All participants must sign a waiver releasing CityROCK from liability and acknowledging their own personal responsibility for safe climbing.

For climbers under 18 you have to insist that your legal guardian or parent sign our waiver document. You can download the waiver here in word form, or here in Adobe PDF.

You can also click here to send an email directly to your legal guardian with the pdf file as an attachment.

The to read the waiver in PDF format you will need a PDF reader. To download the Adobe PDF reader, please click on the logo below and follow the instructions on the Adobe website.

21 Anson Street, Observatory, Cape, 7925, South Africa Date (d/m/y) _____/_____/_____
REGISTRATION FORM AND DISCLAIMER AGREEMENT

First Name_______________________  Surname_________________________________

Birthday (y/m/d) ____/____/____

Address __________________________________________________________________________

_______________________________City ______________________ Postal Code _______

Home Phone __________ Cell Phone _______________________ W Phone _______  _  ______

Email address for CityROCK Newsletter & updates only: _________________________________

How did you find out about CityROCK Indoor Climbing Gym: ____________________________

Staff use only.

Course: _______________ Birthday:______ Corporate:_________

Other:    ____________

Monthly Pass:

User Card # ___________    Period From __________________ To ___________________

Receipt Number: ___________________________

Belay Cards:

Top Rope Test: _______ Lead Test: _______

Belay Test Date:  ____________   Time:  ____________   Payment:  ______________

Belay Test Result:         Pass     Fail       Conditional                    Instructor _______________

Comments ____________________________________________________________________

                  ____________________________________________________________________

DISCLAIMER AGREEMENT

Entered into by and between

THE INDOOR CLIMBING CENTRE CC
Registration No. 2002 / 060110 / 23
(Hereinafter referred to as the “Centre ")

And

___________________________________
(Hereinafter referred to as the "Climber")

Whereas
The Centre and the Climber have entered into an agreement in terms whereof the Centre has allowed the Climber to make use of its climbing facilities on the terms and conditions as set forth in this agreement, which the parties desire to be recorded in writing.

The Climber understands that participation in the sport of rock climbing and the use of an indoor climbing wall includes certain dangers and risks, some of which include:
injury sustained in a fall and hitting the wall, projections (permanent or temporary in place), or the floor (including any object or objects resting on the floor)
injuries resulting from rope management error and normal rope activity on the premises (including abrasion, entanglement, belaying, rappelling and lowering, and rescue scenarios)
injury due to falling climbers or objects
cuts and abrasions resulting from bodily contact with the climbing wall
failure of harnesses, ropes, slings, carabineers or any other hardware or part of the climbing systems and structures

The Climber further acknowledges that the previous list is not inclusive of all possible risks associated with the use of the indoor climbing facility, and that the previous list in no way limits that extent or reach of this Disclaimer.

The ability of the Climber to climb in the Centre gives no indication of his/her ability to climb on natural rock in the outdoor environment.

THEREFORE IT IS AGREED UPON AS FOLLOWS:

1. WAIVER
The Climber acknowledges that the activity in which he/she participates by its very nature carries inherent risks which could cause him/her to sustain bodily injury and/or suffer damages and waives any claim so arising against the Centre or its members, employees or any third party.

2. DISCLAIMER
The Climber makes use of the Centre’s facilities at entirely his/her own risk and agrees that the Centre will not be held liable and/or responsible for any loss, injury, damages, death, and/or compensation of whatsoever nature and howsoever arising as a result thereof, irrespective of whether negligence or gross negligence exists on the part of the Centre or any member, employee or third party, whether gross or otherwise, and the Climber does hereby waive any claim it may have against the Centre as a result thereof.

3. MEDICAL FITNESS
The Climber hereby warrants that he/she is medically fit so as to participate in activities of this nature, it not being the responsibility of the Centre to have the Climber undergo any medical examination, the onus being on the Climber to do so. The Centre shall not be obliged to call upon the Climber to provide a medical certificate. The Centre, its members or employees, shall not be liable for any claim or injury or loss or damages arising from or in connection with the agreement.

4. GENERAL
The clause headings to this agreement are for information purposes only and plays no part in the interpretation of the context. Reference to the masculine gender shall include the female gender and vice versa.

Climber’s Name (print) _________________

Climber’s Signature ___________________

Witness’s Name (print) ________________

Witness’s Signature __________________

If Climber is under 18 years of age:
I have read, understood and agree with all the information provided in the “Important Information For Parents, Guardians And Children/Young Persons (Ages 5-18)” document. Also, I agree to all the terms and conditions contained in this Agreement.

Parent / Legal Guardian’s Name (print) _____________________________

Parent / Legal Guardian’s Signature _______________________________

Date_____________ Witness Name_____________ Signature_______________