Application Form

apply date	{{formValue.date \| moment('YYYY/MM/DD')}}
name		{{formValue.name}}
gender		{{formValue.gender == 0 ? 'male' : 'female'}}
birthday		{{formValue.birthday}}
zip code		{{formValue.zip}}
prefecture		{{formValue.pref}}
address		{{formValue.address1}}
building name		{{formValue.address2}}
age category	grade	{{getCategoryText()}}学年：{{formValue.grade}}
phone number		{{formValue.tel}}
emergency contact information	Please enter a contact other than your own. (Home, home, family's mobile phone number etc.) phone number name relationship	phone number：{{formValue.emergency_tel}} name：{{formValue.emergency_name}} relationship：{{formValue.emergency_relationship}}
e-mail		{{formValue.email}}
experimence of climbing	more than years	{{this.getExperienceText()}}
How do you know about LUNA?	Multiple selection is possible TV Facebook Instagram Search Engine sakura Passpost Toyota Health Insurance Association Sankei News Internet News City Living PINNACLE2 Member Introduction of acquaintance magazine, others	{{getWayText()}} Introduction of acquaintance：{{formValue.friend_name}} magazine, others：{{formValue.magazine_name}}

Commitment Form

Bouldering is a sport that involves serious risks (death or serious damage). The facilities of bouldering wall cannot guarantee 100% safety. In addition, for the use of bouldering area by primary school children , it is the responsibility of the parents to secure their children’s safety. The bouldering wall holds can rotate or break. Mats also cannot prevent 100% sprains or fractures at the time of landing.
In addition, reckless behaviors of users and visitors can cause a serious risk to other users. For example, if two people climb the same wall at the same time, there is a possibility of a collision at the time of falling.
Based on above, in my application for use, I (parent) will comply with the staff’s instructions and make every effort to prevent accidents. In the case when dangerous acts are continued without following the instructions of the staff, I will accept all such as the suspension of the use of and the withdrawal from the facilities, no admittance, no refund of fees and the like. In addition, I will not claim compensation, money and the like for injury or damage incurred by the use of the facilities. I will handle it at my own risk.
In addition, I will follow the following as consideration to neighbors.
・I will not use outdoor facilities (vending machine, smoking area, wood deck and the like) after 9pm.
・I will not do the idling of my vehicle.

signature

signature of parent or guardian (under 18 years old)