If you are under 18 years old, this form needs to be completed by your parent or guardian.

    Activity & Date

    Select Activity*

    Date*

    Details of Participant

    Emergency Contact Details

    In case of an emergency, please provide the name and contact number of someone we may contact:

    Medical Details

    Please give us a summary of any relevant medical conditions, allergies or dietary requirements that you have, any medications you use and anything else you feel we should know:

    Medical Declaration

    The medical and other details above are up to date. If any other medical issues arise before my booking, I will inform Sure Footing as soon as possible. I will bring with me the medication which I will need or which may be helpful for me to have available. I know of nothing relating to my health or fitness which might prohibit me from taking part safely in the activities I have booked on to or might jeopardise myself or other people.

    Further Information

    Photography

    Sure Footing would like your permission to take photographs or short video clips of the participant during adventures. We may discreetly use some of this material to promote our activities. Please indicate whether you are happy for images to be taken and used in this way.

    Acknowledgement of Risk

    Sure Footing has taken all reasonable steps to provide you with the level of safety and care appropriate to the activity undertaken. However, there are certain risks which are integral to the activity and which cannot be eliminated without destroying the unique character of outdoor adventure. During an adventure you may therefore encounter or undertake the following:

    • walking/scrambling/climbing/abseiling on rough terrain.
    • extended physical effort.
    • environment hazards (changeable weather and terrain).

    Changes

    I confirm that I will inform Sure Footing if there are any changes to the above information prior to the activity.

    Agreement

    I wish to take part in the outdoor adventure provided by Sure Footing. I understand the nature of the adventure I have booked to attend and confirm that I am fit and able to undertake the activities on it. I understand and agree to the information Sure Footing has given to me and I understand that Sure Footing will rely on the information I have given to it as sufficient for my safety.

    By agreeing you do not release Sure Footing from any of their obligations, nor does it affect your legal rights.