Group Booking Relating To
Monty's Community Hub, 22nd June 7.45pm
Winchester Penguins, 10th July 2pm, Lianne Marsh
Greggs Wednesday morning, January to March 2021
Greggs Monday afternoon December 2020 to April 2021
21st Romsey Beavers, 1st July 5pm
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.