To be completed by participant on passing their lead test at CityROCK.


Between The Indoor Climbing Centre Pty LTD T/A CityROCK, hereafter referred to as


And The Climber, or any person entering CityROCK, hereafter referred to as the


CityROCK and the Climber have entered into an agreement in terms whereof CityROCK has allowed the Climber to make use of its facilities on the terms and conditions below.


CityROCK Lead Climbing Agreement

I acknowledge the fact that there is an inherent danger in the sport of rock climbing, including, but not limited to injury or death, and I understand that no amount of care, caution, instruction or expertise can eliminate this inherent danger completely.

I confirm that I will pass CityROCK's lead test before lead climbing in the gym. I am fully aware of the significant risks of lead climbing and that a lead fall may result in:

  1. Impact with the ground.
  2. Hard impact with climbing wall surface.
  3. Feet hitting holds and injuring feet, legs, etc.Inverting through hitting holds, having ropes tangled behind the climber's legs or other causes, which may result in serious injury.
  4. Severe abrasions due to rope burn and contact with the climbing surface

The following are key to safe lead climbing.

  1. Tying in properly with a double figure eight.
  2. Connecting belay device correctly with rope through carabiner.
  3. Buddy check.
  4. Clear verbal commands, verbal and visual communication with your climbing partner.
  5. Clipping the quickdraws the correct way.
  6. No Z-clipping.
  7. Not belaying directly under the climber.
  8. Being aware of the features of the climbing wall that may get in the way of a climbing fall such as an overhang or arête.
  9. Where the weight difference between climbing partners is significant an Edelrid Ohm is to be utilised. This can be rented at front desk or purchased in the gear shop.

I understand that learning to lead climb at CityROCK does not qualify me to lead climb outside. I will ensure that my belayer is known to me personally to be a safe belayer and has also passed the CityROCK Lead Belay Test. 

I have read and understood all the gym rules, including, but not limited to, the lead climbing rules, and I agree to abide by them. I understand that if I breach any of the rules CityROCK reserves the right to permanently revoke my privileges and deny me access to their facilities.

I Agree



The Climber acknowledges that the activity in which he/she participates in by its very nature dangerous and carries inherent risks. These risks could cause him/her to sustain bodily injury or death and/or suffer damages and the Climber waives any claim however arising against CityROCK or its members, employees or any third party.


The Climber makes use of CityROCK's facilities at entirely his/her own risk. The Climber agrees that CityROCK will not be held liable and/or responsible for any loss, injury, damages, death, and/or compensation of whatsoever nature and howsoever arising as a result thereof.

We will not be responsible for, and shall not pay for, any loss, damage or theft of items left unattended.

I Agree

Please select who will be participating...
AdultAdult and a Minor
First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Information

Id Number *

Contact Number *
First Participant's Signature*
Parent or Guardian's Email Address


Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact Name and Surname *

Emergency Contact number *
Relation to participant*
Staff to complete

Testing Staff Name *

Date of lead test *
I am confident that the participant is lead climbing competent to climb at CityROCK.*
CityROCK branch *
Cape Town
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*

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

Id Number *

Contact Number *
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.

One or more problems exist. Please scroll up.

Powered by  Smartwaiver - TRY IT FREE!