The Climbing Works Privacy Policy

The Peak Bouldering Company Ltd T/A The Climbing Works (the “Wall”, “we”, “us”) (registered company number 5870471) is committed to protecting your privacy. At all times we aim to respect any personal information you share with us, or that we receive from others, and keep it safe. This Privacy Notice (“Notice”) sets out our data processing practices and your rights and options regarding the ways in which your personal information is used and collected (including through our website – www.climbingworks.com).

This Notice contains important information about your personal rights to privacy. Please read it carefully to understand how we use your personal information. 

The provision of your personal information to us is voluntary. However, without providing us with your personal information, your use of our services or your interaction with us may be impaired. For example, you may be unable to sign up as a member, or make an online booking.

Contents of this policy:

1. How we collect personal information about you
2. What personal information do we use?
3. How and why will we use your personal information?
4. Lawful bases
5. Communications for marketing/ fundraising
6. Children’s personal information
7. How long do we keep your personal information?
8. Will we share your personal information?
9. Security/ storage of and access to your personal information
10. International Data Transfers
11. Exercising your Rights
12. Changes to this Notice
13. Links and third parties
14. How to contact us

 

1. We collect personal information about you:

a. When you give it to us directly

For example, personal information that you submit through our website by making a booking to use our facilities, registering as a member or signing up for our email newsletter; or personal information that you give to us when you communicate with us by email, phone or letter.

b. When we obtain it indirectly

For example, your personal information may be shared with us by third parties including, for example, the Association of Climbing Walls (Britain) Limited (“ABC”), an organisation established to promote safe management practices in climbing walls of which we are a member; third party service providers; analytics providers and search information providers. To the extent we have not done so already, we will notify you when we receive personal information about you from them and tell you how and why we intend to use that personal information.

c. When it is available publicly

Your personal information may be available to us from external publicly available sources. For example, depending on your privacy settings for social media services, we may access information from those accounts or services (for example when you choose to interact with us via Facebook, Twitter and Instagram).

d. When you visit our website

When you visit our website, we automatically collect the following types of personal information:

(a) Technical information, including the internet protocol (IP) address used to connect your device to the internet, browser type and version, time zone setting, browser plug-in types and versions and operating systems and platforms.

(b) Information about your visit to the websites, including the uniform resource locator (URL) clickstream to, through and from the website (including date and time), services you viewed or searched for, page response times, download errors, length of visits to certain pages, referral sources, page interaction information (such as scrolling and clicks) and methods used to browse away from the page. 

We collect and use your personal information by using cookies on our website – please see our Cookie Notice (https://www.climbingworks.com/cookie-policy/).

In general, we may combine your personal information from these different sources set out in a-d above, for the purposes set out in this Notice.

 

2. What personal information do we use?

We may collect, store and otherwise process the following kinds of personal information:

  1. your name and contact details including postal address, telephone number, email address, emergency contact details and, where applicable, social media identity;
  2. your date of birth and gender;
  3. your financial information, such as bank details and/ or credit/ debit card details,
  4. information about your computer/ mobile device and your visits to and use of this website, including, for example, your IP address and geographical location;
  5. personal descriptions and photographs;
  6. details of your qualifications/ experience;

and/ or any other personal information which we obtain as per paragraph 1.

Do we process special categories of data?

The EU General Data Protection Regulation (“GDPR”) recognises certain categories of personal information as sensitive and therefore requiring more protection, for example information about your health, ethnicity and religious beliefs.

In certain situations, the Wall may collect and/or use these special categories of data (for example, information on climbers’ medical conditions relevant to their use of our facilities). We will only process these special categories of data if there is a valid reason for doing so and where the GDPR allows us to do so.

 

3. How and why will we use your personal information?

Your personal information, however provided to us, will be used for the purposes specified in this Notice. In particular, we may use your personal information:

  1. to register you as a member of the Wall;
  2. to allow you to make a booking to use our facilities;
  3. to otherwise provide you with services, products or information you have requested;
  4. to provide further information about our work, services or activities (where necessary, only where you have provided your consent to receive such information);
  5. to assist you with certification schemes, such as NIBAS;
  6. to answer your questions/ requests and communicate with you in general;
  7. to allow you to apply for a job or volunteer role with us;
  8. to manage relationships with our partners and service providers;
  9. to analyse and improve our work, services, activities, products or information (including our website), or for our internal records;
  10. to keep our facilities safe and secure;
  11. to run/administer the activities of the Wall, including our website, and ensure that content is presented in the most effective manner for you and for your device; 
  12. to audit and/ or administer our accounts;
  13. to satisfy legal obligations which are binding on us, for example in relation to regulatory, government and/or law enforcement bodies with whom we may work (for example requirements relating to the payment of tax or anti-money laundering and accident reporting);
  14. for the prevention of fraud or misuse of services; and/or
  15. for the establishment, defence and/ or enforcement of legal claims.

 

4. Lawful bases

The GDPR requires us to rely on one or more lawful bases to use your personal information. We consider the grounds listed below to be relevant:

a. Where you have provided your consent for us to use your personal information in a certain way (for example, we may ask for your consent to use your personal information to send you email newsletters, or to collect special categories of your personal information. Special categories of personal information are explained in paragraph 2 above).

b. Where necessary so that we can comply with a legal obligation to which we are subject (for example, where we are obliged to share your personal information with regulatory bodies which govern our work and services).

c. Where necessary for the performance of a contract to which you are a party or to take steps at your request prior to entering a contract (for example, to provide you access to our facilities in return for your booking fee).

d. Where it is in your/someone else’s vital interests (for example, in case of medical emergency suffered by a climber).

e. Where there is a legitimate interest in us doing so.

The GDPR allows us to collect and process your personal information if it is reasonably necessary to achieve our or others’ legitimate interests (as long as that processing is fair, balanced and does not unduly impact your rights as an individual).

In broad terms, our “legitimate interests” means the interests of running of the Wall as a commercial entity and ensuring the best possible user experience.

When we process your personal information to achieve such legitimate interests, we consider and balance any potential impact on you (both positive and negative), and on your rights under data protection laws. We will not use your personal information for activities where our interests are overridden by the impact on you, for example where use would be excessively intrusive (unless, for instance, we are otherwise required or permitted to by law).

 

5. Communications for marketing / promotional purposes 

We may use your contact details to provide you with information about our work, events, services and/or activities which we consider may be of interest to you (for example, about services you previously used, or events involving our, or other walls’, facilities). 

Where we do this via email, SMS or telephone (where you are registered with the Telephone Preference Service), we will not do so without your prior consent (unless allowed to do so via applicable law).
Where you have provided us with your consent previously but do not wish to be contacted by us about our work, events, services and/or activities in the future, please let us know by email at info@climbingworks.com. You can opt out of receiving emails from the Wall at any time by clicking the “unsubscribe” link at the bottom of our emails.

 

6. Children’s personal information

When we process children’s personal information, where required we will not do so without their consent or, where required, the consent of a parent / guardian. We will always have in place appropriate safeguards to ensure that children’s personal information is handled with due care.

 

7. How long do we keep your personal information?

In general, unless still required in connection with the purpose(s) for which it was collected and/or processed, we remove your personal information from our records six years after the date it was collected. However, if before that date (i) your personal information is no longer required in connection with such purpose(s), (ii) we are no longer lawfully entitled to process it or (iii) you validly exercise your right of erasure (please see Section 11 below), we will remove it from our records at the relevant time.

If you request to receive no further contact from us, we may keep some basic information about you on our suppression list in order to comply with your request and avoid sending you unwanted materials in the future.

 

8. Will we share your personal information?

We do not share, sell or rent your personal information to third parties for marketing purposes. However, in general we may disclose your personal information to selected third parties in order to achieve the purposes set out in this Notice. 

These parties may include (but are not limited to):

  1. The ABC and the ABC Training Trust;
  2. local government agencies;
  3. funding bodes such as Sport England and NGB;
  4. awarding bodies such as Mountain Training;
  5. other members of the ABC;
  6. healthcare professionals;
  7. providers of kit and equipment;
  8. suppliers and sub-contractors for the performance of any contract we enter into with them, for example IT service providers such as website hosts or cloud storage providers, including;
    • Rock Gym Pro for our membership database backups on US servers (US Privacy Shield),
    •  Smartwaiver for digital forms connected to the membership database (US Privacy Shield),
    • Sage Pay for website purchases,
    • Bookeo for online bookings,
    • First Data for card payment processing in the centre,
    • World Pay for card payment processing in the centre,
    • Mail Chimp for emailing competitor information for the Climbing Works International Festival (US Privacy Shield)
  9. professional service providers such as accountants and lawyers;
  10. parties assisting us with research to monitor the impact/effectiveness of our work, events, services and activities; and
  11. regulatory authorities, such as tax authorities.

In particular, we reserve the right to disclose your personal information to third parties:

  • in the event that we sell or buy any business or assets, in which case we will disclose your personal information to the (prospective) seller or buyer of such business or assets;
  • if substantially all of our assets are acquired by a third party, personal information held by us may be one of the transferred assets; 
  • if we are under any legal or regulatory duty to do so; and/or 
  • to protect the rights, property or safety of the Wall, its personnel, users, visitors or others.

 

9. Security/storage of and access to your personal information 

The Wall is committed to keeping your personal information safe and secure and we have appropriate and proportionate security policies and organisational and technical measures in place to help protect your information. 

Your personal information is only accessible by appropriately trained staff, volunteers and contractors, and stored on secure servers which have features to prevent unauthorised access.

 

10. International Data Transfers

Given that we are a UK-based organisation we will normally only transfer your personal information within the European Economic Area (“EEA”), where all countries have the same level of data protection law as under the GDPR.

However, because we may sometimes use agencies and/or suppliers to process personal information on our behalf, it is possible that personal information we collect from you will be transferred to and stored in a location outside the EEA, for example the United States.

Please note that some countries outside of the EEA have a lower standard of protection for personal information, including lower security requirements and fewer rights for individuals. Where your personal information is transferred, stored and/or otherwise processed outside the EEA in a country that does not offer an equivalent standard of protection to the EEA, we will take all reasonable steps necessary to ensure that the recipient implements appropriate safeguards (such as by entering into standard contractual clauses which have been approved by the European Commission) designed to protect your personal information and to ensure that your personal information is treated securely and in accordance with this Notice. If you have any questions about the transfer of your personal information, please contact us using the details below. 

Unfortunately, no transmission of your personal information over the internet can be guaranteed to be 100% secure – however, once we have received your personal information, we will use strict procedures and security features to try and prevent unauthorised access.

 

11. Exercising your Rights

Where we rely on your consent to use your personal information, you have the right to withdraw that consent at any time. This includes the right to ask us to stop using your personal information for marketing or fundraising purposes or to unsubscribe from our email list at any time.

You also have the following rights:

a. Right of access – you can write to us to ask for confirmation of what personal information we hold on you and to request a copy of that personal information. Provided we are satisfied that you are entitled to see the personal information requested and we have successfully confirmed your identity, we will provide you with your personal information subject to any exemptions that apply.

b. Right of erasure – at your request we will delete your personal information from our records as far as we are required to do so. In many cases we would propose to suppress further communications with you, rather than delete it.

c. Right of rectification – if you believe our records of your personal information are inaccurate, you have the right to ask for those records to be updated. You can also ask us to check the personal information we hold about you if you are unsure whether it is accurate/up to date.

d. Right to restrict processing – you have the right to ask for processing of your personal information to be restricted if there is disagreement about its accuracy or legitimate usage.

e. Right to object – you have the right to object to processing where we are (i) processing your personal information on the basis of the legitimate interests basis (see paragraph 4), (ii) using your personal information for direct marketing or (iii) using your information for statistical purposes.

f. Right to data portability – to the extent required by the GDPR, where we are processing your personal information (that you have provided to us) either (i) by relying on your consent or (ii) because such processing is necessary for the performance of a contract to which you are party or to take steps at your request prior to entering into a contact, and in either case we are processing using automated means (i.e. with no human involvement), you may ask us to provide the personal information to you – or another service provider – in a machine-readable format. 

g. Rights related to automated decision-making – you have the right not to be subject to a decision based solely on automated processing of your personal information which produces legal or similarly significant effects on you, unless such a decision (i) is necessary to enter into/perform a contract between you and us/another organisation; (ii) is authorised by EU or Member State law to which the Wall is subject (as long as that law offers you sufficient protection); or (iii) is based on your explicit consent.

Please note that some of these rights only apply in limited circumstances. For more information, we suggest that you contact us using the details in paragraph 14 below.

We encourage you to raise any concerns or complaints you have about the way we use your personal information by contacting us using the details provided in paragraph 14 below.  You are further entitled to make a complaint to the Information Commissioner’s Office – www.ico.org.uk. For further information on how to exercise this right, please contact us using the details below.

 

12. Changes to this Notice

We may update this Notice from time to time. We will notify you of significant changes by contacting you directly where reasonably possible for us to do so and by placing an update notice on our website.

This Notice was last updated on 05/02/2019.

 

13. Links and third parties

We link our website directly to other sites. This Notice does not cover external websites and we are not responsible for the privacy practices or content of those sites. We encourage you to read the privacy policies of any external websites you visit via links on our website.

 

14. How to contact us

Please let us know if you have any questions or concerns about this Notice or about the way in which the Wall processes your personal information by contacting us at the channels below. Please ask for / mark messages for the attention of Daniel Waters, Data Security Officer.

Email: management@climbingworks.com
Telephone 01142509990
Post: The Climbing Works, Unit B, Centenary Works, 150 Little London Road, Sheffield, S8 0UJ

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Mini Works Supervisor

This form is for registration of a non-climbing adult as a Mini Works Supervisor ("Adult Supervisor") to allow them to supervise under 18 Novices at The Mini Works and register their own children as Under 18 Novices.

If you wish to climb yourself or supervise Novices at The Climbing Works you will need to complete a full Adult Induction.

IMPORTANT:
If you are an experienced climber please do not complete this form! Experienced adults who have climbed at least 6 times in the past 12 months including unsupervised indoor bouldering should instead register as Adult Unsupervised Climbers.


Review The Climbing Works Privacy Policy

Risks

Please be aware that indoor climbing, even in a well-managed facility, is not risk-free. By climbing here, you acknowledge the following statement:

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

  • Climbing is movement at height and there is a risk that you could slip & fall at any time.  Climbing beyond your capabilities on any wall is more likely to result in a fall.
  • The soft matting under the bouldering walls does not make the activity safe.  Broken and sprained limbs are common. Uncontrolled falls are likely to result in injuries to yourself or others, and even a well controlled jump from height can result in injury.  You must make your own assessment of the risks whenever you climb.
  • Climbing holds can spin or break.  This can cause you to fall unexpectedly and increases the risk of injury.
  • When climbing you must always ensure your landing zone is clear.  Obstructions in a climber’s landing zone increase the risk of injury.
  • When moving around the centre you must be aware of the location of other climbers and their “landing zones” and avoid obstructing them.  Climbers may not always be visible; wall features like arches, corners and overhangs may obstruct your view. Proceed with caution when moving around the centre and get into the habit of looking up.  Being landed on may result in significant injury to all parties involved.

To be completed by the Mini Works Adult Supervisor:

By initialling below I confirm that I have read about and understood the Risks involved when climbing at any of the walls at the Climbing Works:


 

Conditions of Use

Privacy - In order to register you as a member or otherwise permit use of our facilities or services we need to record & store personal information.  Providing us with this information is voluntary, but failure to do so may impair your use of our services or any interaction with you.  Full details of our privacy notice can be found at reception or viewed online at www.climbingworks.com/privacy-notice.

Our Responsibilities - The rules of the climbing centre set out below 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 must politely ask you to leave.

Your Responsibilities - You must act responsibly and politely towards the other users of the centre. Good practice guidance is posted around the centre adjacent to the relevant facilities. These describe the accepted methods of use and how customers would normally be expected to behave towards each other.

Unsupervised Climbing - Before you climb without supervision the centre expects you to understand, and be able to describe the dangers involved with bouldering and accept the risks involved.  You are required to register as an Unsupervised Climber to say that you are prepared to comply by the Rules below and that you understand the risks involved in your participation.  Anyone who has not registered as an Unsupervised Climber is classed as a Novice and must not climb or enter matted areas without supervision.

Unsupervised climbing is just that; staff will provide whatever help and advice they can, but instruction in climbing techniques will only be provided where it has been booked and paid for in advance. If you are not confident in the use of any facility or technique then do not attempt to use it without the supervision of someone who is competent to do so.

Supervised Climbing - An adult (over 18) registered as an Unsupervised Climber ("Adult Climber") or may supervise up to two Adult or Under 18 Novices (or one Under 5 Novice at peak times), as long as they are prepared to take full responsibility for the safety and behaviour of those Novices.

An adult (over 18) registered as a Mini Works Supervisor ("Adult Supervisor") may supervise up to two Under 18 Novices (or one Under 5 Novice at peak times) in the Mini Works only as long as they are prepared to take full responsibility for the safety and behaviour of those Under 18 Novices. They are unable to supervise Adult Novices.

Groups of three or more Novices must only be supervised by an instructor holding relevant Mountain Training qualifications.

Children - All children (under 18s) in the centre are considered to be Novices and must be closely supervised by a registered Adult Climber or Adult Supervisor at all times, with the exception of 14 to 17 year olds who have been assessed by our staff and registered as an Unsupervised Climber ("Junior Climber").  Please advise a member of staff if you feel that children are not being supervised appropriately.

Staff - Our staff are here to ensure you have a safe and positive experience. Abusive behaviour towards staff will not be tolerated.

Personal Property - The wall accepts no responsibility for any loss of or damage to customer's personal property whether they are in lockers or not. Customers are advised that they use the bike racks and car park at their own risk.

 

Rules

General Safety

You Must:

  • Report to reception on each visit before you climb.
  • You must exercise care, common sense, self-preservation and respect to others at all times.
  • Report any problems with the walls, holds, equipment or other climbers’ behaviour to a member of staff immediately.
  • Be aware of the other climbers around you and how your actions will affect them.
  • Not distract people while they are climbing.

Bouldering

  • Always climb within your capabilities and descend by down climbing whenever possible. A fall, or jumping off, may result in an injury to you, or another climber.
  • Never climb directly above or below another climber.
  • Don’t sit or stand under the wall when people are bouldering.
  • Problems finish on the last obvious hold. DO NOT grab or touch the top of the wall, or any girders, metalwork or lights.
  • Don’t boulder with hardware hanging on your clothes or chalk bag.
  • Keep the mat free of objects and obstructions like bottles, bags, clothing, chalk bags, brushes, shoes etc. No food or drink on the mats.

Gym & Training Equipment

The Climbing Works has a number of climbing specific training aids (such as campus boards) and gym equipment (such as free weights) located around the centre.

  • This equipment is open to registered climbers over 14.
  • Users must read and follow the guidance notes displayed in the training area prior to using any equipment.
  • Equipment may not be removed from the training area.

 

The Climbing Works Unit E - Additional Conditions of Use

Unit E is not permanently staffed

  • Sign in at the Main Reception of The Climbing Works before heading over there.
  • In the event of injury or any issues with equipment or other users please notify staff at Main Reception.
  • There is a clearly marked “panic button” located inside the entrance which links to main reception (for emergency use only).

CCTV

  • CCTV is in operation for the purpose of monitoring usage, entry & any incidents.
  • There is a live feed to reception & the office, and footage is stored for 7 days in case review is required.

Competition style boulder problems

Most of the climbing in Unit E is more challenging than that found in the main centre.

  • Be aware of your abilities and that uncontrolled falls may lead to a greater risk of injury.
  • Like the Competition Wall descent by climbing down is likely to be more challenging due to the absence of easier circuits – bear this in mind before climbing all the way to the top.

Unit E Gym Equipment

There is a wider array of gym equipment available in the fitness suite than in the main centre including Olympic bars and weight plates.

  • The gym area is for adults only, apart from for specific pre-arranged use
  • Only use equipment that you are familiar with and confident using
  • If you are trying hard then get someone you trust to spot you
  • Be considerate to other users:
    • Give each other space to work
    • Return the equipment when you’re finished

Under 18s

Experienced 14 - 17 year old's registered as Junior Unsupervised Climbers may use the bouldering area only (but not the gym) with the consent of their parent or legal guardian:

  • ​They must sign in to use Unit E specifically at the same time as one or more other Junior or Adult Unsupervised Climbers, and may only stay over there for as long as the other climber(s) they signed in with stay in the Unit E bouldering area.  Should other climbers leave such that the Junior Unsupervised Climber would be left alone, they should return to climb in the Climbing Works or the Mini Works.
  • This access is at our discretion so Junior Unsupervised Climbers who misuse the facilities or show poor ettiquete to other users will be barred from Unit E.

Other Under 18s may only use Unit E as part of our internal groups with our vetted coaches, or at select advertised times when the unit is staffed (e.g. special events).

 

To be completed by the Mini Works Adult Supervisor:

By initialling below I confirm that I have read and understood the Conditions of Use & Rules of the Climbing Works:


First Participant's Name

First Name*

Middle Name

Last Name*

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
Third Participant's Name

First Name*

Middle Name

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
Fourth Participant's Name

First Name*

Middle Name

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
Fifth Participant's Name

First Name*

Middle Name

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
Sixth Participant's Name

First Name*

Middle Name

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
Seventh Participant's Name

First Name*

Middle Name

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
Eighth Participant's Name

First Name*

Middle Name

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
Ninth Participant's Name

First Name*

Middle Name

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
Tenth Participant's Name

First Name*

Middle Name

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
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*
Conditions of Use & Rules

If you have any questions regarding the application of the Conditions of Use or the Rules please ask a member of staff before submitting your form.

Have you read and understood the Conditions of Use and Rules of The Centre?*
Do you have any questions regarding the application of the Conditions of Use and Rules of The Centre?*
Do you agree to abide by the Conditions of Use and Rules of The Centre and ensure that your supervised guests do the same?*
Do you understand that the matting under the walls does not guarantee the safety of climbers?*
Do you understand that failure to exercise due care could result in injury or death to yourself or others?*
Do you agree to the Privacy Policy of the Climbing Works?*
Parent or legal guardian must sign for any participating minor (those under 18 years of age) and agree that they and the Under 18 Novice understand the Risks involved and will adhere to the Conditions of Use and Rules of the centre. Your participating minor must be signed in & supervised by a registered Adult Unsupervised Climber or Adult Supervisor on each visit to The Climbing Works. The supervising adult will be asked to sign to agree that they have your consent to supervise your child on each visit.


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*

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

Medical Considerations:


Please let us know if there is anything we should be aware of.
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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