If the above details are correct, please proceed to the next page to provide Medical Details.
All persons taking part in activities must complete the following fields as fully as possible, prior to activity commencement. All information given will be treated with the strictest confidence.
Do you have a medical condition?
Are you receiving any medication or treatment?
Do you suffer from allergies? i.e. stings, bites, penicillin, elastoplasts etc
Are you prone to repetitive sports injuries?
Can you swim?
Do you have any dietary needs? i.e. vegetarian, celiac etc (only applicable if ordered packed lunches)
Are there any areas we have not yet covered that you feel may be relevant?
Please provide your approx. Height & Weight.
If the above details are correct, please proceed to the final page - Disclaimer.
Whilst we are dedicated to the safety of the clients and endeavour to ensure all activities are operated to a very high standard of safety, there is always an element of unforeseen risk. Anyone wishing to take part in an activity operated by Black Mountain Activities does so with this understanding. All activities offered can be physically demanding therefore, you should be in reasonably good health & physically fit before participating. It is always advisable to seek medical advice if you are unsure about your health.
Understanding & Acceptance of Risk
I (the participant) can confirm that all details given are true and correct and that i am fit and able to participate in the activities organised.
I (the participant) understand that all activities take place in the outdoors where conditions may be wet, slippery & dangerous. I accept there is an element of risk in the activities i am undertaking and that Black Mountain Activities Ltd will not be held liable for personal injury, death or for loss or damage of property, other than as a result of negligence on the part of Black Mountain Activities Ltd.
I agree to comply with the rules and regulations given by staff at all times and should an instructor feel i am jeopardizing the safety of myself and/or others i will be excluded from the activity and no refund will be given.
I (the participant) consent to any emergency medical treatment necessary by on-site first aiders or qualified medical respondents in the event of an accident.
I (the participant) consent to Black mountain Activities Ltd taking photographs and video as means of promoting the business through displays, presentations, social media and website.
Please ensure all details provided within this form are correct and up to date. If you should have any queries, please give us a call on 01497 847897.