Please read the following:
Assumption of Risk, Waiver, Release, and Indemnity
By accepting this form, I consent to the following: *
FOR MYSELF, SPOUSE, AND CHILD/WARD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my child’s participation; and, I willingly agree to comply with the program’s stated and customary terms and conditions for participation.
If I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from participation and bring such attention to the nearest staff member immediately; and, I myself, my spouse, my child/children, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS The Farm Gym pty ltd; its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my child’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
Further, I grant full permission to The Farm Gym pty ltd to use any photographs, motion pictures, recordings, or any other record of these classes or events for any legitimate purpose including commercial advertising.
If I have a child under the age of 18 at The Farm gym or on the property,(307 Nambour-Mapleton Rd, Burnside, 4560 QLD) I take full responsibility for them and understand that the above release and indemnify applies to all/any child/children in my care.
ASSUMPTION OF RISK:
I declare that the answers overleaf are correct and that I have not withheld any information or material that may determine the ability of my child/ward to participate in the aforementioned program.
I am aware that during participation in any program arranged by The Farm Gym and their employees or agents (eg Teen Boys To Men or Young Guns), certain risks or dangers may occur which may include, amongst others:
1. Involvement in physical activity and exertion;
2. Bodily injury and/or illness including the potential for permanent disability and death;
3. Possible equipment failure, malfunction, or operator error;
4. Hazards of participating in activities outdoors and/or at height;
5. My own negligence and/or negligence of others; and
6. Difficulties of evacuation if my child/ward is injured or disabled.
I make the following representations:
I, the parent/guardian, assert that I have explained to my child/ward: the risks of the activity, his/her responsibilities for adhering to the rules and regulations and that my child/ward understands this agreement.
To my knowledge, my child/ward has no impairments, illnesses, or conditions that might endanger them or others whilst participating in events at The Farm Gym*. - I will disclose any impairments, illnesses, or conditions that might affect my child/ward's ability to train at The Farm Gym* to an event director or staff member before undertaking any training.
I agree that to my knowledge my child/ward will not take any legal or illegal substance before or during the program that may affect their judgment or physical responses during the program.
I acknowledge that the enjoyment and excitement of adventure programs are derived in part from risks incurred by participation in those activities and that these risks may exceed those commonly accepted at work or at home. I accept all the above-mentioned risks of my program, and the possibility of personal injury, loss, or property damage resulting therefrom and will hold The Farm Gym Pty Ltd, its employees, and agents free from any and all liability, actions, debts, claims, and demands of any nature whatsoever, subject to the rights and privileges which apply under the Fair Trading Act (1984), the Competition and Consumer Act (2010), & the Civil Liability Amendment Act 2003. In entering this agreement I am not relying on any representations made by or on behalf of The Farm Gym pty ltd, but do so only of my own free will.
First Aid Consent: I give full permission for any person connected with (eg: Staff, Volunteers, Other parents present) The Farm Gym pty ltd to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well-being of the child.
Waiver: I have read this form carefully and understand that by signing it I am releasing valuable legal rights that I might otherwise have and that I indemnify The Farm Gym pty ltd from the consequences of my child/ward’s negligent or intentional acts that cause damage or injury. - I willingly assume full responsibility for the risks to which my child/ward will be exposed to in participating in activities at The Farm Gym* and in participating in activities organized by The Farm Gym Pty Ltd.
Release: In consideration of the foregoing, I, for myself, my heirs, executors, administrators, personal representatives, successors and assigns, waive and release all rights, claims, and causes of action I have or may have against The Farm Gym pty ltd or anyone associated with The Farm Gym pty ltd and its associates, its agents, employees, officers, directors, successors and assigns that may arise as a result of my child/ward's participation in classes or events and any pre and post class events activities at The Farm Gym*. I acknowledge in providing this release I am not relying on any representations made by or on behalf of The Farm Gym pty ltd and do so of my own free will.
Indemnification: I recognize that there is risk involved in the types of activities offered at The Farm Gym*. I agree to indemnify and hold harmless The Farm Gym pty ltd, its principals, directors, agents, employees, and volunteers from liability of the injury or death of any person(s) and damage to property that may result from my or my child/ward’s negligent or intentional act of omission while participating in activities at or offered by The Farm Gym. I have read and understood the foregoing acknowledgment of risk, release of liability, and indemnity prior to signing it and that it shall be binding upon my heirs and assigns, or whilst engaging in activities offered by The Farm Gym pty ltd for myself, my spouse or my child/ward. I have read and understood the foregoing acknowledgment of risk, release of liability, and indemnity prior to signing it and that it shall be binding upon heirs and assigns.
I agree, I have read and understood the foregoing Release and Indemnity and I understand that by accepting this form, it obliges me and any person/s in my care under the age of 18 to indemnify the parties named in respect of liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by accepting this form I am waiving valuable legal rights.
I, for myself, my spouse, my child/ward:, and on behalf of my/our heirs, assigns, personal representatives, and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE to the fullest extent permitted by law.
I, FOR MYSELF, MY SPOUSE, AND MY CHILD/WARD, HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGNING IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Following: * - meaning the rest of this document.
The Farm Gym* - pertaining to the business ‘The Farm Gym’ residing at the address of 307 Nambour Mapleton Rd, Burnside, 4560, Qld, Australia.