Tel: 07971 622616
Scafell PIke Routes
Scafell Pike from Wasdale
Scafell Pike from Langdale
Scafell Pike from Borrowdale
Scafell Pike from Eskdale
Broad Stand & other Scrambles
Challenge Training Days
Coniston Old Man & Wetherlam Round
Crinkle Crags and Bowfell
Booking Form - Individual or Group
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Contact Telephone No.
Other Telephone No.
Date of Birth
Route / Activity
3 Peaks Challenge
Winter Skills Course
Date of activity
Medical Conditions / Allergies / Disabilities
Notes / Other information
Name of Emergency Contact
Emergency Contact Tel No.
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Relationship of Emergency Contact to You
I agree to the following payment terms:
Deposit of 50% of total cost upon booking and final balance payable prior to commencing course.
Total value of course is due if booking less than 30 days before the route / activity begins.
Payment details will provided by email following receipt of this form.
In consideration of Climb Scafell (t/a Mountain Journeys) allowing me to take part in and engage in any adventure activity, I hereby acknowledge and declare as follows:
I confirm that I am over the age of 18 (if under 18 you must be accompanied by a parent/guardian at all times and they sign below on any child’s behalf).
I agree to be bound by and obey these terms and conditions and all other rules, regulations and conditions of Mountain Journeys and its officials, including those rules, regulations or conditions contained in this Disclaimer and any other applicable safety rules.
I acknowledge that I owe a duty to myself and others whilst engaging in any activity provided by Mountain Journeys to ensure that I do not take any action or step to do or fail to do anything as to endanger my safety and/or the safety of others.
I confirm that I will not attempt to repair, modify or tamper with any equipment provided to me for any purpose whilst engaging in any activity and will comply with all instructions in relation to the safe and proper use of such equipment.
I will not, whilst engaging in any activity provided by Mountain Journeys, use any equipment other than those provided to me by Mountain Journeys without the consent of a representative of Mountain Journeys.
I acknowledge that engaging in an activity provided by Mountain Journeys can be physically and mentally demanding and confirm that I am in good health and know of no reason, physical or mental why I could be unable to engage in such activity.
I agree to pay to Mountain Journeys a sum equivalent to the new value of the item plus an administration charge of £50 if I fail to return to Mountain Journeys any equipment provided to me for the purpose of engaging in any activity.
I acknowledge that engaging in the activity provided by Mountain Journeys may be dangerous. I therefore recognise that engaging in any activity is at my own risk. I confirm that Mountain Journeys is entitled at any time for whatever reason to deny me access and/or engagement in any activity. I will not hold Mountain Journeys or any of its representatives responsible for any illness, loss, injury or death sustained before, during or after participation in an activity provided by Mountain Journeys
I confirm that I understand the necessity to take out insurance for the activity.
I hereby acknowledge the above disclaimer
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| tel: 07971 622616
Mountain Journeys, 2 Cambridge Villas, Ambleside, LA22 9DL