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XC - Climbing & Skatepark

Jarman Park,

Hemel Hempstead,

Hertfordshire,

HP2 4JS

High Ropes - Acknowledgment of Risk

Participation Statement

“All high ropes activities have a risk of serious injury or death. Participants must be aware of and accept that even if they follow all good practice there may still be the risk of accident and injury. It is the responsibility of the participant to adhere to the conditions of use.”

It is important that you understand this document. There is inherent risk involved with high ropes and associated activities. By signing this form, you are stating you understand that these risks cannot be completely removed. If you do not understand any of the terminology or content, ask a member of staff to clarify.

 

Conditions of use

General Safety

  • Report to reception on each visit before your high ropes session.
  • You must exercise care, common sense and self-preservation at all times.
  • Report any problems with the high ropes or other high ropes users' behaviour to a member of staff immediately.
  • Be aware of the other users around you on the course and how your actions will affect them.
  • Please make yourself aware of the location of the fire exits in the building and fire assembly points.

As a user of this high ropes course, you must be aware of and accept the following:

  • Participants must understand that participating in high ropes while pregnant can increase the risk posed to mother and unborn child.
  • You must do everything reasonable and practical to avoid endangering yourself or others.
  • You have to be aware of and adhere to the safety rules of the centre at all times.
  • Please empty your pockets and remove all jewellery before going onto the course.

High Ropes

  • All high ropes users are required to wear the safety equipment provided at all times.
  • A minimum of two and a maximum of 12 participants are authorised to use the high ropes course at any one time.
  • Adults and children are not permitted to use the high ropes course at the same time unless they are part of the same party or family.
  • If you wish to leave the high ropes, you must inform your instructor before heading downstairs.
  • You must be aware that parts of the high ropes course are not lit.
  • At no time should you tamper with anything metal or adjust your harness yourself.
  • Do not touch the trolleys you are attached to or the railing system they are attached to.
  • Do not push hands into connecting parts or elements, chains, eyelets or bolts.
  • No jumping, running or swinging on the high ropes course.
  • Try not to cause the elements, obstacles to hit each other or the standing platforms.
  • Only one person allowed on the elements, obstacles and platforms at any time.
  • You must remove any objects from your person that could cause damage to the system or harm to yourself or others.
  • You must remove all jewellery and pocket contents, wear clean closed top shoes that can be securely fastened and tie all long hair back in a low pony tail.
  • You must keep noise to a minimum so that you and your instructor can communicate safely.
  • You must not distract the people in the climbing area.

 Our Duty of Care

The conditions of use of the high ropes course are not intended to limit your enjoyment of the facilities; they are part of the duty of care that we, as operators, owe to you, the customer, by law. As such, they are not negotiable and if you are not prepared to abide by them then the staff may ask you to leave.

Your Duty of Care

You have a duty of care to act responsibly towards the other users of the centre, follow good practice and abide by the conditions of use of the centre. Statements of ‘Good Practice’ are posted around the centre adjacent to the relevant facilities. These describe the accepted methods of use of equipment and climbing areas.

Declarations

I certify that to the best of my knowledge, I do not suffer from a medical condition that might have the effect of making it more likely that I be involved in an accident that could result in injury to myself or others. I also confirm that the above information is correct and if any information changes I will notify the centre.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS.

 










Please select who will be participating...
AdultMinor
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First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Gender:*
Male
Female
Other

If other, please specify:
First Participant's Signature*
Participant's Address
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 Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
Please answer 'YES' or 'NO' to the following questions
Do you understand there is a risk of injury involved?*
No
Yes
Have you read and understood this Acknowledgement of Risk & Conditions of Use for High Ropes? (If you have any questions inform a member of staff)*
No
Yes
Do you understand that failure to exercise due care could result in your injury or death?*
No
Yes
Do you agree to abide by this document and the conditions of use of the High Ropes Course?*
No
Yes
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*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Gender:*
Male
Female
Other

If other, please specify:
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.


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