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Rock Climbing Sign-Up

 

Thank you for your interest in our rock climbing courses! Please fill out this form to help us understand your needs and recommend the most suitable course for you. We offer a variety of courses tailored to different skill levels and goals.

 

Personal Information

 

First Name

Last Name

Phone Number

Email Address

Date of Birth

Emergency Contact Information

 

First Name

Last Name

Phone Number

Relationship

Climbing Experience

 

If yes, please describe your experience level.

None

Beginner (1-6 months)

Intermediate (6 months - 2 years)

Advanced (2+ years)

 

What type of climbing have you done?

Indoor Climbing (Bouldering)

Indoor Climbing (Top Rope)

Outdoor Climbing (Bouldering)

Outdoor Climbing (Top Rope)

Lead Climbing

Trad Climbing

Multi-Pitch Climbing

Other:

 

What is your highest climbing grade achieved?

Climbing Type

Highest Grade

A
B
1
Indoor Bouldering
 
2
Indoor Top Rope
 
3
Outdoor Bouldering
 
4
Outdoor Top Rope
 
5
Lead Climbing
 
6
Trad Climbing
 

Do you have any certifications or training? (e.g., belay certification, first aid, etc.)

 

Course Preferences

 

What type of course are you interested in?

Beginner Courses

Introduction to Indoor Climbing (Bouldering)

Introduction to Indoor Climbing (Top Rope)

Basic Knots and Belaying Techniques

 

Intermediate Courses

Lead Climbing Fundamentals

Outdoor Climbing Basics

Climbing Movement and Technique

 

Advanced Courses

Trad Climbing Techniques

Multi-Pitch Climbing

Advanced Lead Climbing and Anchors

 

Specialized Courses

Climbing Safety and Rescue Techniques

Strength and Conditioning for Climbers

Mental Training for Climbers

 

What is your primary goal for taking this course?

Learn the basics of climbing

Improve technique and skills

Gain outdoor climbing experience

Prepare for advanced climbing (e.g., lead, trad, multi-pitch)

Other:

 

Preferred Course Duration

Single-Day Workshop

Weekend Course

Weekly Sessions (e.g., 4-6 weeks)

Custom/Other:

 

Preferred Location

Indoor Climbing Gym

Local Outdoor Crag

Specific Climbing Area:

 

Physical and Medical Information

 

Do you have any medical conditions or injuries that may affect your ability to climb?

 

Are you comfortable with strenuous physical activity?

Yes

No

Somewhat:

 

Do you have any allergies or dietary restrictions we should be aware of?

 

Additional Information

 

How did you hear about us?

 

Do you have any specific questions or requests?

 

Would you like to be added to our mailing list for updates on courses and events?

 

Availability

 

What is your preferred start date for the course?

 

What days/times are you typically available for climbing?

Weekdays (Morning)

Weekdays (Afternoon/Evening)

Weekends

Flexible:

 

Confirmation

 

By submitting this form, I confirm that the information provided is accurate to the best of my knowledge. I understand that rock climbing involves inherent risks, and I am responsible for my own safety and well-being during the course.

 

Signature

Next Steps

Once we receive your completed form, we will contact you to discuss course options, availability, and any additional details. Thank you for choosing us for your rock climbing journey!

 

Inquiry Template Insight

Please remove this inquiry form template insight section before publishing.


The Rock Climbing Course Inquiry Form is designed to gather comprehensive information from potential students to ensure they are matched with the most suitable rock climbing course. Below is an insight into the structure, purpose, and key elements of the form:


1. Purpose of the Form

The primary goal of this form is to:

  • Assess the student's climbing experience, goals, and preferences.
  • Ensure the student is placed in a course that matches their skill level and objectives.
  • Gather necessary personal, medical, and emergency contact information for safety and communication purposes.
  • Provide the climbing school or instructor with the details needed to tailor the course to the student's needs.

2. Key Sections and Their Importance

Section 1: Personal Information

  • Why it’s important: Collects basic details for communication and record-keeping. Emergency contact information is critical for safety during climbing activities.

Section 2: Climbing Experience

  • Why it’s important: Helps determine the student's skill level and prior knowledge. This ensures they are placed in the appropriate course (beginner, intermediate, or advanced) and avoids mismatches that could lead to frustration or safety risks.

Section 3: Course Preferences

  • Why it’s important: Identifies the student's goals and interests, such as learning basic skills, improving technique, or preparing for advanced climbing. This section also helps the instructor understand the student's preferred learning format (e.g., single-day workshop vs. weekly sessions).

Section 4: Physical and Medical Information

  • Why it’s important: Ensures the instructor is aware of any medical conditions, injuries, or physical limitations that may affect the student's ability to participate safely. This information is crucial for risk management and tailoring the course to the student's needs.

Section 5: Additional Information

  • Why it’s important: Provides insights into how the student found the course, allowing the organization to improve marketing efforts. It also gives the student an opportunity to ask questions or make special requests.

Section 6: Availability

  • Why it’s important: Helps schedule the course at a time that works for the student, increasing the likelihood of their participation.

Section 7: Confirmation

  • Why it’s important: Ensures the student acknowledges the risks involved in rock climbing and confirms the accuracy of the information provided. This is a legal safeguard for the climbing school or instructor.

3. Key Features of the Form

  • Comprehensive yet concise: The form covers all necessary information without being overly lengthy or overwhelming.
  • Customizable options: Students can select from a range of courses, durations, and locations, making it adaptable to their needs.
  • Safety-focused: The inclusion of medical and emergency contact information highlights the importance of safety in rock climbing.
  • Goal-oriented: By asking about the student's primary goals, the form ensures the course aligns with their expectations.

4. Benefits for the Student

  • Personalized experience: The form ensures the student is matched with a course that suits their skill level and goals.
  • Safety assurance: By providing medical and emergency information, the student can feel confident that their well-being is prioritized.
  • Clear communication: The form allows the student to express their preferences and ask questions, fostering a positive relationship with the instructor or organization.

5. Benefits for the Instructor/Organization

  • Efficient course planning: The form provides all the information needed to design and schedule courses effectively.
  • Risk management: Medical and emergency information helps mitigate potential risks during climbing activities.
  • Improved student satisfaction: By understanding the student's goals and preferences, the instructor can deliver a more tailored and enjoyable experience.

To configure an element, select it on the form.

To add a new question or element, click the Question & Element button in the vertical toolbar on the left.