Name *

First Name

Last Name

Phone

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Membership type *

Family Membership ($150)

Individual Membership ($60)

Emergency Contact Details *

Country

(###)

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Social media image use licence *

I agree to have my/my child’s image to be used on BOPSCA Facebook Page, Instagram, on our website, or any other promotional material. No images will be automatically licenced for use elsewhere.

Yes

No

Liability Waiver *

In consideration of being allowed to participate in the activities organised by the Bay of Plenty Sport Climbing Association (BOPSCA) and to use any facilities and equipment owned and/or under the control of BOPSCA, in addition to the payment of any fee or charge, I hereby waive, release and forever discharge BOPSCA from any and all responsibility or liability for injuries or damages resulting from my participation in any activities or my use of equipment or facilities in the abovementioned activities to the maximum extent permissible by New Zealand law.  I understand, and I am aware that activities the club organises are potentially hazardous. I acknowledge and agree that I am voluntarily participating in these activities and using equipment and facilities with the knowledge of the dangers involved. I understand that although BOPSCA will take steps to reduce the risks and increase the safety of all activities, it is not possible for BOPSCA to make these activities completely safe. I also acknowledge that I am personally responsible for my preparation prior to activities and my concentration and attention during these activities.

Yes

Agreement *

I confirm that I am over the full age of eighteen (18) years/ or I am the parent/guardian/caregiver of the applicant who is under 18 years of age. I have read this agreement and liability waiver prior to signing below and I understand it. I agree that this agreement and any rights, duties and obligations between the parties to this agreement shall be governed by and interpreted solely in accordance with the laws of New Zealand. 

I agree