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UNDER 18 SUPERVISION FORM

This 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.


Conditions of Supervsion

A registered adult (18+) may supervise up to two participants, up to the level of competence and registration of the supervisor. Therefore:

  • “Boulder Only” registered adults (18+) may only supervise in the bouldering areas. 
  • “Auto-Belay & Boulder” registered adults may only supervise in the auto-belay and bouldering areas.
  • “Ropes & Boulder” registered adults may supervise in all areas. 

Supervisors must be prepared to take full responsibility for the safety of those they are supervising and complete the relevant supervision forms at reception before any activity starts.

Each site may have different age limits. Speak to staff or see the website for specific age restrictions in each centre.

Do you agree to the statements above?

I Agree


Supervisors must take their responsibilities seriously. They must accept, on behalf of minors they are supervising, the ABC participation statement which is as follows:

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.”

Do you agree to the statements above?

I Agree


Supervisors must ensure that those they are supervising adhere to the terms and conditions of use that are found at reception and on their registration / acceptance of risk forms.

Furthermore supervisors must be able to SEE those they are supervising and be CLOSE enough to affect their behaviour at ALL TIMES. 

Do you agree to the statements above?

I Agree


Declaration of fitness

Do you, the adult supervisor, certify that to the best of your knowledge, the minor (under 18) under my supervision does not suffer from a medical condition which might have the effect of making it more likely that they will be involved in an accident which could result in injury to themselves or others?

I Agree


Declaration of fact

Do you, the adult supervisor, certify that the above information is correct and if any information changes you will notify the centre?

I Agree

First Participant's Name
First Name*
Middle Name
Last Name*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Participant's 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:*
Adult Supervisor's Email Address
Email*
Confirm Email*
Tick to get discounted climbing equipment and be invited to special events! (Don't worry, we'll only email once a month max and you can unsubscribe at any time)
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Adult Supervisor's Questions
1. If you are not the Parent or Legal Guardian, do you certify that you have obtained permission to act in 'loco parentis’ for the Participant?*

'Loco parentis' means “in place of the parent”, meaning you are responsible for decisions related to someone’s child on behalf of the parent.

2. Do you agree to ONLY supervise in areas that you are competent to use AND that match your registration level? If you are unsure, please speak to a member of staff now.*
3. Do you agree to ensure that those under your supervision adhere to the Terms & Conditions of Use?*
4. Do you agree to be responsible for the safety and behaviour of those you are supervising during their visit? *
5. Do you understand that failure to supervise properly may result in serious injury or death?*
6. Do you understand that failure to supervise properly may result in your climbing session being stopped?*
Parent(s) or 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 guardian agrees that they are also subject to all the terms of this document, as set forth above.
Adult Supervisor's Name
First Name*
Middle Name
Last Name*
Relationship*
Phone*
Adult Supervisor's Date of Birth*
Date of Birth
Adult Supervisor'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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