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BORNEO Adventure Recreation Club

Balikpapan East Kalimantan

INDONESIA

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SESSIONS

Organized group instruction, coaching and motivation for young minds and bodies. We  provide  the  opportunity  to  safely  learn  how  to   rock  climb  and  mountain  bike.

Believing  experien<al  educa<on  should  be  fun,   exci<ng  and  challenging,  our  prac<ce  sessions  are   geared  to  mo<vate  minds  and  teach  skills  necessary   for  outdoor  adventure  pursuits. For  informa<on,  please  contact  Brent  Fullerton.

CONTACT

+62812 534 20100 hp aci_balikpapan@yahoo.com

Climbing Venues: - BPP Sport & Recreation Complex - FPTI Boulder Gym - Samarinda Climbing Site


EXTRAS:

GUIDELINES Safety The club is dedicated to children who want to develop adventure skills in climbing and biking. For safety and instructional reasons, membership is limited. Supervision Qualified instructors, both American and Indonesian, will be on-site to manage and instruct members. Parent supervision is not mandatory; however, parents are welcome to attend. Parents who want to belay will be provided instruction. Schedule Two-hour practice sessions are organized on Saturdays at the Balikpapan Sports & Recreation Complex ‘sports dome’ and FPTI bouldering gym ‘cage’.

Payment Registration fee in the amount of 1.5 million IDR is non-refundable. Registration includes instruction, gear rental and maintenance costs. Respect Be respectful of others. We share the wall with any local clubs that are training and competing in wall climbing events, including regional contests and the SEA Games. Equipment All climbing gear will be provided. Members must provide a small day pack with 2 liters of water, snack, hat and sunscreen. For biking sessions, members will need their own a mountain bike and helmet. Climbing and biking gear is available for purchase locally.

Communication The program manager will send announcements via email and SMS text messages. Brent Fullerton: 0812 5342 0100, aci_balikpapan@yahoo.com Visit our wiki: adventurerecreationclub.wikispaces.com

Transportation Members must provide their own transportation to the sites. Drop off and pick up members on time. Carpooling is highly recommended.

Map: Balikpapan Sports and Recreation Complex (Dome) & FTPI Bouldering Gym (Cage)

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PERSONAL DETAILS Name _____________________________________ Age

_____________________________________

DOB

_____________________________________

Parents

_________________________________

Address

_________________________________

Tel (h)

_________________________________

Tel (w)

_________________________________

Tel (m)

_________________________________

E-mail

Read carefully, sign and return

__________________________________

Medical / Injury Details Detail any medical conditions/allergies that we should be aware of: _________________________________________________________________________________________________ Please provide details of medication that must be administered: _________________________________________________________________________________________________ Does the member have any past or current injuries that we should be aware of? _________________________________________________________________________________________________

Emergency Contact Name

_____________________________________________

Relationship

_____________________________________

Tel (m)

__________________________________________

Tel (h)

__________________________________________

Tel (w)

__________________________________________

Parents, would you be prepared to become a volunteer helper at our club? ___________ If yes, the program manager will contact you.

Signed ____________________________________________________ Date ______________________________________


CONSENT FORM Parent Consent and Liability Waiver

Name of child ________________________________________ Date of birth ________________________________________ Parent _______________________________________________

Read carefully, sign and return

Consent - Please read carefully and initial each descriptor.

_____ I agree to my son / daughter taking part in the activities of wall climbing and mountain biking.

_____ I confirm to the best of my knowledge that my son / daughter does not suffer from any medical condition.

_____ I understand that any person(s) representing Adventure Recreation Club accept no responsibility for loss, damage injury or death caused by or during attendance on any of the organized climbing and mountain biking sessions.

Signed (parent) ___________________________________________ Date _______________________________

Adventure Recreation Club

BORNEO

Balikpapan East Kalimantan

INDONESIA


Adventure Recreation Club Borneo