Climbat Climbing Competition PUMP COMP 2014

Registration Form
Please fill in your details clearly below after reading the rules and regulations. Forms must be handed in to the main desk in Climbat.
Personal Details First name Last name Date of birth Declaration of Applicant If the applicant is below 18 years of age the following must be completed be a legal guardian on behalf of the applicant / / Gender: Climber T-shirt size: F S / M M L XL XXL

I have read, understood and voluntarily agree to abide by all of the Terms and Conditions of the competition (shown overleaf) I have received a copy of, read, understood and voluntarily agree to keep up-to-date with and abide by the Gym Rules I, ___________________________ the applicant / co-signer / parent / guardian confirm that this application has been completed accurately to the best of my knowledge and that I have had sufficient opportunity to read and ask questions. I am aware that climbing is a dangerous activity with obvious risk. I accept responsibility for my own / my ward's involvement and understand that failure to exercise due care could result in serious injury or death. I warrant that I do not suffer from any medical condition that may increase the likelihood of my involvement in an accident or affect my ability to participate safely in strenuous exercise.

Signature ________________ Date