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Registration, Declaration and Indemnity Form

ACKNOWLEDGEMENT, RELEASE AND INDEMNITY FOR CLIMBERS

This signed agreement shall be valid for as long as Kinetics Climbing Pte. Ltd. continues to exist as a business entity.

  • THIS DOCUMENT IS A LEGALLY BINDING AGREEMENT. BY SIGNING THIS AGREEMENT I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND ACCEPTED THE TERMS AND CONDITIONS STATED IN THIS AGREEMENT. I FURTHER ACKNOWLEDGE AND AGREE THAT I AM WAIVING MY RIGHTS TO BRING ANY COURT ACTION TO RECOVER COMPENSATION OR OBTAIN ANY OTHER REMEDY FOR ANY INJURY TO MYSELF OR MY PROPERTY.

ACKNOWLEDGEMENT AND ASSUMPTION OF RISKS & RESPONSIBILITY:

I acknowledge and fully understand that Sport Climbing is a sport (the "Sport") with SIGNIFICANT ELEMENTS OF RISKS and endeavor to abide by all rules of safety. I warrant and further acknowledge that in consenting to taking part in this sport, I ACCEPT ALL RISKS AND LIABILITY ASSOCIATED WITH THE SPORT and that such acknowledgement is a condition precedent prior to my patronage to Kinetics Climbing Pte. Ltd.

RELEASE AND INDEMNITY:

I agree to INDEMNIFY AND HOLD HARMLESS Kinetics Climbing Pte. Ltd., each of its partners, shareholders, associates, officers, employees and agents including its instructors, assistants and guides, manufacturers, leasers and insurers, against all and any losses, claims, damages or liabilities, joint and several, to which they may become subject under any statute or at common law or otherwise, insofar as such losses, claims, damages or liabilities, settlements, actions or proceeding are caused by any mishap or accident occurring during or related to the Sport.

I acknowledge the inherent risks of the Sport that I am undertaking in the facility. I further acknowledge the nature and extent of the risks inherent in the Sport and use of the facility. I acknowledge that there are possible risks associated with the use of the facility and that these may result in injury, illness or death.

In consideration of and in recognition of the inherent risks of the Sport associated with the use of the facility, I and/on behalf of any minor children that I am responsible for agree on behalf of myself, my/our heirs, representatives, successors, executors, administrators or assigns, hereby agree that Kinetics Climbing Pte. Ltd, its related/affiliated companies and their respective offices, employees, servants and agents will not be responsible or liable for any claims or demands, obligations and/or causes of action of any nature whatsoever associated with or otherwise arising howsoever from my/our participation and release, waive and, discharge Kinetics Climbing Pte. Ltd, its related/affiliated companies and their respective offices, employees, servants and agents and all persons authorized by it from any and all liabilities or claims made by other individuals or entities as a result of my/our actions.

I further certify, acknowledge and agree on behalf of myself and/or any minor children for which I am responsible that I am (we are) physically and mentally capable of participating in the Sport.

I have read, understood, acknowledged and agreed to all the matters referred to in this agreement.

Kinetics Climbing Pte. Ltd.
RULES AND REGULATIONS

General Climbing Centre Rules:

  • All climbers and observers must check in at the front desk before proceeding to the climbing areas
  • Climbing is inherently dangerous. Participants must assume the risks of climbing/bouldering. All climbers, course participants and individuals operating a safety system at Kinetics Climbing must sign a release of liability form
  • Do not stand underneath a climber
  • Immediately report any problems to our staff; eg. Loose holds, damaged ropes, wall damage, near accidents, accidents
  • Do not remove ropes or attempt to manipulate any fixation points
  • Keep the climbing area clear; place unused gear at one side
  • Bare bodied climbing is prohibited
  • Smoking is prohibited at all times within the facility
  • Food and drinks are not permitted in the climbing areas, except for plastic bottled water
  • The use of loose chalk/ chalk block is strictly prohibited. Chalkball must be used with a chalkbag/ chalkpot to prevent spillage.
  • Courses or lessons in progress have priority on routes. If an instructor requires the route you are on, you may be asked to move onto another route. Please finish the climb and allow the lesson to continue
  • All persons using Kinetics Climbing facility are expected to respect other individuals in the Centre and conduct themselves in good order. Any person deemed by the Management to be behaving in an unsafe or disorderly fashion will be asked to leave the facility
  • Kinetics Climbing's staff reserve the right to revoke climbing privileges at any time

Climbing Rules:

  • All belayers and climbers must use the proper belay technique and agree to double check their set-up before beginning the climb. The belayer will check the climber's gear and knots, and the climber will check the belayer's system and exchange confirmation that the setup is correct. This is important and must be performed at the start of EACH AND EVERY CLIMB!
  • Use the rope which is closest to the final hold of the attempted route; avoid any potentially dangerous swings
  • All participants must use UIAA approved ropes, harnesses, carabiners and belay devices
  • Kinetics Climbing Management and staff reserve the right to check harnesses, knots, safety systems, etc. at any time
  • The minimum age to belay is 13

Climbers:

  • Only the figure of 8 knot must be used when tying a climbing rope to a climber's harness
  • "Clipping" the rope to the harness with the aid of a locking carabiner is prohibited
  • Grabbing onto of any hangers or structural members of the building or climbing wall is prohibited at Kinetics Climbing
  • Strictly no topping out/ climbing over walls

Bouldering

  • Bouldering is allowed only over padded areas
  • Strictly no topping out/ climbing over walls
  • Do not boulder underneath roped climbers
  • It is recommended to have a minimum of one spotter per climber when bouldering.
  • A climber's voluntary participation in bouldering indicates their acknowledgement that bouldering is dangerous and that a spotter may not prevent injuries. Spotters understand that the climber may injure them if they should fall.
  • Right of way belongs to the first climber to start a route
  • Watch out for anyone sitting below your falling zone
  • Boulder within your personal competency limits

I have read and hereby agree to abide by the rules and regulations of this facility.

I Agree

Dated: November 22, 2019

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
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

Emergency Contact's Name*

Emergency Contact's Phone Number*
For parent/ legal guardian of climber under the age of 18 years only. I, as parent/ legal guardian/ responsible party of the above mentioned minor under 18 years of age, has read, acknowledged and understood this release. I understand that this RELEASE is a legally binding contract that is severable; in other words, that if any part of it is held by a court of law to be unenforceable, the rest of it shall survive. As a parent/ legal guardian/ responsible party of a minor climbing at Kinetics Climbing Pte Ltd, whether or not I am attending, or am present when the minor is participating, I agree to indemnify and hold harmless Kinetics Climbing Pte Ltd and all other parties released in the manner described herein and agree to all terms and conditions mentioned in this agreement.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Last 4 digits and alphabet of NRIC/ FIN/ Passport Number: *

Occupation:

Nationality: *

*Please check 1 box only

I will only be bouldering/climbing and will not attempt to belay/ teach belaying within Kinetics Climbing
Proficient Climber without SNCS certification

I declare that I am able to carry out the following proficiently:

  • I can wear a safety harness correctly
  • I can tie a figure of 8 knot and thread it correctly through the harness tie in loop
  • I can belay a climber safely on top rope
  • I can belay a climber safely on a lead climb
  • I am able to make my own judgements regarding my equipment and climbing safety

Singapore National Climbing Standards (SNCS) Certified

Certified Course Date
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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