Bouldering Waiver
KAP must have your signed waiver on file in order for you to participate Please fill out this form, read the waiver and sign below. Climber's under the age fo 18 must have a Parent or Legal Guardian complete this form.
Climber's Name
First Name
Last Name
Climber's Birth Date
-
Month
-
Day
Year
Date
Climber's Phone Number
Please enter a valid phone number.
Climber's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type a question
I have read the Ketchikan Afterschool Program Bouldering Waiver and understand the risks involved with indoor climbing. ***If climber is under the age of 18 this box must be checked by a legal parent or guardian.
Signature of Climber
Clear
Under 18
Parents/Guardians please fill out the following:
Name of Parent/Guardian
First Name
Last Name
Address of Parent/Guardian
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Parent/Guardian signature if climber is under the age of 18
Clear
Submit
Should be Empty: