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This form is used to record customer info for outdoor gear rental. 

BEFORE ENTERING IN THE ACTIVITY IT WAS AGREED UPON AS FOLLOWS:

• WAIVER

The renter 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 Renter/Participant waives any claim however arising, including the negligence of CityROCK or its members, employees or any third party. 

• DISCLAIMER

The renter makes use of CityROCK's gear rental at entirely his/her own risk. The renter 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. The renter is solely repsonsible for the gear rented and will be held accountable for ANY loss or damage to the gear. (The renter will pay for the full replacement cost of the item in question and lose any deposit.)

The gear must be returned in the same condition as it was rented. Late return penalty fees will apply. 

• RENTAL GEAR PRICES

  • Metolius Magnum Boulder Pad - R200/day - Replacement R6,000
  • Metolius Session Boulder Pad - R140/day - Replacement R2,800
  • Climbing Harness - R80/day  - Replacement R600
  • Climbing shoes - R100/day - Replacement R800
  • Chalk bag - R30/day - Replacement R400
  • Helmet - R60/day - Replacement R800

 

 

First Renter Name

First Name*

Last Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Rental period

Date Out: *

Return Date: *

Sign out staff Name and Surname *
Gear Rental
Select rental item*

Details (include shoe size and/or brand)

Any visible damage of the rental gear before leaving
Select rental item

Details (include shoe size and/or brand)

Any visible damage of the rental gear before leaving
Select rental items

Details (include shoe size and/or brand)

Any visible damage of the rental gear before leaving
Select rental items

Details (include shoe size and/or brand)

Any visible damage of the rental gear before leaving
Select rental items

Details (include shoe size and/or brand)

Any visible damage of the rental gear before leaving
Renter details

Should the rental gear come back damaged or not returned within 5 days of the specified return date, the rented items will be billed to the below credit card at their replacement value. 


Name on credit card *

Card number *

CVC *

Expiry date *
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*

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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