Bouldering Only Sign-In

ADULT (over18s) REGISTRATION FORM for

Bouldering only at Boathouse Climbing Centre Participation Statement

Boathouse Climbing Centre recognises that climbing and mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement.

GDPR: This data is for the use of an incident and maybe passed onto 3^rd parties such as the emergency services to aid in the wellbeing of you, it is held on file for insurance purpose only, and can be destroyed by written consent from you 5 years from last entrance to the wall!

Full details of all Boathouse Climbing Centre Terms and Conditions can be found here.

Unsupervised Climbing - Before you climb without supervision the centre expects you to be competent

Anyone who has not registered is classed as a novice and must not climb without supervision.

Unsupervised climbing is just that! Staff will provide whatever help and advice they can, but instruction in the use of equipment or climbing techniques will only be provided where it has been booked and paid for in advance. If you are not confident in the use of any climbing equipment or technique then do not attempt to use it without the supervision of someone who is competent to do so.

Are you over 18 years of age?*

Yes No

If you are not 18 years or above you can not register and require a different induction if appropriate

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Gender

Male Female Non-Binary Other Prefer not to say

Date of Birth*

Contact Telephone Number*

Email Address*

Emergency Contact Name:*

Emergency Contact Number:*

Risks - “The British Mountaineering Council recognises that climbing and mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement.”

Association of British Climbing Walls ABC Statement "All climbing activities have a risk of serious injury or death. Participants must recognise 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."

Although the climbing centre is an artificial environment the risks involved are no less serious than when climbing outside on a crag or mountain. There is an additional risk that bolt-on holds can spin or break.

Climbing beyond your capabilities on any wall is likely to result in a fall. Any fall may result in an injury despite the safety systems in place to avoid it. You must make your own assessment of the risks whenever you climb.

Our Duty of Care - The rules of the climbing centre set out below are not intended to limit your enjoyment of the facilities. They are part of the duty of care that we, as operators, owe to you, the customer, by law. As such they are not negotiable and if you are not prepared to abide by them then the staff must politely ask you to leave.

Your Duty of Care - You also have a duty of care to act responsibly towards the other users of the centre. Statements of ‘Good Practice’ are posted around the centre adjacent to the relevant facilities. These describe the accepted methods of use and how customers would normally be expected to behave towards each other.

GENERAL SAFETY

Report to reception on each visit before you climb.
You must exercise care, common sense and self preservation at all times.
Report any problems with the walls, equipment or other climbers’ behaviour to a member of staff immediately.
Be aware of the other climbers around you and how your actions will affect them.
Do not distract people while they are climbing or belaying.
Stand well back from the climbing walls unless you are spotting a climber.
Never stand directly under someone who is climbing.

Poor Practice discipline -

A Reminder that you have duty of care to each other and those around as stated in the rules.
Persistent poor practice (3) in one session or a pattern of behaviour will result in – retraining needed, and even disbarment from the centre, until re assessment.
Dangerous behaviour will result in – retraining needed, and even disbarment from the centre, until re assessment.

Do you agree to abide by the Rules of the Climbing Centre?*

Yes No

Conditions of Registration

After you have read the Conditions of Use and Rules of the climbing centre, you must answer the following questions by writing either “YES” or “NO” in the box provided then sign the declaration at the bottom of the form. Only climbers who give satisfactory answers to the questions will be registered and allowed to climb unsupervised.

BOULDERING Please Note it is a 4.5 Meter high bouldering wall and roof

THE SOFT FLOORING DOES NOT MAKE THE CLIMBING ANY SAFER. Broken and sprained limbs are common on this type of climbing wall despite the soft landing. Uncontrolled falls are likely to result in injuries to yourself or others. Always climb within your capabilities and descend by down climbing, at the very least a controlled fall, jumping is not advisable.

Never climb directly above or below another climber.

No Harness to be worn while bouldering.

A bouldering pad must be used in the tower area.

Spotters in place if needed.

No swinging on the steel.

Training finger boards and the ‘The Thing” is at your own risk and due to greater risk to under 18s having long term injury should always supervised by an experienced and or qualified coach. If you are un-sure how to use the equipment, please ask a member of staff.

Have you read and understood the Terms and Conditions of Use and Rules of the Centre?*

Yes No

Do you have any questions regarding the application of the Conditions of Use or the Rules?*

Yes No

Do you understand that failure to exercise due care could result in your injury or death?*

Yes No

Do you agree to climb on the Bouldering routes only?*

Yes No

If you want to use the ropes or Auto belays you will need to register and be inducted in the use.

Declaration of Fitness*

I certify that, to the best of my knowledge, I do not suffer from a medical condition, which might increase the risk of an accident to myself, or others while bouldering.

Medical Condition*

I will inform the Boathouse Climbing Centre if I develop any medical condition, which could increase the risk of an accident while bouldering.

Signature*

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Use your mouse or finger to draw your signature above

Print Name of Signature*

First Name

Last Name