Clogwyn Climbing Wall Acknowledgement of Risk Form

Form for members of the public participating in climbing activity on the Mersey Weaver Scouts Clogwyn Climbing Wall. If you are unsure of any aspect of the form you should not fill this in. Please fill it in where a team member can answer any questions or clarify any points that may be unclear. If you have any impairments that can affect your filling in of the form or climbing, please fill in the form within with staff support.

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Participation statement

“All climbing 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 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 one of our volunteers to clarify.

Conditions of use

General Safety

You must exercise care, common sense and self-preservation at all times.
Report any problems with the walls, equipment immediately via our online form. 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 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.

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. These describe the accepted methods of use of equipment and climbing areas.

Unsupervised Climbing

Anyone who is not competent to climb unsupervised must be supervised by a competent person.

Supervised Climbing

An adult who has registered at the centre, and proved competency, may supervise up to two novice climbers, as long as they are prepared to take full responsibility for the safety of those people.
Groups of three or more novices must only be supervised by an instructor holding the relevant valid Mountain Leader Training qualification and insurance or other relevant qualification.
All children in the centre must be supervised by an adult unless they have been assessed and hold a Scout Permit or NGB award for unsupervised climbing.

Confirmation*

I confirm I have read and understood the above conditions of use

Personal Information

Are you over 18 or signing as parent/carer on behalf of a young person?*

I am over 18

I am a parent/carer signing on behalf of a young person

Young Person's Name*

First Last

Date of Birth*

Name*

First Last

Date of Birth*

Email*

Enter Email Confirm Email

Emergency Contact

Emergency Contact's Name*

First Last

Emergency Contact's Phone Number*

Medical Conditions and Additional Needs

Details of any medications currently being taken:

Details of any disabilities, conditions, allergies, special needs or cultural needs that might affect this activity:

Declarations

Signature*

I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.

I have noted the arrangements for the activity and agree to the named person taking part.

Parent's/Guardian's Name*

First Last

Relationship to young person*

Parent

Guardian

Other