REGISTRATION FORM AND ACCEPTANCE OF RISK OF ACTIVITY

Name *

First

Last

Date of birth *

Age *

Gender *

Weight (kg) *

Height (cm) *

Email *

Contact number *

Discipline *

Walk
Scramble
Rock climb

Duration of the program *

Date of trip *

Emergency contact name *

First

Last

Relationship *

Email *

Contact number *

I have rock climbed before: *

I consider my experience: *

Please specify any past experience:

Do you have any allergies? *

Please specify

Do you have any dietary preferences? *

Please specify

Are you currently taking any medications? *

Please specify

Do you have any recent medical surgeries/health concerns? *

Please specify

Any other pertinent medical information?

ACKNOWLEDGEMENT AND ACCEPTANCE OF RISK Hamlet Mountaineering recognises that climbing and mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement. While you are far more likely to have an accident on the way to an activity we ask that all participants take their time to consider these risks, however small, and satisfy themselves that they are happy with them. By taking part in an activity you accept these risks and will be responsible for your own actions and involvement. Please confirm that you declare to know and understand the risks involved in participation in these activities, which can not be completely eliminated, even if there is compliance with safety standards accredited by Hamlet Mountaineering, which aim to reduce the risks of this activity inherently may involve. *

I understand and accept the risks involved