Climbing Net

Child's Name *

First Name

Last Name

Child's Date of Birth *

MM

DD

YYYY

I understand that all activities at height have inherent risks. We provide safety equipment, instruction and supervision to minimise these risks *

Yes

I certify to the best of my knowledge that the child named above does not suffer from any medical condition that may affect their ability to take part in this activity *

Yes

I understand that the child named above must listen to all safety information given prior to taking part in the activity and will wear all safety equipment provided *

Yes

Form completed by

First Name

Last Name

Contact telephone number *

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