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ADULT (18+) REGISTRATION FORM

Unsupervised Bouldering at 3 Wise Monkeys Climbing Centre


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ONLINE FILLING IN OF AOR FORM:
This Acknowledgement of Risk Form is for unsupervised climbing at Three Wise Monkeys Climbing Lochaber Limited.  If you are unsure of any aspect of the form you should not fill this in online. Please come to Fassifern Road, Fort William PH33 6QX and fill it in where a staff member can answer any questions or clarify any points that may be unclear. If you have any impairments that can affect your filling in of the form or climbing, please fill in the form within the centre with staff support.

UNSUPERVISED CLIMBING

PARTICIPATION STATEMENT

“All climbing and bouldering 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
climbing centres 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 you climb
- You must exercise care, common sense and self-preservation at all times
- Report any problems with the walls, equipment or other climbers' behaviour to a member
of staff immediately. This is particularly important with broken or spinning holds
- Be aware of the other climbers around you and how your actions will affect them
- Never stand directly underneath someone who is climbing
- If you have children, you must keep them under control and supervise them directly at all
times. Be close enough to affect or control the child’s behaviour at all times
- Please make yourself aware of the location of the fire exits in the building and fire
assembly points
As a user of this climbing wall, you must be aware of and accept the following:
- Volumes on the walls are designed to enhance the quality of climbing but you must be
aware of and accept that when climbing above them there is an additional risk of falling
onto them
- Climbing beyond your capabilities on any wall is likely to result in a fall. Any fall may
result in an injury despite the safety systems in place. You must make your own
assessment of the risks whenever you climb
- Participants must understand that climbing while pregnant can increase the risk posed to
mother and unborn child
- Participants must be aware and accept that climbing holds can spin or break
- 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
- Stand back from the climbing walls unless you are spotting a climber
- Please empty your pockets and remove all jewellery before climbing
Bouldering
- Whenever possible, downclimb, or if this is not possible, use a controlled/planned jump
- It is your responsibility to ensure that you can climb down or land safely; don’t climb into
a situation that you cannot safely get out of
- Never climb directly above or below another climber
- Top out (climb over the top) in designated areas only, if unsure, climb down
- Remove anything from pockets that could hurt you when landing
- Always be aware of people climbing above and around you
Training area
- You use the training equipment at your own risk
- If you are unsure how to safely use any item, please ask a member of staff
THE SOFT MATTING DOES NOT REMOVE THE RISK OF INJURY. Injuries can still occur
even after a controlled/planned jump but are more likely after an uncontrolled fall. You
should always be doing your utmost to avoid the risk of uncontrolled falls. This includes
paying attention to how you will land and always assessing the risk of each climb that you
undertake.
Our Duty of Care
The conditions of use of the climbing centre 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.
Unsupervised Climbing
Before you can use the bouldering walls without supervision, you must be aware of the safe
usage of bouldering and know how to use the bouldering walls safely. You are required to
register to say that you know how to boulder and that you are prepared to abide by the rules
and that you understand the risks involved in your participation. Anyone who is not
competent to climb unsupervised must be supervised by a competent person.
Supervised Climbing
An adult who has registered at the centre, and proved competency, may supervise up to two
novice climbers, as long as they are prepared to take full responsibility for the safety of those
people.
Groups of three or more novices must only be supervised by an instructor holding the
relevant valid Mountain Leader Training qualification and insurance or other relevant
qualification.
All children in the centre must be supervised by an adult unless they have been assessed by
the management and registered for unsupervised climbing.


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.

August 14, 2022

 

First Your Name

First Name*

Last Name*

Phone*
First Your Date of Birth*
First Your Information

Medical Notes
First Your Signature*
Second Your Name

First Name*

Last Name*
Second Your Date of Birth*
Second Your Information

Medical Notes
Third Your Name

First Name*

Last Name*
Third Your Date of Birth*
Third Your Information

Medical Notes
Fourth Your Name

First Name*

Last Name*
Fourth Your Date of Birth*
Fourth Your Information

Medical Notes
Fifth Your Name

First Name*

Last Name*
Fifth Your Date of Birth*
Fifth Your Information

Medical Notes
Sixth Your Name

First Name*

Last Name*
Sixth Your Date of Birth*
Sixth Your Information

Medical Notes
Seventh Your Name

First Name*

Last Name*
Seventh Your Date of Birth*
Seventh Your Information

Medical Notes
Eighth Your Name

First Name*

Last Name*
Eighth Your Date of Birth*
Eighth Your Information

Medical Notes
Ninth Your Name

First Name*

Last Name*
Ninth Your Date of Birth*
Ninth Your Information

Medical Notes
Tenth Your Name

First Name*

Last Name*
Tenth Your Date of Birth*
Tenth Your Information

Medical Notes
Your 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*
IMPORTANT!

Once a form is completed, it cannot be edited. Please read through and carefully answer the following questions.

Please answer 'yes' or 'no' to the following questions
Are you over 18 years of age?*
Do you wish to receive any paid training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand there is a risk of injury involved?*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing 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.
Parent or Guardian's Name

First Name*

Last Name*

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

Medical Notes
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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