Reservation Form

Use the form below to send us a reservation request. After you submit your request, you will be contacted to confirm your reservation and arrange for payment.  The starred(*) items below are required.

This form is only a request and not an actual reservation. ¬†Confirmations will be made after we’ve spoken with you and have the details worked out.

Contact Info

First Name:*

Last Name:*



Secondary Phone:


Mailing Address


City:* State:* Zip:*

Event Info

Event Date:*

Start Time:*

End Time:*

Total Hours:
Note: Total Hours should be for climbing time ONLY not transportation.

Event Address

Event Address:

Event City: State: Zip:

Company/Organization Name:

Event Day Phone:

Special Instructions:

Select at least one item you would like at your event: *
 Rock Wall Zorbs Ziplines Air Jumpers



How did you hear about Climb On?

If other, please provide more info:



Enter the Above Text*: