New Member Sign-up & Liability Waiver

Welcome to the gym! Please complete every section so we can get you safely on the wall. This form covers your contact details, climbing background, health considerations, and the liability waiver every climber must acknowledge.

Section 1 — Member Information

Full name:

Date of birth:

Email address:

Phone number:

Street address:

City:

ZIP / postal code:

Emergency contact name:

Emergency contact phone:

Emergency contact relationship:

Section 2 — Climbing Experience

Self-rated skill level:

Beginner — first time or under 6 months

Novice — 6–24 months

Intermediate — 2–5 years

Advanced — 5+ years and lead-climbing

Expert — coach / route-setter level

What do you climb? (tick all that apply)

Top-rope

Lead climbing

Bouldering

Sport climbing outdoors

Trad climbing outdoors

Belay certification status:

Not certified

Top-rope belay certified

Lead belay certified

Certified at another gym

Approximate years climbing:

Section 3 — Health & Medical

Your safety matters. Please tick anything that applies, and add details below if relevant.

Heart, blood-pressure or circulatory condition

Recent injuries, surgeries, or sprains (last 6 months)

Pregnancy

Asthma or breathing condition

Severe allergies (food, latex, bee stings, etc.)

Currently taking prescription medication that affects balance, judgement, or coordination

None of the above

Please provide any details our staff should know:

Section 4 — Liability Waiver Acknowledgment

Climbing is an inherently dangerous activity. Please read each statement carefully and acknowledge by ticking the box.

I understand that rock climbing involves risk of falls, equipment failure, collisions, and serious injury or death.

I confirm I am physically able to participate, or have disclosed any conditions above.

I agree to follow all gym rules, staff instructions, and posted safety procedures.

I voluntarily assume all risks of climbing and release the gym, its staff, owners and contractors from liability for injury or loss arising from my participation, except where caused by gross negligence.

I have read and understood this waiver in full.

Section 5 — Membership Plan Selection

Pick the plan that fits how you climb:

Single drop-in (one visit)

10-visit punch card

Monthly unlimited — solo

Monthly unlimited — couple

Annual unlimited — solo

Family plan (up to 4 members)

Student / military discount (ID required)

Not sure yet — please contact me

Section 6 — Auto-renewal & Marketing

Communication & billing preferences:

Yes — auto-renew my membership monthly/annually

Yes — email me about new routes, comps, classes and gym news

Yes — text me last-minute spot openings for classes

How did you hear about us?

Section 7 — Signature

Member signature:

If under 18, parent/guardian signature:

Date:

Welcome to the family. Climb on!