Edgeworks Climbing Participant Agreement

This is the person participating in any activities. If the participant is a minor, the form must be signed by a parent or legal guardian.

Participant Name

First Name *

Middle Initial

Last Name *

Date of birth of the participant, not the person signing the waiver.

Participant Date Of Birth *

Participant Address

Address *

City *

State *

Zip/Postal *

Country

Phone Numbers *

Cell Phone

Home Phone

Work Phone

Email Address *

We pinkie swear we'll only send you really great offers and invitations to climbing events! Your email address is sacred to us. We'll NEVER share it.

Can we email you great deals? *

Yes, please do!

No, I'd like to pay full price!

Is anyone in your household a member of?:

Emergency Contact

Emergency Contact Name *

Emergency Contact Relation *

Emergency Contact Phone *

Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.

This is the Parent or Legal Guardian who will sign the form.

Parent or Court-Appointed Legal Guardian (Present/Signing)

First & Last Name *

Parent or Legal Guardian Phone *

Relationship *