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Sign in to Boudler Shack for a self-taught instructed climbing session. 

As the qualified leader of a self-taught group at Boulder Shack Climbing Gym you must agree that:

  • You have read, understood and signed the Main Bouldering Waiver for yourself on your first visit to Boulder Shack.
  • You will only work within the remit of your qualification (CWA, SPA...)
  • You will not exceed a maximum ratio of 1 instructor per 9 participants. 
  • You will assess your groups age, behaviour and needs and reduce the instructor : participant ratio where appropriate.
  • You will ensure you have clearly explained the risks of climbing to all members of your group and be confident they understand them.
  • You have gained informed (having had the risks of climbing/bouldering explained to them) parental or legal guardian consent for all under 18's in your care.
  • You have immediate access to medical and emergency contact details of all under 18's in your care.
  • You will ensure you and your group abide by the terms of use and rules of Boulder Shack Climbing Gym as stated in the Main Bouldering Waiver.
  • You have a valid first aid certificate, appropriate public liability insurance and qualifications for climbing with your group.
  • You have a safeguarding policy in place and will follow it's associated procedures.

Your Data

By participating at Boulder Shack Climbing Gym you accept that we will be keeping your data indefinitely, however at anytime you can ask for your data to be deleted. In the event of a First Aid form needing to be filled out we will be keep this information for 3 years (form your 18th birthday). We take protecting your data seriously, all of the data that we gather is kept in accordance with the Data Protection Act..  

Please initial if you agree to the above


 


First Instructor Name

First Name*

Middle Name

Last Name*

Phone*
First Instructor Date of Birth*
First Instructor Additional Information

Organisation *
First Instructor Signature*
Second Instructor Name

First Name*

Middle Name

Last Name*
Second Instructor Date of Birth*
Second Instructor Additional Information

Organisation *
Third Instructor Name

First Name*

Middle Name

Last Name*
Third Instructor Date of Birth*
Third Instructor Additional Information

Organisation *
Fourth Instructor Name

First Name*

Middle Name

Last Name*
Fourth Instructor Date of Birth*
Fourth Instructor Additional Information

Organisation *
Fifth Instructor Name

First Name*

Middle Name

Last Name*
Fifth Instructor Date of Birth*
Fifth Instructor Additional Information

Organisation *
Sixth Instructor Name

First Name*

Middle Name

Last Name*
Sixth Instructor Date of Birth*
Sixth Instructor Additional Information

Organisation *
Seventh Instructor Name

First Name*

Middle Name

Last Name*
Seventh Instructor Date of Birth*
Seventh Instructor Additional Information

Organisation *
Eighth Instructor Name

First Name*

Middle Name

Last Name*
Eighth Instructor Date of Birth*
Eighth Instructor Additional Information

Organisation *
Ninth Instructor Name

First Name*

Middle Name

Last Name*
Ninth Instructor Date of Birth*
Ninth Instructor Additional Information

Organisation *
Tenth Instructor Name

First Name*

Middle Name

Last Name*
Tenth Instructor Date of Birth*
Tenth Instructor Additional Information

Organisation *
Parent or Guardian's Email Address

Email*

Confirm Email*
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Participant Numbers & Ages
How many participants are you signing in?*
How many of the above are under 18?*
Participants Names

Participant 1 Name

Participant 2 Name

Participant 3 Name

Participant 4 Name

Participant 5 Name

Participant 6 Name

Participant 7 Name

Participant 8 Name

Participant 9 Name
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Additional Information

Organisation *
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. You can withdraw your consent at any time. 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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