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Adults or Adults with Supervised Children: Acknowledgment of Risk





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 climbing centres and associated activities. By signing this form you are stating 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 to clarify. 

Conditions of Use General Safety

Report to reception on each visit before you climb.

  • You must exercise care, common sense and self-preservation at all times.
  • Report any problems with the walls, equipment or other climbers' behaviour to a member of staff immediately. This is particularly important with broken or spinning holds.
  • Be aware of the other climbers around you and how your actions will affect them.
  • Never stand directly underneath someone who is climbing.
  • If you have children, you must keep them under control and supervise them directly at all times. Be close enough to affect or control the child’s behaviour at all times.
  • Please make yourself aware of the location of the fire exits in the building and fire assembly points.

As a user of this climbing wall, you must be aware of and accept the following:

  • 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
  • Climbing beyond your capabilities on any wall 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.
  • Participants must understand that climbing while pregnant can increase the risk posed to mother and unborn child.
  • Participants must be aware and accept that climbing holds can spin or break
  • You must do everything reasonable and practical to avoid endangering yourself or others.
  • You have to be aware of and adhere to the safety rules of the centre at all times.
  • Stand back from the climbing walls unless you are spotting a climber.
  • Please empty your pockets and remove all jewellery before climbing.

Bouldering

  • Whenever possible downclimb, or 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.
  • Never climb directly above or below another climber.
  • Top out (climb over the top) in designated areas only, if unsure climb down.
  • Remove anything from pockets that could hurt you when landing.
  • Always be aware of people climbing above and around you.

Training Area and Gym

  • Customers agree to use any exercise equipment provided by Stronghold at their own risk. The equipment is strictly for the use of customers aged 18 years and above, unless signed off by a Stronghold coach. Customers are responsible for keeping the equipment in a safe and tidy manner. 

 

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 be doing 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.

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 U18 Years Old Climbing An adult who has registered at the centre and proved competency, may supervise Under 18's by adhering to the following supervision policy.

  • You can supervise two children aged between 6yrs and 17yrs old - You can't climb.
  • You can supervise one child between 6yrs and 17yrs old - You can climb
  • You can supervise a child aged between 4yrs and 5yrs - You can't climb
  • One child aged 0-3yrs old per adult are allowed into the climbing area, not on the climbing matting. The child must be either secure in a buggy or supervised at all times - You can climb.

If you wish to climb with 2 children aged 6ys - 17yrs old, ask at reception to book a supervision competency check. 

The adult must be prepared to take full responsibility for the safety of those people, comply with the U18 supervisors policy and have completed an Acknowledgment of Risk Form for each Under 18 climber.

All children in the centre must be supervised by an adult unless they have been assessed by the management and registered for unsupervised climbing.

Groups of three or more U18's or novices must only be supervised by an instructor holding the relevant valid qualification and insurance and has complied with our external instructors policy.

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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.

Date: January 28, 2023

 







First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
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*
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 about Stronghold Climbing Centres by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Declarations - Please tick to confirm
I do not wish to receive any paid training for instruction prior to use the bouldering/climbing facility. (If YES please inform a member of staff and they will advise)
I have read and understood this acknowledgment of risk and Conditions of Use for bouldering. (If you have any questions inform a member of staff)
Do you understand that failure to exercise due care could result in your, or participants you are supervising's injury or death.
I understand that the boulder matting doesn't remove the risk of injury.
I agree to abide by this document and the conditions of use of the climbing centre.
I have watched the boulder safety video and understand safe use of the bouldering area.

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 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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