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CONSENT FOR CLIMBING UNSUPERVISED

(AGES 12-15)

Climbing Competency Evaluation
A climbing competency evaluation will take place in a formal evaluation with an FBC Staff Member, reviewing the following:

"My child:

  • Has recieved a Bouldering Orientation by an FBC Staff Member
  • Demonstrates proper falling/jumping technique without error
  • Understands there is no food or drink, including water bottles, permitted on the crash mats
  • Has agreed to ask for help as needed
  • Has demonstrated confidence in themselves and their climbing ability
  • Has demonstrated respect to staff and other FBC patrons"

 

"I understand this priviledge is contingent on my child adhereing to the guidlines set forth above."

I Agree

 

Parental/Guardian Consent - Please Read Thoroughly

I Agree
I have signed a liability waiver for my child.
I Agree
I understand that my child has been evaluated as a competent climber and I give permission for my child to climb at Fredericton Bouldering Co-op's facility unsupervised by an adult. I understand that I am responsible for the actions of my child and if they demonstrate unsafe and/or inappropriate behaviour will be required to leave the facility and be re-evaluated at a later date at the discretion of Fredericton Bouldering Co-op staff.

 

First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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*

Middle Name

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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