British Mountaineering Council

BMC NORTH WALES Junior Mountain Meet - 2016

APPLICATION FORM TO BE COMPLETED BY YOUNG CLIMBER Personal Details and Parental Consent

Name of young climber……………………………………………………………………………………………………… Age……………………… Date of Birth………………………..Telephone………………………………… Address……………………………………………………………………………………………………………………… … ……………………………………………………………………………………………………………………………… ….. All participants on the North Wales Junior Mountain Meet must provide the following signed parental consent. Parental Consent I confirm I am the parent/guardian of the above-named child and that I consent for him or her to take part in the North Wales Junior Mountain Meet. I also confirm that I have read the enclosed event information and am aware that climbing, hillwalking and mountaineering are activities with a danger of personal injury or death. I am aware that the adults taking out the youngsters are not necessarily qualified however are experienced climbers who have been checked under the Disclosure of Barring Service (DBS – previously CRB) and the weekend is overseen by a qualified instructor. I am happy for photographs or video are taken of the above-named child for BMC / CC promotional purposes Signed (parent or guardian only)….. ……………………………… Date………………………………..

Medical Matters (to be completed by parent/guardian) Does your son/daughter have any medical problems you feel we should know about? (include all details about Asthma, Diabetes, Epilepsy if applicable) Please include below details of any medicines being taken, any allergies e.g. penicillin, plasters etc or special dietary or other treatment necessary Medicine/Tablets Allergies Dietary requirements Other treatment His/Her National Health Service Medical Card No (if known): His/Her doctor’s name and surgery address

Doctor’s telephone numbers Any Religious needs

Climbing Ability - As a minimum, young climbers joining the Youth Meet must be able to:  Put on their harness correctly  Tie in correctly to a rope  Belay a lead climber safely. BMC NORTH WALES Junior Mountain Meet - 2016

 Have had some previous roped climbing experience (climbing wall and/or outdoors) Why have you applied to join this meet and what do you hope to get out of it? Continue your response overleaf if there is not enough space here: ………………………………………………………………………………………….. ……. ……………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………. The information we require below is simply to allow us to pair up climbers for the weekend and will not form any part of a selection process, so please be as honest as possible! Years of climbing experience: ……………….. How often have you climbed outside?………………… Do you lead climb? Indoor: YES/NO Outdoor: YES/NO Have you led on traditional gear? YES/NO If you have answered yes to either of the above questions please indicate your leading grade: Traditional gear: Diff/Sev VS/HVS E1/E2 E3/E4 E5+ Bolted routes (French grade): up to 4 5 6a/6b 6c/7a 7b+ Seconding/top roping grade: (please indicate if outdoor or indoor) ……………………………………………….. What climbing equipment are you able to bring with you to the meet? (please tick boxes) Rope: single Helmet Rock Boots Harness half Belay device – type………………. Hardware – list here approximately (eg full rack/a few wires/ a few quickdraws etc)

You will be expected to wear a helmet whilst climbing. A helmet will be available on loan if necessary by prior arrangement.

To be signed by the applicant: I confirm that the above information is correct and that I have read and fully understood the details of the event and am fit to fully participate in the BMC North Wales Junior Mountain Meet. Signed: Date: