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The
Community Center
Indoor
Rock Climbing Consent Form/ Liability Waiver
Warning!!!
Rock Climbing is a sport in which you may be injured or killed. The risks of rock climbing remain even when climbing indoors. Never climb alone and /or without a rope. Always wear a harness and always tie-in using a retraced figure 8 knot. Never let someone belay unless you trust him or her with your life.
Adult or Parent(s)/ Guardian(s) information:
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Please list the name(s) of any minor child(ren) that you are responsible for and consent to usage of the indoor climbing structure. Children under the age of 14 must be under direct adult supervision and may require a chest harness.
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Name:___________________________________ Date of Birth:___/___/____
Waiver: