Activities ↓
Coasteering
Caving
Canyoning
Rock Climbing
PaddleBoarding / Kayaking
Team Building
Guided Mountain Day
Educational and Dofe Provision ↓
Duke of Edinburgh Award Expedition
Skills 4 Retention & Higher Education
Skills 4 Life Adventure/ Youth Packages
Gold2025
Professional Courses ↓
Paddlesport Safety Rescue
Paddle Sport Instructor (PSI)
About us
Contact
Activities ↓
Coasteering
Caving
Canyoning
Rock Climbing
PaddleBoarding / Kayaking
Team Building
Guided Mountain Day
Educational and Dofe Provision ↓
Duke of Edinburgh Award Expedition
Skills 4 Retention & Higher Education
Skills 4 Life Adventure/ Youth Packages
Gold2025
Professional Courses ↓
Paddlesport Safety Rescue
Paddle Sport Instructor (PSI)
About us
Contact
Climbing club
LoadedUK: Registration form
COVID-19 symptoms Disclosure:
*
PLACE AN X IN THE BOX TO CONFIRM THIS STATEMENT IS TRUE FOR YOU THE NAMED PARTICIPANT To my knowledge I have no COVID 19 Symptoms relating to; cough, high temperature or loss of smell/taste By marking an x in the box, I hereby confirm this statement is true
Confirm I have no symptoms
Name
First Name
Last Name
Age
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
Please provide the details of 2 people we can contact in the event of an emergency.
Name
*
Telephone/Mobile
*
Address
*
Relationship to you
*
Can you swim?
*
Yes
No
Do you have any special dietary requirements or food allergies?
*
Medical Details:
The information provided on this form will be treated as confidential and is only required in order to enable our instructors to make appropriate decisions and provide care and medical help as appropriate. Please answer the questions fully and honestly. If, at the start of a course it is found that the information has not been given correctly LoadedUK reserves the right to refuse participation.
Will you be on any medication during the event?
*
Yes
No
If you are on medication, please state the condition being treated, the medication and the dosage
*
Have you ever had:
Asthma, bronchitis, tuberculosis or other lung conditions?
*
Yes
No
Diabetes?
*
Yes
No
Epilepsy, fainting attacks, migraine or severe head injury?
*
Yes
No
Allergic reaction (e.g. Hay-fever, insect bites, medication, foods) ?
*
Yes
No
History of broken bones, muscle tears or tendon/ligament damage?
*
Yes
No
A tetnus injection? If so state date of most recent below:
*
Yes
No
Are you suffering from, or are you a carrier of any infectious diseases?
*
Yes
No
If you answered yes to any of the above please give details below:
*
IF THERE ARE ANY CHANGES TO THE ABOVE, PLEASE INFORM LOADEDUK IMMEDIATELY
STATEMENT
I FULLY UNDERSTAND AND REALISE THAT THIS COURSE/EVENT WILL INVOLVE ME PARTAKING IN OUTDOOR PURSUIT ACTIVITIES AND HERE BY PARTICIPATE UNDER MY OWN WILL AND CHOICE. I DECLARE THAT ALL MEDICAL AND ENROLMENT INFORMATION ON THIS FORM IS TRUE AND THAT I HAVE NOT WITHELD ANY RELEVANT INFORMATION
I understand that the personal information requested above is held on computer and required to allow LoadedUK to provide the promised service to their normal high standards. By providing them with the information required I am deemed to have accepted their terms and conditions and to have gained consent from my parent or other person acting in 'loco parentis' to disclose my details to LoadedUK.
Signature
*
Print Name:
*
Please tick if you do not with for photos of your son/daughter to be used in promotional material.
CLIMBING CLUB AGREEMENT AND CODE OF CONDUCT
Bouldering wall code of conduct:
1) No more than two climbers to be using the bouldering wall at anytime. 2) No one should be lying or sat underneath any persons climbing on the wall. 3) Long hair must be tied back before climbing and all jewellery must be removed before climbing (Including: Rings, necklaces, chains, bracelets and dangly earrings) 4) All holds should be tightened and checked before climbing and the tool to tighten holds should be available before session. 5) Climbing shoes must be used on the wall at all times.
By signing this code of conduct and hereby declare; 1. I have read these terms and 2. I have understood these terms and take personal responsibility to comply with these terms of behavioral conduct. I realise that not adhering to these formal community safety standards will not only put myself at risk but also place other people at risk of serious harm. I understand that not abiding to these codes of conduct could lead me being asked to leave the premises by staff to maintain safety
Signature:
*
Print name:
Thank you!
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