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Release of liability 

Boulder Barn Climbing

 

 

Please complete all sections of the following form and should you have any questions please speak to a member of staff. “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’’  

 

Before completing this wavier online it is important that you read "The Boulder Barn's Conditions of Use & Rules" that can be found on our website

 

 

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

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Medical Conditions

(if none please write none) *
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*
To help comply with GDPR consent requirements, we need to confirm that you would like to receive occasional content from us about upcoming events and services. If you do not wish to received content please uncheck the box
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Release of liability wavier
Are you competent to take part in bouldering activities and understand and accept the risks involved?*
No
Yes
Do you understand the need for, and will use a spotter where appropriate?*
No
Yes
Do you understand that the matting under the walls does not fully prevent serious injuries. Do you also understand it is advised to down climb in a controlled manner and not jump from routes?*
No
Yes
Do you understand that you must never climb above the red line on the roped section of wall (taller wall) unless supervised by Boulder Barn staff during a roped session?*
No
Yes
Do you understand that none of the walls are stand on top boulders and must therefore not be climbed over or behind?*
No
Yes
Do you understand that failure to exercise due care could result in your injury or death?*
No
Yes
Have you read and understood the Conditions of Use and Rules of the centre?*
No
Yes
Do you have any questions regarding the application of the Conditions of Use or the Rules?*
No
Yes
Do you agree to abide by the Condition of use and Rules of the climbing centre?*
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.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Medical Conditions

(if none please write none) *
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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