Heads up: Parents only!

This form should only be filled in by a parent on behalf of a child.

Welcome to Frome Boulder Rooms

Delighted to meet you.

Please do not print out this form – it needs to be completed online.

Any questions? We’re here to help. But seriously, please do not print out this form.

Acknowledgement of Risk Form

This Acknowledgement of Risk Form is for Over 18's and parents/ guardians supervising Under 18's climbing at Frome Boulder Rooms. If you are unsure of any aspect of the form you should not fill this in online. Please come into Frome Boulder Rooms and fill it in where a staff member can answer any questions or clarify any points that may be unclear. If you have any issues that can affect your filling in of the form, please fill in the form within the centre with staff support

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.”

It is important that 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."

Conditions of use

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. This is particularly important with broken or spinning holds

- Be aware of the other climbers around you and how your actions will affect them

- Never stand directly underneath someone who is climbing

- If you have children, you must keep them under control and supervise them directly at all times. Be close enough to affect or control the child’s behaviour at all times

- Please make yourself aware of the location of the fire exits in the building and fire assembly points

As a user of this climbing wall, you must be aware of and accept the following:

- Volumes on the walls are designed to enhance the quality of climbing but you must be aware of and accept that when climbing above them there is an additional risk of falling onto them

- 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. You must make your own assessment of the risks whenever you climb

- Participants must understand that climbing while pregnant can increase the risk posed to mother and unborn child

- Participants must be aware and accept that climbing holds can spin or break

- You must do everything reasonable and practical to avoid endangering yourself or others

- You have to be aware of and adhere to the safety rules and supervision of the centre at all times

- Stand back from the climbing walls unless you are spotting a climber

- Please empty your pockets and remove all jewellery before climbing

-You use the training area equipment at your own risk

Bouldering

- Whenever possible, down climb, or if this is not possible, use a controlled/planned jump

- It is your responsibility to ensure that you can climb down or land safely; don’t climb into a situation that you cannot safely get out of

- Never climb directly above or below another climber

- Remove anything from pockets that could hurt you when landing

- Always be aware of people climbing above and around you

Supervising

By signing this form, you are declaring:

-that you aware of the rules of the centre and safety guidelines outlined in the registration process/ on the family page of the website, and you are willing to abide by them.

- that you understand, as a supervising adult it is your responsibility to ensure your young ones are following the rules of the centre.

-that you understand, as a supervising adult it is your responsibility to be looking out for the hazards outlined in the registration process, on behalf of your children.

-that you understand that you may supervise no more than 2 children at any time.

Photography

Staff at Frome Boulder Rooms, or other permitted peoples hold the right to take photographs in and around the centre. By signing this form, you consent to potentially being in any photographic or video media that may be used in promotion for Frome Boulder Rooms website and/or social media.

THE SOFT MATTING DOES NOT REMOVE THE RISK OF INJURY.

Injuries can still occur even after a controlled/planned jump but are more likely after an uncontrolled fall. You should always be doing your utmost to avoid the risk of uncontrolled falls. This includes paying attention to how you will land and always assessing the risk of each climb that you undertake.

Our Duty of Care

The conditions of use of the climbing centre 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 may ask you to leave.

Your Duty of Care

You have a duty of care to act responsibly towards the other users of the centre, follow good practice and abide by the conditions of use of the centre. Statements of ‘Good Practice’ are posted around the centre adjacent to the relevant facilities. These describe the accepted methods of use of equipment and climbing areas.

Declarations

I certify that to the best of my knowledge, I do not suffer from a medical condition that might have the effect of making it more likely that I will be involved in an accident that could result in injury to myself or others.

I confirm that the above information is correct and if any information changes I will notify the centre.

If signing on behalf of a minor (child under 18 years), I declare that both/all parents or legal guardians of the child have agreed to their participation in this activity.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT, AND THE SUPERVISION RULES OF THE CENTRE.

I HAVE READ AND UNDERSTOOD THIS DOCUMENT AND I AGREE TO BE BOUND BY ITS TERMS.

Parental Consent

Parent’s name

Photographic consent

From time to time we may wish to take photo/video of kids’ clubs for promotional purposes.

Do you give consent for your child to appear in these videos?

I give consent for my child to be involved in promotional material.

No I do not wish my child to take part in promotional material.

Child’s details

Title

Firstname

Surname

Gender

Dob

Do you have any access requirements we should know about?

Address

Postcode

Country

Rest of address

Contact details

Daytime telephone

Evening telephone

Emergency contact number

Emergency contact name

Please answer the following questions

Do you understand that failure to to exercise due care, and follow the rules of the centre could result in injury or death?

Yes

Have you watched the Frome Boulder Rooms Induction Video

Yes

Have you fully read and understood the conditions of this Participation Agreement?

Yes

Do you agree to abide by the rules and conditions set out in this document when using the facilities at Frome Boulder Rooms?

Yes

Do you understand that the matting does not remove the risk of injury?

Yes

Do you agree to supervise your child according to the supervision guidelines or specific advice given to you by a member of staff?

Yes

Are you, the person filling out this form, over 18 years of age?

Yes

Do you understand that failure to to exercise due care, and follow the rules of the centre could result in you being asked to leave Frome Boulder Rooms?

Yes

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT AND WATCH THE INDUCTION VIDEO. I HAVE UNDERSTOOD THE FORM AND VIDEO AND ACKNOWLEDGE I AM BOUND BY ITS TERMS

Yes

Please sign here: