New member sign-up with liability waiver, first-time climber and day-pass booking, class and private coaching registration, birthday party and group event booking, and combined customer feedback with corporate partnership inquiry — for indoor bouldering, top-rope, and lead-climbing gyms
Get started with PocperWelcome 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.
Full name:
Date of birth:
Email address:
Phone number:
Street address:
City:
ZIP / postal code:
Emergency contact name:
Emergency contact phone:
Emergency contact relationship:
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:
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:
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.
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
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?
Member signature:
If under 18, parent/guardian signature:
Date:
Welcome to the family. Climb on!
The New Member Sign-up & Liability Waiver template is a ready-to-use form from Pocper's Indoor Rock Climbing Gym pack. Customize the fields to match your workflow, then share a link so clients can complete it and upload documents in real time.