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The Rock at Caves Beach
WAIVER FORM

A waiver must be completed by all climbers (or their parent/legal guardian if under 18 years of age) before the climber may use our facilities.

Bouldering (low height climbing without ropes) is a dangerous sport. YOU ARE PARTICIPATING AT YOUR OWN RISK.

Bouldering involves risks and as such may cause various injuries resulting in death or serious injuries including serious disability. Other injuries possible, but not limited to, include sprains, breaks, concussion, or back injuries. Climbing may worsen a previous condition, it is recommended that anyone wishing to climb with a medical condition should obtain medical advice from a medical practitioner before climbing.

Bouldering can bring on anxiety or panic and is a physically demanding sport. As such climbing for some people with underlying previous conditions, may induce heart attack or other life threatening health concerns.

I assume all risks and hazards incidental to my or my child’s participation in bouldering at The Rock at Caves Beach and I choose to participate, doing so entirely at my own risk. 

I Agree

I have been advised of the risks of climbing and have been shown how to climb, fall and use the facility safely and agree to follow all rules provided on signage and given verbally by staff of The Rock at Caves Beach. 

I Agree

I hereby agree to indemnify and hold harmless the releasees, including but not limited to; The Rock at Caves Beach, C3 Church Southern Beaches Inc, the board of directors, all staff and volunteers from any loss, liability, damage or costs that may incur due to my participation on this day or in the future.

I Agree

I acknowledge that I have read, understood and agreed to the terms of this document and that I or my child are sufficiently fit to climb.

I Agree

Today's Date: May 9, 2024

First Climber's Name

First Name*

Middle Name

Last Name*

Phone*
First Climber's Date of Birth*
First Climber's Signature*
Second Climber's Name

First Name*

Middle Name

Last Name*
Second Climber's Date of Birth*
Third Climber's Name

First Name*

Middle Name

Last Name*
Third Climber's Date of Birth*
Fourth Climber's Name

First Name*

Middle Name

Last Name*
Fourth Climber's Date of Birth*
Fifth Climber's Name

First Name*

Middle Name

Last Name*
Fifth Climber's Date of Birth*
Sixth Climber's Name

First Name*

Middle Name

Last Name*
Sixth Climber's Date of Birth*
Seventh Climber's Name

First Name*

Middle Name

Last Name*
Seventh Climber's Date of Birth*
Eighth Climber's Name

First Name*

Middle Name

Last Name*
Eighth Climber's Date of Birth*
Ninth Climber's Name

First Name*

Middle Name

Last Name*
Ninth Climber's Date of Birth*
Tenth Climber's Name

First Name*

Middle Name

Last Name*
Tenth Climber's Date of Birth*
Climber'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*
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Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
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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