Loading...

CRAZY CLIMB FORM

The following document relates to Luckwell Developments Ltd and/or its subsidiaries and associate companies (including, but not limited to, the centres trading as Redpoint and Flashpoint). The information on this form will be stored by Luckwell Developments Ltd and/or its subsidiaries and associate companies (including, but not limited to, the centres trading as Redpoint and Flashpoint) indefinitely for reasons of legal security. You can request copies but requests to delete your information will not be accepted. Your information will be handled in line with our privacy policy, which is available on our websites.


ACCEPTANCE OF RISK

Association of British Climbing Walls 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. 

Do you agree to Acknowledgement of Risk statements above:

I Agree


CONDITIONS OF USE

Declaration of fitness:

You must disclose to the lead instructor any condition that may affect you, or minors you are responsible for, taking part in activities such as: asthma, diabetes, epilepsy, fainting, allergies, heart condition, blood condition that could affect bleeding, recent or long standing injuries such as back, knee or ankle, anything currently under investigation or any other medical condition.

Behaviour:

In the interests of safety, the participant must follow the instructions of the staff at all times. Failure do to do so may result in the participant not being allowed to continue with the activity. If the session is stopped due to the behaviour of the participant, no refunds will be made.

Photos:

We may use any photos or video taken of you, or your group, in our centre on our website or social media. If you would like to opt out you must make it clear to the instructors and Duty Manager. Kindly only photograph or film your own group within the centre.

Do you agree to Conditions of Use statements above:

I Agree


DECLARATION

By completing this document, you (the adult participant OR the parent/appointed guardian of the under 18 participant) agree that you have read, understood and accept the following:

  • You have read, understood and accept the ACCEPTANCE OF RISK and CONDITIONS OF USE statements above.
  • You are the legal guardian of the child(ren) listed below, or have the permission of the parents (or legal guardians) for participation in this session.
  • You have a list of all the parents contact details so that they can be contacted in an emergency.

Do you agree to Declaration statements above:

I Agree

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Accompanying Adult's Email Address

Email*
OPT-IN for Update Emails and Promo Deals
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
The ACCOMPANYING ADULT 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 ACCOMPANYING ADULT agrees that they are also subject to all the terms of this document, as set forth above.
Accompanying Adult's Name

First Name*

Last Name*

Relationship*

Phone*
Accompanying Adult's Date of Birth*
Accompanying Adult'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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE! and  Rock Gym Pro