Peak Pursuits Waiver

December/January Vacation Care 2021

Parent/Guardian completing this form:

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email Address

Number of Climbers

Climbers' Details

Select number of children above and complete the fields below.

Parent/Guardian Contact Phone Number

Parent/Guardian Postcode

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Climber 1 First Name

Climber 2 First Name

Climber 3 First Name

Climber First Name

Climber 1 Last Name

Climber 2 Last Name

Climber 3 Last Name

Climber 4 Last Name

Climber 1 DOB

Climber 2 DOB

Climber 3 DOB

Climber 4 DOB

Individual Waiver

Peak Pursuits conducts a variety of rigorous physical adventure activities that include, without limitation a High Ropes course, climbing walls and various vertical activities.

Participating in Peak Pursuits Climbing activities may be physically and emotionally demanding and there is also an element of risk involved.

Participants must be in good health and physically and mentally fit.
Participants must comply with the rules and regulations as set out by Peak Pursuits.

The undersigned Participant indemnifies Peak Pursuits in respect of any claim or demand made or action commenced by the Participant or any person against Peak Pursuits in connection with any loss or damage suffered by Peak Pursuits in connection with the Participant’s participation in the activities conducted by Peak Pursuits.

The Participant releases and discharges Peak Pursuits from any and all claims, actions, suits, demands, costs, damages and expenses which the Participant may hereafter have against Peak Pursuits.

I have read and understand the waiver as stated.

I acknowledge and agree with the waiver and release.

I affirm that my health is good and my participation in PEAK PURSUITS activities is voluntary.

I release Peak Pursuits from all liability for any injury to me from participation in PEAK PURSUITS activities.

Parent/Guardian Signature

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