Indemnity Form (18YO and above participants)
Participant's Full Name *
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Participant's NRIC/Passport No (please enter only the last 4 digits and the alphabet in the format: SXXX1234A) *
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Participant's Date of Birth *
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Participant's Contact Number *
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Emergency Person's Contact Number *
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Emergency Contact Name *
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Relationship to Participant *
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Acknowledgement, waiver & release from liability agreement
This document is a legally binding agreement. By signing this agreement you are acknowledging that you have read, understood, and accepted the terms and conditions stated in this agreement. You further acknowledge and agree that you are waiving your rights to bring any court action to recover compensation or obtain any other remedy for any injury to yourself or your property.

Acknowledgement: I acknowledge that there are significant elements of risk associated with the height activities (sport of rock climbing and similar activities provided by Boulder World). I further acknowledge the nature and extent of the risks inherent in the height activities and the use of the facilities. I acknowledge that there are possible risks associated with the use of the facility, and that other unknown and unanticipated risks may result in injury, illness, or death.

Release, assumption of risk and responsibility: In consideration of, and in recognition of the inherent risks of the activity associated with the use of the facility, I, and/or on behalf of any minor children for which I am responsible for, agree on behalf of myself, my/our heirs, representatives, successors, executors, administrators assigns, to hereby release, waive, discharge and agree not to sue its officers, directors, shareholders, agents and employees, for any and all claims or demands, obligations and/or causes of actions of any nature whatsoever which I may have against its officers, directors, shareholders, agents and employees, on account of any personal injury, property damage, death or accident of any kind arising out of or any way connected with use of the facility or equipment, whether my/our use if supervised or unsupervised and I/we agree to indemnify and hold harmless the persons or entities mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of my/our actions.

I further certify, acknowledge and agree on behalf of myself and/or any minor children for which I am responsible, that:
I am (we are) physically and mentally capable of participating in the activity and.or use the equipment. I/we assume responsibility for and voluntarily assume the risks for any personal injury, death and related expenses involved with this activity. I/we assume responsibility for damage to my/our personal property, and I/we assume the risks for accidents or injury caused by negligence of my fellow climbers, further, I declare that all information given intros form is true and correct to the best of my knowledge and belief.

I HAVE HAD SUFFICENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUNDE BY ITS TERMS.

Electronic Signature of Participant(18 and older must sign) *
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Name of Participant *
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Date *
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