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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 Age Acknowledgment*
First Participant's Date of Birth*
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*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
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.


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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
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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