Novice Adult Participation Waiver Slough Climbing Wall

This form is for a novice or beginner adult (18+) wishes to participate in climbing activity supervised by qualified instructor, for example taster session, private lesson, course for beginners.

Signee Information

First Name *

Last Name *

Your Date of Birth *

Phone *

Email Address *

Address*

Town*

Post code*

Emergency person name*

Emergency person contact mobile number*

Do you have disability or medical conditions, that you think we should be aware of, as they may affect climbing activity (please provide details)*

I read and understood 'THE BMC PARTICIPATION STATMENT'*

The BMC recognises that climbing and mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions.

I read and understood Climbing Club Kuluar Terms and Conditions*

https://u-scale.co.uk/pages/terms-conditions

How did you find out about our climbing wall

Supervisior details

This section is ONLY for qualified competent climbers who may supervise you. Please leave this section blank, unless asked by the staff member.

Supervisor name

Leave it blank unless asked by the staff member.

Supervisor declaration

I am qualified as a competent climber by the Climbing Club Kuluar staff member and I will supervised the adult novice named above. I am taking full responsibility for this novice adult safety as a supervisor.

Child/Youth Information:

Add Another Name

Click here to sign

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.