NBRH Joining Application & Waiver of Liability Form First Name e.g. John Last Name e.g. Smith Email e.g. someone@example.com Phone Number e.g. 0412 345 678 Date of Birth Address How many minors / dependents None 1 2 3 4 5 RELEASE – PLEASE READ CAREFULLY I understand that indoor climbing is a dangerous recreational activity and may result in serious injury or death. I participate entirely at my own risk. I confirm that I am not under the influence of alcohol, drugs, or illicit substances and will not use the facility while under such influence. I acknowledge that wearing jewellery or loose articles may cause injury and accept responsibility for removing such items while on the premises. I understand that lead climbing requires staff approval and completion of the required assessment before participation. I hereby release Northern Beaches Rockhouse Pty Ltd, its owners, employees, and agents from any claims arising from my participation. I understand this waiver is ongoing and applies to all future visits unless revoked in writing. I confirm that I am 18 years or older or that a parent or legal guardian has consented on my behalf. Please initial to confirm agreement Initials of all participants covered by this waiver Submit Waiver Ready.
