REGISTRATION FORM

ADULT SUPERVISED CLIMBER (18+) at Boulderworld Ltd


BMC PARTICIPATION STATEMENT ‘ THE BRITISH MOUNTAINEERING COUNCIL RECOGNISED THAT CLIMBING AND MOUNTAINEERING ARE ACTIVITIES WITH A DANGER TO PERSONAL INJURY OR DEATH. PARTICIPANTS IN THESE ACTIVITIES SHOULD BE AWARE OF AND ACCEPT THESE RISKS AND BE RE-SPONSIBLE FOR THEIR OWN ACTIONS AND INVOLVEMENT’

The following information will be used to complete a document that you will read and then sign. Please complete the flowing form to create the document. You can preview the document you will be signing.

Participant Details

First Name
 
Surname
 
Date of Birth
 
Email address
 
Username
 
Password
 
Confirm password
 

Participant Adress

Line1
 
Line 2
Line 3
Line 4
City
 
County
 
Post Code
 

Participant Telephone

Phone number
 

Emergency Contact

Full Name
 
Phone
 

Conditions of Registration

Please answer the following questions YES or NO in the box provided. Only climbers who give satisfactory answers to the questions will be registered and allowed to climb unsupervised. Please read all the questions carefully. If you have not answered a question correct you will be asked to complete the form again.

Are you over 18 years old?
 
Do you understand the matting under the walls does not guarantee your safety?
 
Do you understand that failure to exercise due care could result in injury or death?
 
Do you agree to abide by the RULES of the climbing centre?
 
Do you understand that you must be supervised at all times whilst in the centre by a registered member over the age of 18 that is signed off to climb unsupervised?
 
Do you have any questions about climbing under supervision at BoulderWorld Climbing Centre?
 


Customer Agreement

Please read each of the following statements and tick each box to say that you understand.
By ticking this box I am confirming that I understand each of the above statements and the dangers involved in climbing and I agree to abide by the terms and conditions provided by Boulder world Belfast.  
By ticking this box I confirm that the above information is correct and if any information changes, I will notify Boulder Belfast.  
Can we use your email to send you news and updates needed for you BoulderWorld Account ?
 
I have read and agree to the CONDITIONS OF USE. 
required fields