Joining Form Thank you for your interest in joining one of my courses. Please fill in the details below to join the course. Name * First Name Last Name Date of Birth MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Emergency Contact * First Name Last Name Emergency Contact Relationship * Emergency Contact Phone * (###) ### #### Any Medical Information Course Learn to Climb Learn to Lead Climb Real Rock Experience Group Climbing Course Start Date * MM DD YYYY You're past experience level and what you would like to gain from this course? Participation Statement * We take every care to keep you safe but we also along with the BMC recognise that climbing and mountaineering are activities with a risk of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions. Parents and young participants should be aware that climbing, hill walking and mountaineering are activities with risk of personal injury or death. Parents and participants of these activities should be aware of and accept these risks and be responsible for their own actions and involvement. By selecting the box below you are accepting that you understand the risks involved. If under the age of 18 parent or guardian must sign. If for any reason you need to cancel your booking please let us know as soon as possible. If you cancel more than 1 month before the date of your course a full refund will be given. If you cancel within 1 month of your booking 50% refund will be given. If you cancel within 2 weeks of your booking no refund will be given. If we cancel for any reason a full refund will be given. I am happy to participate knowing the above information Signed * Thank you!