stoned, and the driving style was an adventure in itself!
Nevertheless, we reached the falls safely and managed to avoid most of the people trying to sell stuff. It was fairly crowded, but that's to be expected with a major tourist attraction. We did notice some people trying to climb by themselves without guides, and truly, I wouldn't recommend it. For one, being with a group is more secure. You basically form a human chain to climb up and follow where the person ahead of you steps, as directed by the guides. I didn't see one single person slip in our group, which was amazing, considering the general lack of athletic ability! Plus, the general camaraderie is fun--there are people from all over the world trying to do this. I was holding on to a Chinese guy's hand and my partner was hanging onto another non-English speaker on the other side.
Do choose your footwear carefully--if you have "pool socks", bring them or buy some. Regular sports shoes are difficult when they get wet, and sandals don't protect enough from the sharp rocks. Definitely don't wear anything that might slip off! It will be down the falls and gone in seconds.
Our guide held on to all the cameras for the group, and we stopped several times on the way up for him to take pictures of each couple/group/family. It was quite good, as the camera surely would have gotten drenched if one of us held onto it, and we got some nice photographs. They'll try to get you to do silly stuff like kiss or fall backwards into the small pools--it's all part of the fun.
Overall, this is a highly recommended activity for most ability levels.
From journals
A Hedonistic Trip to Jamaica