Loading...

ADULT NOVICE SUPERVISION FORM


BMC Participation Statement:

“The British Mountaineering Council recognises that climbing and mountaineering are activities with a danger of injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement,’’.

Redpoint Worcester will allow a maximum of two novices per supervisor.

Novice climbers are the responsibility of the supervisor and the supervisor must remain with their novice(s) when in the centre at all times. The supervisor must take all reasonable actions to maintain safe climbing practices, ensuring the Conditions of use of the centre are adhered to at all times.

Both the Supervisor and Novice must understand and agree to the standard of supervision as outlined below by Redpoint Worcester. Novices must not belay without the supervisor being on the ground backing up the brake rope at all times.

I agree to inform Climb Worcester Ltd of any medical care received after visiting Redpoint Worcester as a result of visiting the centre.



First Supervisor's Name
First Name*
Last Name*
First Supervisor's Date of Birth*
Date of Birth
First Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
First Supervisor's Signature*
Second Supervisor's Name
First Name*
Last Name*
Supervisor's Date of Birth*
Date of Birth
Second Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Third Supervisor's Name
First Name*
Last Name*
Supervisor's Date of Birth*
Date of Birth
Third Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Fourth Supervisor's Name
First Name*
Last Name*
Supervisor's Date of Birth*
Date of Birth
Fourth Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Fifth Supervisor's Name
First Name*
Last Name*
Supervisor's Date of Birth*
Date of Birth
Fifth Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Sixth Supervisor's Name
First Name*
Last Name*
Supervisor's Date of Birth*
Date of Birth
Sixth Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Seventh Supervisor's Name
First Name*
Last Name*
Supervisor's Date of Birth*
Date of Birth
Seventh Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Eighth Supervisor's Name
First Name*
Last Name*
Supervisor's Date of Birth*
Date of Birth
Eighth Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Ninth Supervisor's Name
First Name*
Last Name*
Supervisor's Date of Birth*
Date of Birth
Ninth Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Tenth Supervisor's Name
First Name*
Last Name*
Supervisor's Date of Birth*
Date of Birth
Tenth Supervisor's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Parent or Guardian's Email Address
Email*
Confirm Email*
Novices Name

Full Name:

Click to customize text box label
Date of Birth *
Have you read and understood the BMC participation statement?*
Do you agree for the supervising member named above to be responsible for your safety during your visit to the centre?*
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*
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
As the supervising person do you agree to be responsible for the safety and behaviour of your novice during their visit?*
Are you able and willing to assist your novice in the correct use of a climbing harness?*
Are you able and willing to assist your novice in tying into their harness using an appropriate knot?*
Will you ensure your novice belays safely OR does not belay at all during their visit?*
Do you require further instruction in any of the above techniques?*
Do you understand that in order to ensure safe belaying by your novice, You must physically hold the brake rope if they are belaying and lowering?*
Do you understand that failure to supervise your novice(s) properly may result in both yourself and your novice being stopped from climbing?*
As the Supervising Person do you agree to draw your novice's attention to the terms and conditions of the centre and ensure that they adhere to them?*
Parent or Guardian's Signature*
Electronic Signature Consent by Novice*
 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