Group Booking Relating To
Party - Whicher - 10.10..21 @ 15:00
Southampton City Scouts - Tim Bills - 2nd November @ 7pm
Birthday party, Tang, 17.10.2021, 12:30
Highfield Cubs 12th October @ 7pm
Highfield Cubs 5th October @ 7pm
Kids Party, Graft, 17/10/21, 15:00
Kids Party - Callie Wilson, 9th October @ 3pm
Tom Prutz Scouts, Friday 17th December @ 7pm
Tom Prutz Scouts, Tuesday 14th December @ 7pm
Party - Ellis - 25.09.2021 @ 12:30
Thornden School - Year 10 Healthy Living and Fitness, Wednesdays @ 1.30pm
Gregg Friday's 2.15pm, Year 11 (January to February)
Gregg Thursday's 2.15pm, Year 10 Block 3 (January to February)
Gregg Thursday's 2.15pm, Year 10 Block 2 (October to December)
Gregg Wednesday's 11.30am, Class 9Y (January to March)
Gregg Monday's 2.15pm, Class 9X (December to April)
Gregg Monday's 9.30am, Class 7X, (3 lots of 4 weeks, October to March)
Thea Andrews Birthday Party, 25th September @ 3pm
Parent / Guardian Full Name
Parent / Guardian Phone
Parent / Guardian Email
Participant Full Name
Participant Date of Birth
Medical Conditions to be Aware of?
Does this participant have any medical conditions that will affect their ability to climb or that you feel Boulder Shack should be are of? Including things such as asthma, allergies, recent injuries or medical treatment if the participant is on any medication.
If Yes Above, Please Provide Full Details
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Mobile Number
Consent to Climb
Yes, I understand and give consent.
Do you give consent for your child to climb with Boulder Shack Climbing Gym?
By giving consent you are confirming that you are this participants parent or legal guardian; you must not give consent if you are not a parent or legal guardian.
By giving consent you are also confirming that you understand and accept that climbing and bouldering are activities with an inherent danger of serious personal injury. Boulder Shack Climbing Gym will do all it reasonably can to manage the safety of climbers but can not prevent accidents from occurring.