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Gravity Climbing Centre

ADULT ACKNOWLEDGEMENT OF RISK FORM

ACKNOWLEDGEMENT OF RISK FORM

Unsupervised Climbing Participation Statement:

“All climbing and bouldering activities have a risk of serious injury or death. Participants must be aware of and accept that even if they follow all good practice there may still be the risk of accident and injury. It is the responsibility of the participant to adhere to the conditions of use”

It is important that you understand this document. There is inherent risk involved with indoor bouldering and associated activities. By signing this form you are stating that you understand that these risks cannot be completely removed. If you do not understand any of the terminology or content, ask a member of staff.

Participants should consider having medical/personal accident insurance before undertaking this activity.

By initialing below I confirm that I have read about and understood the risks involved when climbing at Gravity Climbing Centre.


CONDITIONS OF USE:

General Safety:

  • Report to reception on each visit.
  • You must exercise care, common sense and self-preservation at all times.
  • Report any problems with the walls, holds, equipment or other climbers' behaviour to a member of staff immediately.
  • When moving around the centre, be aware of 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. Exercise caution while moving around the climbing area. Never sit, stand or walk directly underneath someone who is climbing. Being landed on may result in significant injury to all parties involved.
  • Do not distract anyone who is climbing.
  • Please make yourself aware of the location of the fire exits in the building.

Bouldering:

  • Climb within your capabilities. Climbing beyond your capabilities is likely to result in a fall. Any fall may result in an injury despite the safety systems in place. You must make your own assessment of the risks whenever you climb.
  • Descend by downclimbing whenever possible. If this is not possible, use a controlled/planned jump - It is your responsibility to ensure that you can climb down or land safely; don’t climb into a situation that you cannot safely get out of.
  • THE SOFT MATTING DOES NOT REMOVE THE RISK OF INJURY. Injuries can still occur even after a controlled/ planned jump but are more likely after an uncontrolled fall. You should always do your utmost to avoid the risk of uncontrolled falls. This includes paying attention to how you will land and always assessing the risk of each climb that you undertake.
  • Always be aware of people climbing above and around you. Never climb directly above or below another climber.
  • Problems finish on the last obvious hold. Do not grab or touch the top of the wall.
  • Keep the mat free of objects. Objects such as mobile phones, water bottles, clothing, shoes and bags should not be brought onto the mats.
  • Participants must be aware and accept that climbing holds can spin or break.
  • Participants must understand that climbing while pregnant can increase the risk posed to mother and unborn child.
  • Please remove all jewellery before climbing. Remove anything from pockets that could hurt you when landing.

Competitions and ‘competition style’ bouldering:

  • Areas of the centre may be laid out for competitions or competition style bouldering. It may be more difficult to descend by downclimbing due to the absence of easier circuits. Consider this before climbing to the top.
  • Be aware that dynamic climbing and uncontrolled falls may lead to greater risk of injury.
  • Volumes on the walls are designed to enhance the quality of climbing but you must be aware of and accept that when climbing above them there is an additional risk of falling onto them.

Training equipment:

  • You use the training equipment at your own risk.
  • If you are unsure how to safely use any piece of training equipment, ask a member of staff. 

Our Duty of Care
The conditions of use of the climbing centre 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 may ask you to leave.

Your Duty of Care
You have a duty of care to act responsibly towards the other users of the centre, follow good practice and abide by the conditions of use of the centre. Statements of ‘Good Practice’ are posted around the centre adjacent to the relevant facilities. These describe the accepted methods of use of equipment and climbing areas.

Unsupervised Climbing
Before you can use the bouldering walls without supervision, you must be aware of the safe usage of bouldering and know how to use the bouldering walls safely. You are required to register to say that you know how to boulder and that you are prepared to abide by the rules and that you understand the risks involved in your participation. Anyone who is not competent to climb unsupervised must be supervised by a competent person.

Supervised Climbing
If you cannot climb unsupervised, you must be supervised by a Gravity staff member or an instructor holding the relevant, valid Mountain Leader Training qualification and insurance or other relevant qualification. If you are aged under 14 you may be also supervised by a parent/guardian who is an adult registered member of Gravity.

By initialing below I confirm that I have read and understood the conditions of use at Gravity Climbing Centre.


Declarations:

I certify that to the best of my knowledge, I do not suffer from a medical condition that might have the effect of making it more likely that I be involved in an accident that could result in injury to myself or others.

I also confirm that the above information is correct and if any information changes I will notify the centre.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS.

Today's Date: May 12, 2024


First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
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*
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. IF YOU HAVE NOT READ ALL OF THE ABOVE INFORMATION PLEASE DO SO NOW BEFORE SIGNING.


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*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Are you over 18 years of age?*
Do you wish to receive any training or instruction before proceeding to use the bouldering / wall facilities, including such equipment as has been hired to you for your use? (If yes, please ensure you have informed a member of staff)*
Do you understand there is a risk of injury involved?*
Have you read and understood this Acknowledgment of Risk and Conditions of Use for climbing or bouldering? (If you have any questions, inform a member of staff)*
Do you understand that failure to exercise due care could result in your injury or death?*
Do you understand that the boulder matting does not remove the risk of injury?*
Have you watched and understood the bouldering safety video and understand good practice for use of the bouldering?*
Do you agree to abide by this document and the conditions of use of the climbing centre?*
Gender*

Medical Considerations* Please let us know if there is anything we should be aware of here.

Climber's Prior Experience

Unless you are attending an Induction, our minimum level of recent experience to register as an Unsupervised Climber is to have climbed at least 6 times in the past 12 months, including bouldering at an indoor bouldering wall. If this is not the case but you have extensive climbing experience outside of the past 12 months please talk to a member of staff before registering. 

How many times have you climbed in the past 12 months? *please note, you need to have climbed a minimum of 3 times to meet the requirements to register as an unsupervised climber at Gravity.*
Please indicate the nature of your climbing experience*

If you climb regularly without supervision at another wall, please state where and how often you have climbed. We cannot register you for unsupervised climbing without this information. *
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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