Booking form

Participation Statement “The British Mountaineering Coucil recognises that climbing, hill walking and mountaineering are activities
with a danger of personal injury or death. Participants in these activities should be aware of and accept
these risks and be responsible for their own actions and involvement.”

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Name *

First

Last

Address *

Phone: *

Email *

Email

Confirm Email

Date of birth: *

Emergency contact name: *

First

Last

Emergency contact phone: *

Any medical, physical or behavioural conditions, including relevant past injuries, allergies and any medications being taken/given:

You do not need to provide your own equipment but please list any of your own climbing gear that you would like to bring along:

Do you have your own climbing shoes:

• Yes
• No

If not, what size are you?

Date/s of trip:

I give my permission for Jim to keep my contact details on file (see Ts & Cs GDPR) *

• Yes
• No

Conditions need Phone:

I have read, understood and agree to the Terms & Conditions (see menu above) *

• Yes

Signature (type your full name) *

Date of signature *

Submit

For participants under the age of 18, this must be signed by the accompanying parent or guardian.
Thank you for your booking.