Participant Details: UK Courses

Participant Details: UK COURSES
PERSONAL DETAILS
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

Street Address Line 3County / State

Post/ Zip Code
Phone Number
Mobile Number*
E-mail*
example@example.com
Date of Birth*

DayMonthYear
Date
Gender*

MaleFemale
Occupation
COURSE
Course Booked*
Course Start Date*

DayMonthYear
Date
EMERGENCY CONTACT (Next of Kin)
Name*

First NameLast Name
Relationship to participant:*
Email*
example@example.com
Phone Number*
MEDICAL

NOTE: Disclosure is unlikely to prevent participation and greatly enhances our ability to deliver your course successfully. Any information will be treated confidentially.
Do you have any relevant medical conditions (e.g. allergies, diabetes, disabilities), medications or injuries? Include as much detail as possible.*
FITNESS
What types of exercise do you do and how regularly do you engage in each exercise?*
MOUNTAIN ACTIVITIES EXPERIENCE
Please list any altitude, climbing, trekking, ski touring, mountaineering or wild camping experience. Include dates/grades/duration where possible.*
RISK SUMMARY
It’s important to understand and accept the risks involved in our courses before booking. Specific risks associated with the mountain environment include: cold injuries & hypothermia, trips & falls, rock fall & water hazards. In winter, these also include avalanche and severe weather risks. We put a huge amount of work into making our courses as safe as they can be, but risk cannot be removed entirely. The risks associated with your specific course can be discussed at the time of booking, will form part of your briefing at the start, and will be discussed while on the hill.
PARTICIPATION STATEMENT
When attending a Summit Guides course, participants recognise that: “climbing, hill walking and mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement.” BMC Participation Statement www.thebmc.co.uk/risk-and-safety
By ticking this box I show I have read and agree with the BMC Participation Statement
BOOKING CONDITIONS
I have read, understood and agree to the Booking Conditions. www.summitguides.com/booking-conditions
By ticking this box I show I have read and agree with the Booking Conditions
CONSENT TO USE PHOTOGRAPHS AND MEDIA
As part of our services, Summit Guides may take photographs and videos of clients during the activities on our trips. These images and recordings may be used for promotional, marketing, and advertising purposes, including but not limited to our website, social media channels, printed materials, and other media.
1. I hereby grant Summit Guides the irrevocable, royalty-free, worldwide right and licence to use, reproduce, publish, and distribute photographs and/or video footage of me taken during the activity for marketing and promotional purposes.
2. I understand that these images may be used in various formats and media, including digital and print, and may be edited or adapted as necessary.
3. I waive any right to inspect or approve the finished product or the specific use to which the images may be applied.
4. I understand that I may withdraw this consent at any time by providing written notice to Summit Guides.
5. I release Summit Guides from any claims, demands, or liabilities arising out of or in connection with the use of the photographs or videos as described above.
I consent to the use of photography and media in this wayI DO NOT consent to the use of photography and media in this way
Signature*

Clear
Date*

DayMonthYear
Date
This form must be submitted at least 10 days before the start of your course.

This form must be completed, even if you have attended a Summit Guides course before (in case your circumstances have changed).
Should be Empty:

Participant Details: UK COURSES

PERSONAL DETAILS

COURSE

EMERGENCY CONTACT (Next of Kin)

MEDICAL

FITNESS

MOUNTAIN ACTIVITIES EXPERIENCE

RISK SUMMARY

PARTICIPATION STATEMENT

BOOKING CONDITIONS

CONSENT TO USE PHOTOGRAPHS AND MEDIA