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Adult - Novice Agreement Bouldering Only

 

This form is only to be completed for novice climbers over 18 years of age

Please ensure that all parties carefully read the entire form before signing. If you have any questions please ask a member of Rope Race staff.

The BMC Participation Statement

'The BMC recognises that climbing and mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions.'

The Supervisor

I am a boulderer experienced in the use of all bouldering equipment, techniques and do not require any instruction.

I am willing to take full responsibility of the novis named on this form whilst in Rope Race Climbing Centre and will make sure they follow all the rules and conditions of use.

I understand the BMC participation statement and that climbing is a sport with an element of risk.

Supervisors Signature

 

Novice Climber

I understand that, I will not be able to use Rope Race Climbing Centre, unless I am under the supervision of the named ‘Supervisor’ who is over the age of 18 and willing to take full responsibility for me whilst in Rope Race Climbing Centre.

 

Participation Statement

“The British Mountaineering Council recognises that climbing and mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement.” 

 

Declaration of fitness

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

 

Declaration of fact

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

First Novice Name

First Name*

Middle Name

Last Name*

Phone*
First Novice Date of Birth*
First Novice Signature*
Second Novice Name

First Name*

Middle Name

Last Name*
Second Novice Date of Birth*
Third Novice Name

First Name*

Middle Name

Last Name*
Third Novice Date of Birth*
Fourth Novice Name

First Name*

Middle Name

Last Name*
Fourth Novice Date of Birth*
Fifth Novice Name

First Name*

Middle Name

Last Name*
Fifth Novice Date of Birth*
Sixth Novice Name

First Name*

Middle Name

Last Name*
Sixth Novice Date of Birth*
Seventh Novice Name

First Name*

Middle Name

Last Name*
Seventh Novice Date of Birth*
Eighth Novice Name

First Name*

Middle Name

Last Name*
Eighth Novice Date of Birth*
Ninth Novice Name

First Name*

Middle Name

Last Name*
Ninth Novice Date of Birth*
Tenth Novice Name

First Name*

Middle Name

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

Email*

Confirm Email*
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Supervisor Information

First Name *

Last Name *

Date of Birth *
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*

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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