Loading...

ISLAND ROCK CLIMBING GYM - BOULDERING ORIENTATION VIDEO & FORM

YOU MUST COMPLETE THIS FORM AFTER WATCHING THE ORIENTATION VIDEO

Island Rock Gym, Inc. Bouldering Orientation Video & Form

Read this document carefully and in its entirety. This is a legally binding agreement that must be completed by all adult (ages 18 or older) participants, or by a parent or legal guardian for any participants under the age of 18. 

WARNING: CLIMBING IS DANGEROUS. THE POSSIBILITY OF GETTING INJURED CANNOT BE ELIMINATED FROM CLIMBING. YOU MUST BE WILLING TO ACCEPT AND MANAGE THIS RISK TO CLIMB. BOULDERING (UNROPED CLIMBING) INVOLVES EVEN MORE RISK BECAUSE YOU WILL FALL, FALLS CAN HAPPEN AT ANY TIME, AND ALL FALLS ARE GROUND FALLS WHICH CAN RESULT IN INJURY OR DEATH.


Bouldering Rules & Orientation:

All participants, and/or their parents or guardians, must have reviewed and fully executed the Participation Agreement, Assumption of Risk, Unconditional Release and Waiver of Liability, watched the Combo Bouldering and General Orientation video (the “Bouldering Orientation Video”), and reviewed the full waiver and facility rules – posted throughout the facility, in the video(s) viewed prior to filling out this document, and/or posted within this document, and/or any addendum(s) to this document

I understand that Climbing and/or Bouldering is a Dangerous Sport. The sport of climbing involves inherent and other risks, hazards, and dangers that can lead to serious injury to or death and damage and destruction to equipment and property. By choosing to engage in the sport of climbing, Participants accept and assume responsibility for their own safety and actions and any losses or injuries they suffer resulting from the inherent and other risks of the sport. I understand that the padded floor provided (where present) cannot and do not eliminate injury or death and is not a guarantee of safety.

My signature indicates that I understand the information above and agree that the climbing gym staff has presented to me the following information, which I will abide by at all times in accordance with facility policies:

The following activities and/or areas in the facility are age restricted:

  • Top Rope Climbing: Ages 4+ (min. age to climb at Island Rock)
  • Bouldering:
  • Ages 14+;
  • Ages 8-13 w/ mandatory parental and/or guardian supervision & spotting at all times 
  • Top Rope Belaying: Ages 15+
  • Lead Climbing: Ages 16+
  • Mezzanine Areas: Ages 15+

I Agree

Bouldering (un-roped climbing) Requirements, Rules, and Policies:

  • Bouldering is permitted in designated areas only, or no more than 4 feet in areas designated for Roped Climbing.
  • Boulderers must take responsibility for not climbing beyond their ability and ensuring their own safety in bouldering areas. Boulder at your own risk.
  • ALL FALLS WHILE BOULDERING RESULT WITH AN IMPACT WITH THE GROUND. Falls can happen at any time. This means that Bouldering comes with increased level of risks because YOU WILL FALL and ALL FALLS ARE GROUND FALLS, which can result in injury or death. 
  • The higher you boulder, the higher the risk – don’t climb beyond your comfort level.
  • Bouldering can result in serious injury(ies), including but not limited to:
  • death;
  • strains, sprains, dislocations, or fractures to muscles, bones, or soft tissue in or around feet, ankles, knees, legs, hips, torso, shoulders, arms, elbows, wrists, hands, fingers, back, spine, neck, or head. 
  • Don’t walk underneath anyone bouldering. All falls result in ground falls, meaning if you are underneath a climber when they fall they WILL fall on you which can result in injury or death to either party.
  • Ensure no objects or people are beneath you or in your landing zone.
  • Proper Falling Technique: is essential when bouldering. When falling, it is important to do the following:
  • Stay relaxed and alert, don't tense up, and protect your head and limbs.
  • Absorb the forces of the fall by landing on both feet, bending your knees, then rolling down to the ground if necessary.
  • NEVER try to catch yourself with your arms.
  • Falling on the seams of pads, in between pads or edges of pads increases injury risk.
  • Traversing IS NEVER allowed more than 4 feet off the ground.
  • Topping out IS NEVER allowed at Island Rock.
  • Climbers are responsible for appointing their own spotters.
  • Climbers should always assess their comfort level in spotting another climber, or in being spotted. Island Rock staff will show anyone how to spot properly if asked.
  • Climbers should always down-climb to a point where they can step off the wall when possible. 
  • Grading: Boulder problems are rated using the V-Scale (V-Beginner, V0, V1, V2, V3, etc.) with VB (beginner) being the easiest and increasing accordingly.
  • New Climbers: Should stick to easier problems and refrain from climbing to the top until they are more comfortable with climbing, down climbing, and proper falling technique.
  • Island Rock does not recommend wearing headphones, jewelry, harnesses, etc. while bouldering.
  • Anyone ages 8 - 13 must be under strict supervision while bouldering by a trained climber over the age of 15 with valid Island Rock waiver(s) and orientation(s) on file and cannot climb without being spotted unless with one of our youth programs.
  • Spotting and Supervising: All climbers ages 8-13 MUST be under the supervision of a parent or guardian at all times and spotted by someone ages 15 and up with a valid Waiver and Bouldering Orientation on file. Spotting someone while they are climbing is dangerous and includes additional risks that participants must manage. Additionally, spotters do not guarantee the safety of a climber. Climbers can still get injured while spotted. Spotters can get injured while spotting. It is your responsibility to manage risk and assess your spotting abilities. If you need additional training for spotting others, please be sure to ask a staff member before continuing. In general, it is important to do the following while spotting:
  • Keep yourself positioned with a stable stance (feet slightly wider than shoulder-with; slight bend in knees). Position yourself on and/or near the pads, but not underneath any climbers. Raise hands with a slight bend in the elbows and keep palms open to the climber with fingers together. 
  • Focus on the climber and track their movements. Keep an eye on their center of gravity to anticipate their movements in the event of a fall.
  • Protect a climbers head and neck: In the event of a fall, a spotter's goal is to guide the climber to the ground, not 'catch' them. Spotters want to redirect the climber with a controlled and calculated touch to the hips, back, or torso to direct them toward the pads and help them take a fall with proper technique. 
  • Be Prepared: Falls can happen at anytime.
  • Nobody under the age of 8 may boulder unless with one of our youth programs.

I understand that climbing is dangerous. I understand that the possibility of getting injured cannot be eliminated from climbing. I understand that bouldering involves even more risk, and that all falls when bouldering are ground falls. I understand that I WILL FALL while bouldering. I am willing to accept and manage this risk to climb. 

I Agree

August 11, 2026

General Facility Requirements, Rules & Policies: 

  • All participants MUST check in at the front desk and have a valid waiver before participating in any activities.
  • All participants who are BOULDERING must also:
  • Meet the facility age requirements
  • Have a valid Bouldering Orientation Form on file.
  • All participants who are BELAYING on TOP ROPE must also:
  • Meet the facility age requirements
  • Have a valid Bouldering Orientation Form on file;
  • Have a valid Top-Rope Orientation on file;
  • MUST have a valid Island Rock Top-Rope Belaying Certification on file and pass the required Island Rock Top Rope Belay Certification Check/Test(s)
  • All participants who are LEAD CLIMBING or BELAYING ON LEAD must also:
  • Meet the facility age requirements
  • Have a valid Bouldering Orientation Form on file;
  • Have a valid Island Rock Top-Rope Belay Certification on file;
  • Have a valid Lead Orientation form on file;
  • MUST have a valid Island Rock Lead Belay and/or Lead Climb Certification on file and pass the required Island Rock Lead Belay and/or Lead Climbing Certification Check/Test(s).
  • No teaching of belaying, knot tying, and/or leading except by Island Rock staff.
  • All rappelling must be supervised by Island Rock.
  • All top-rope climbing must use ropes and belay devices provided by Island Rock.
  • Harnesses: must be commercial products designed for climbing with CE or UIAA certification (rescue, tree and fire equipment is not permitted).
  • Island Rock reserves the right to inspect and approve or refuse the use of any personal equipment. 
  • Helmets are available on request. Climbers may also use their own helmets.
  • All helmets must be CE or UIAA approved for climbing (non-Climbing helmets, such as bicycle or ski helmets, are not permitted).
  • All roped climbers must tie the rope directly into their harnesses with both a figure 8 follow-through and a fisherman’s knot.
  • No one under the age of 14 will be allowed to climb unless accompanied by an adult who shall be responsible at all times for their safety and conduct.
  • No one under the age of 15 may belay at Island Rock except in classes or lessons conducted by Island Rock.
  • All climbers must inform Island Rock of any accidents or equipment damage and of any situation seen as unsafe or not in accordance with Island Rock’s safety policies/rules.
  • Food is not allowed in the climbing area. 
  • No spectators in the climbing area. Climbers only.
  • No climbing barefoot or with open-toed shoes.
  • No pets allowed.
  • Objectionable language is not permitted. We are a PG-13 facility.  
  • Island Rock is not responsible for lost or stolen property.
  • Island Rock reserves the right to deny the use of its facility to anyone who fails to either comply with these safety policies or in any way compromises their own safety or the safety and enjoyment of others.

I Agree


My signature/initials indicate that I have reviewed and understand 100% of the information that I initialed above and in the video that I watched prior to filling out this document and that the climbing gym staff has presented this information to me. I understand that if I need additional assistance, orientation, instruction, training or assessment during my participation at the climbing facility at any future time that it is my responsibility to seek such assistance, orientation, instruction, training or assessment from the climbing gym staff prior to participating in any activity for which I am not trained or qualified or for which I doubt my abilities. I also agree that if any of my friends, family, or co-workers participate at Island Rock in the future, I will make sure they adhere to the rules/policies of Island Rock.

I have also watched and understand the Bouldering Orientation Video in its entirety, and will refer back to this video or speak to an Island Rock staff member if I have any questions, concerns, or need any additional training.

I Agree

August 11, 2026

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Join our email list? We promise to try not to send you too much SPAM.
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Phone*
Address Line 1:
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:
City:
State/Province:
Zip/Postal:
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE! and  Rock Gym Pro