Junior Registration Form and Climbing Parental Consent

Junior Registration Form and
Climbing Parental Consent
for Junior Climbing

Digital version of the original registration and consent form. Structure, headings, and colour styling have been kept closely aligned to the paper version for easier completion and forwarding.
Staff Name:
Registration Number:
(A) Junior
Title:
Male/Female:
First Name:
Surname:
Address:
Date of Birth:
Post Code:
In Case of Emergency Number:
Mobile Tel. Number:
Email address:
Details of relevant medical history, including medication:

Collection Any parent that brings their children to Westway for any activities must ensure that they collect them on time. Persistent late collections could be considered neglectful and a pattern developing will be recorded by the Duty Manager/Sports Manager. If the child is not picked up within 30 minutes on three occasions without a legitimate reason the Social Services will be called, the parent may be charged for the additional costs of looking after their child and the disruption to services.

(B) Parent/Legal GuardianPlease use 'Same as above' (SAO) where information is shared
Title:
Male/Female:
First Name:
Surname:
Address:
Date of Birth:
Post Code:
Home Tel. Number:
Mobile Tel. Number:
Email address:
In Case of Emergency Name:
In Case of Emergency Number:
Details of relevant medical history, including medication:
Please tick Yes or No
Would you like to receive Everyone Active Guest passes and further information about Sports and Leisure Management promotions and products?
Would you like to receive offers about our carefully selected partners’ promotions and products?
Do you agree to us sharing your data with the Council and Westway Trust?
Please tick preferred methods of communication
How did you hear about us?

PRIVACY POLICY: Everyone Active will manage your data securely and in accordance with all relevant Data Protection laws. We will use your data for managing the services we provide. Full details of how we manage your data can be found in our privacy policy at everyoneactive.com/privacypolicy. Do you agree to Everyone Active holding your and your child’s data?

Junior Climbing Consent

BMC Participation Statement: “The British Mountaineering Council recognises that climbing and mountaineering are activities with a risk 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.”

Parental Consent for Instructed Sessions Private/Parties/Schools/Youth Groups

Please note that this form is only valid for one school year. Children must be 5 years and over.

Agreed conditions
The Westway Climbing Centre recognises that some groups will require greater support to understand and respond to the risks involved in climbing. The Westway will provide tailored supervision for those groups as appropriate, as long as it is reasonably practicable. It is the parent/guardian’s responsibility to convey the risks to the children and to inform the Westway of any particular support that may be required.
Name of the booking:
Please Note: The aforementioned minor will only be permitted to climb under the supervision of an Everyone Active Climbing instructor or a competent registered casual climber.

Casual Climbing Novice Under Supervision (Under 18yrs)

Consent: “I have read the above participation statement and the ‘Junior Climbing Recognition of Risk’ document. I consent to my child climbing at The Westway Sports Centre under the supervision of the climber named below. I have ensured that my child understands that the conditions of use and any instructions given by staff must be adhered to at all times. I undertake to inform Everyone Active of any changes in my child’s health, and any medical treatment received.”

To be completed by the supervisor
If you agree to supervise the above named novice you must abide by all of the following terms and conditions, and sign below to show your agreement.
  • I will ensure that the minor in my care abides by the centre’s general terms and conditions of use.
  • I understand that I am responsible for checking the minor’s harness, knot and/or belay device before they or the person they are belaying climbs.
  • I understand that there is a risk of objects falling from height, including other climbers and broken or spinning holds, and accept that these may harm minors under my supervision, particularly infants who would be unable to take evasive action.
  • I will not climb while a minor under my supervision is belaying.
  • I agree to stand by the minor climber while he or she is belaying, and act as a backup, holding the dead rope at all times.
  • If supervising infants, I understand that all the normal rules and conditions of the centre apply and I will ensure that I am not distracted whilst belaying, that infants are kept well back from the climbing wall, and that no toys or pushchairs obstruct fire paths or are left under the climbing wall where climbers might be lowered onto them.
  • Failure to comply with the above terms and conditions may result in being asked to leave the Climbing Centre.

Parental Consent for Junior Test: Unsupervised Top Rope, Lead or Bouldering (14+ Years)

Consent: “I have read the above participation statement and the ‘Junior Climbing Recognition of Risk’ document and give consent for my child to climb at The Westway Sports Centre. I have ensured that my child understands that the conditions of use and any instructions given by staff must be adhered to at all times. I undertake to inform Everyone Active of any changes in my child’s health, and any medical treatment received.”

Tick as appropriate:
Please Note: Following successful completion of a Junior Test for TOP ROPING, the aforementioned minor will be permitted to top rope and boulder without the supervision of an Everyone Active Climbing instructor or a competent registered casual climber.
Please Note: Following successful completion of a Junior Test for LEAD CLIMBING, the aforementioned minor will be permitted to top rope, lead climb and boulder without the supervision of an Everyone Active Climbing instructor or a competent registered casual climber.