Junior Registration Form at Boulderworld Ltd

Participation Statement

All climbing and bouldering activities have a risk of serious injury or death. Participant must be aware of and accept that even if they follow 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 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.

Personal Information

Childs First Name
Childs First Name should be alphanumeric, can contain ,'_@.- and at most 100 characters long.
Childs Last Name
Childs Last Name should be alphanumeric, can contain ,'_@.- and at most 100 characters long.
Date of Birth
Email contact
Username should be alphanumeric, can contain @_.-, without space and at most 30 characters long.
Password should be alphanumeric, can contain _@.- and at most 15 characters long.
Confirm Password
Parent / Guardian Full Name
Full Name should be alphanumeric, can contain ,'_@.- and at most 50 characters long.
Parent / Guardian Contact Number
Contact Number should be alphanumeric, can contain _@.+- and at most 15 characters long.
Does your child suffer from any medical condition which makes it more likely they could be involved in an accident and cause harm to themselves or others? If yes please inform a member of staff on arrival.

Customer Agreement

Please read each of the following statements and tick each box to say that you understand.

Do you and your child understand that : Matting does not guarantee your safety and down climbing is best practice when bouldering. Climbers should not climb, walk or stand under other climbers. Climbers should be aware of other climbers and observe good practice at all times. You are responsible for any U18 or novice climber within your care. Climbing holds may move, break or spoon and should be reported to a member of staff.
Electronic Signature Consent 
I confirm that I understand the above statements and the dangers involved in bouldering and agree to abide by the terms and conditions provided by BoulderWorld Belfast.
I confirm that the information I have provided in this registration is correct and if any information changes I will notify Boulderworld. 
I confirm I have watched and understood the BoulderWorld Induction Video  
I confirm that until my child is sufficiently competent to climb unsupervised, they will be supervised at all times in the centre by a competent registered member(18+) of Boulderworld or a qualified external or centre instructor. 
I confirm that when my child is sufficiently competent to climb unsupervised they will only do so on successful completion of the centre’s Junior Assessment and I give consent for them to do so. 
By checking here and to the statements above, you are consenting to the use of the electronic signature in lieu of an original signature on paper. By checking here you are wavering that right. Your agreement to use an electronic signature with us for any documents will continue until you notify us in writing that you no longer wish to use an electronic signature.
I have read and agree to the Centre Rules and Conditions of Use