To be completed by the parent/guardian/coach of a child passing their Top Rope Belay 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 Top Rope 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 top rope test before top rope climbing or belaying in the gym.

The following are key to safe climbing.

  • Tying in properly with a double figure eight.
  • Connecting belay device correctly at correct point on harness.
  • Buddy check.
  • Clear verbal commands, verbal and visual communication with your climbing partner.

I understand that learning to climb at CityROCK does not qualify me to climb outside.

I will ensure that my belayer is known to me personally to be a safe belayer and has also passed the CityROCK Top Rope Belay Test.

I have read and understood all the gym rules, including, but not limited to, the top rope 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


Yellow tag: Kids’ Top Rope climbing and belay

This tag indicates that a child under the age of 14 has passed the Top Rope Belay test. Children with this tag are allowed to top rope climb on the high walls, when belayed by an adult with a orange tag. Children with this tag may top rope belay one another, provided that both children have yellow tags and are roughly the same weight. In order to be tested for this tag, the child must either:

a) have completed one of our CityROCK kids courses
b) been trained by a coach recognised by CityROCK

While inside our facility, regardless of climbing ability, all children under 16 must be supervised by a parent, guardian or coach. 

I Agree

Please select who will be participating...
AdultAdult and a Minor
First Parent/Guardian/Coaches Name

First Name*

Last Name*

First Parent/Guardian/Coaches Date of Birth*
First Parent/Guardian/Coaches Information
Relation to participant*
First Parent/Guardian/Coaches Signature*
Parent or Guardian's Email Address


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

Name and Surname *

Date of Birth *
Staff to complete

Testing Staff Name *

Date of top rope test *
I am confident that the participant is top rope 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
Relation to participant*
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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