Required fields are marked with asterisks (*)

Rock Climbing - Permission/Waiver

All Rock Climbing Wall users must complete a Permission/Waiver form prior to climbing the wall. For participants under the age of 18 years, a designated parent/guardian must complete the form.
Participants will be asked to complete a new waiver once every 365 days
Participants ages 11 and under are required to have a parent/guardian onsite and supervising them during use of the Climbing Wall.

Participant Information

First Name and Last Name (hereinafter the “Participant”)

Date of Birth (yyyy/MM/d):

Phone Number:

Street Address:

City/ Town

Postal Code

Email Address

First Name and Last Name

Phone Number:

Relation to Participant: