Digital Waiver

PERSONAL INFORMATION

Please Complete the following questions. Questions with an * are required information. If you are the parent/guardian wishing to pre-register a minor at the centre, THIS IS NOT THE CORRECT FORM. Please complete the Parent/Guardian form.

Name *

First Name Middle Initial Last Name

Date of Birth *

Use / as separator

Address *

Address Line 1
Address Line 2
Town/City	County
Post Code	Country

Phone Number *

- Area Code Number

Email *

example@example.com

Emergency Contact Name *

name

Emergency Contact Number *

- Area Code Phone Number

If you have any medical conditions that make it more likely for you to sustain an injury whilst climbing, please provide details below. Input None if not applicable: *

[Medical Conditions that may affect individual safety OR the safety of other climbers]

Have you climbed at an Indoor Climbing/Bouldering facility before? *

CONDITIONS OF USE

The BRITISH MOUNTAINEERING COUNCIL recognises climbing as an activity with a danger of personal injury or death. Participants in this activity should be aware of, and accept, these risks and be responsible for their own actions and involvement.

RISKS - 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. The soft flooring under the bouldering walls is designed to provide a safer landing for climbers falling from the bouldering wall. THE SOFT FLOORING DOES NOT MAKE THE CLIMBING ANY SAFER. Breaks and sprains are common on this type of climbing wall despite the soft landing. Uncontrolled falls are likely to result in injuries to yourself or others. 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. If in doubt - STOP!

OUR DUTY OF CARE - The RULES OF ROCKBURN 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 will politely ask you to leave.

YOUR DUTY OF CARE - You also have a duty of care to act responsibly toward other users of the centre. Statements of 'Good Practice' are posted around the centre; these describe the accepted methods of use and how customers are expected to behave toward one another.

UNSUPERVISED CLIMBING - Before you climb without supervision Rockburn Ltd expects you to be competent in the use of indoor climbing facilities. You are required to sign a ‘Digital Waiver’ to your experience in the use of artificial climbing structures, that you are prepared to abide by the RULES OF ROCKBURN and that you understand the risks involved in your participation. Anyone who is Under 18 years of age, or has not climbed before, or not used an indoor facility MUST undergo a centre induction BEFORE they can use the facility unsupervised. Unsupervised climbing is EXACTLY that! Staff will provide whatever help and advice they can, but instruction will only be provided where it has been booked and paid for in advance. If you are not COMPETENT & CONFIDENT in the use of a climbing wall then you must not attempt to use it.

SUPERVISED CLIMBING - An adult registered at the centre may supervise up to two novice climbers (aged 6+, or 1 under 6 years of age) as long as they are prepared to take full responsibility for the safety of those people. Groups of three or more novices MUST be supervised by an instructor holding the relevant qualification.

CHILDREN – All children in the centre must be supervised by a competent adult (climber whom has been inducted at the centre)

Have read and understood Rockburn's CONDITIONS OF USE and I AGREE to be bound by their content whilst using the facilities at Rockburn Ltd? *

RULES OF ROCKBURN

GENERAL SAFETY...

Report to reception on each visit before you climb
YOU MUST EXERCISE CARE, CAUTION AND SELF-PRESERVATION AT ALL TIMES
Report any problems with the structure, holds or associated equipment, or other climbers' behaviour, to a member of staff immediately upon discovery
Be aware of the other climbers around you and how your actions will affect them
If you are spectating, STAY OFF THE SAFETY MAT! - this it is for climbers only!
No running on the safety mat at any time

WHEN BOULDERING...

ALWAYS climb within your capabilities
ALWAYS dismount by down climbing to at least half way before jumping off
NEVER climb directly above or below another climber
STAY BACK - Climbers have priority: give climbers 2 metres of space behind them!
NO clothing, bags, items to be left on the safety matting - we provide storage for those bits
REMOVE jewellery/watches and empty pockets before climbing

[If you have any questions regarding the above information, please cotact a member of staff to clarify your queries. You must only complete this form once you both understand and have had sufficient time to assess its content adequately]

Have read and understood the RULES OF ROCKBURN and I AGREE to abide by their content whilst using the facilities at Rockburn Ltd? *

I have had sufficient opportunity to read this entire document. I have read and understood its content, and I agree to be bound by Rockburn's 'CONDITIONS OF USE' and 'RULES OF ROCKBURN' whilst participating at Rockburn Ltd. *

Do you understand that failure to Exercise due care and attention, and self-preservation, may result in injury , or in extreme circumstances, death? *

By placing your name in this box, you are giving a 'digital signature' to Rockburn Ltd in relation to all information submitted in this form in its entirety, assigning your confirmation that it has been completed knowingly, by you, for the purpose of registration to Rockburn Ltd, Bridport. *

Clear

Completed by: *

Completed on: *

Date

Do we have consent to use photographic images and video for marketing purposes? *

This may be used on our website and Facebook pages to promote Rockburn Ltd

Can we email you information about Rockburn? *

For Information on how we use, store and process your data click here

For Information on the types of data we process and how we use, store and process your data, please visit: https://rockburn-bridport.com/yourdata/

PERSONAL INFORMATION

Conditions of Use and Rules of Rockburn

DECLARATION OF ACCEPTANCE

Data Usage and Permissions