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Attendee Waiver Form

All participants or their parents / legal guardians / authorised appointee will need to complete the below form before their visit.

Waiver Form
This may be populated automatically, if you do not see the booking ID, please ask the person responsible for the booking to provide it.

Child / Participant Details

Name
Name
Full name of person completing this waiver participant or parent/ legal guardian on behalf of a minor.

Waiver Agreement for use of Centre and Equipment

Please scroll to the end of the agreement and click to accept.
Waiver Agreement for use of Centre and Equipment

Issued November 1st 2021

SCHEDULE OF TERMS AND CONDITIONS

The provider agrees that:-

The sensory experience equipment (‘The equipment’) for use by the participant is assembled correctly and is in good working order and is adequately maintained in accordance with the manufacturer’s recommendations, if any.

Appropriate instruction and supervision will be provided for use of the equipment.

Appropriate risk management strategies are in place to protect workers and participants against harm to their health, safety and welfare through the elimination or minimisation of risks arising from work or from specified types of substances or plant or equipment on the provider’s premises.

It will take all reasonable precautions to prevent loss, damage or injury to the participants.

A record of incidents will be maintained to record the circumstance of any accident, incident or event reported to it by any participant irrespective of whether the participant intends to make any legal claim in relation to that circumstance.

The participant agrees that –

They (meaning he or she as the case may be) are18 years or over in age and if under 18 or in the ca re of a guardian, the guardian of the participant agrees to these terms and conditions on behalf of the participant.

They will pay the fee imposed by the provider for use of the equipment.

They will disclose to the provider any pre-existing medical condition which may prohibit the participant from using the equipment or which may exacerbate the pre-existing medical condition.

They will complete a questionnaire as to their medical fitness to participate in the use of the equipment if requested by the provider.

They will, if there is any reasonable request by the provider or if the participant has any doubt as to their medical fitness to participate in the use of the equipment, consult their medical practitioner prior to use of the equipment to ensure that the use of the equipment will not cause them any injury, loss or damage or death or exacerbate any pre-existing medical condition.

They will cease using the equipment immediately in circumstances where they suffer any symptoms detrimental to their physical or mental health and inform the provider immediately and record the symptoms in the provider’s incident logbook. Should they believe that an incident has occurred where they have incurred an injury or other loss while using the equipment or otherwise while on the provider’s premises, irrespective of whether or not they intend to make a legal claim of any nature against the provider, they will consent to a staff member or representative of the provider recording the circumstances of any incident in the provider’s incident logbook, and shall confirm the description of the circumstances as a true statement by signing or initially the circumstances noted in the provider’s incident logbook.

Acknowledge that, based on information you provide, the Provider may decide not to allow you to participate in a session or activity, or use a certain piece of equipment, or may require you to provide a medical certificate affirming that you are able to participate in a session or activity or use a certain piece of equipment before allowing you to join, at the Provider’s sole discretion.

Acknowledge that recommendations or instruction provided by the Provider or Representatives may not be tailored for your particular skill or ability level and it is your responsibility to assess whether you are able or want to participate in all or part of a session or activity.

Acknowledge you are solely responsible for ensuring that your physical environment is suitable for your participation in any session or activity;

Where the participant brings their own equipment to the premises of the provider, they are solely responsible to ensure that any of their own equipment used on the provider’s equipment is properly assembled and is in good working order and is adequately maintained and shall record the circumstances of any incident as stated in sub-clause vii above in the provider’s incident log book.

They are to comply with instructions and directions of the provider at all times.

They will not act recklessly while using the equipment or while on the premises of the provider and in such circumstances must vacate the provider’s premises if directed to do so.

They are aware that in engaging in any activity using the equipment on the premises of the provider there is an element of personal risks to them including injury, loss or damage and that the use of the equipment is their personal choice having regard to the risks.

The activity of the participant may be visually recorded (e.g., by video or photograph) for quality control or promotional purposes (on social media or otherwise) by the provider unless the participant denies consent to be recorded.

They forego any claim against the provider for damages or loss or death arising from the participant’s use of the equipment or otherwise while on the premises of the provider in circumstances where the participant has not complied with the terms of this agreement and they hereby indemnify and keep indemnified the provider against any claim, action, loss, damage, cost, liability, expense or payment incurred by the provider in connection with or arising from any breach or default by the participant of its obligations under this contract.

Waiver Agreement

Waiver and Release Form Share My Ability

Issued August 2021

Please read the following terms carefully. By participating in any class, activity or using any equipment provided by Nepean Area Disabilities Organisation (the Owner) you consent to, and agree to release the Owner from liability according to, these terms. Unless the Owner notifies you otherwise, this waiver and release will apply to all activities undertaken by you at Share My Ability (the premises).

You acknowledge that:

  • are over 18 years of age (if not, a parent/guardian must sign on your behalf)
  • understand that the using equipment provided by, and/or engaging in activities at, the premises is a form of physical activity and that there are inherent risks in undertaking any form of physical exercise
  • have disclosed, or will disclose to the Owner prior to commencing your session, any pre-existing conditions that may place you at a higher risk of injury or inhibit your ability to participate in certain activities or using certain equipment, this includes, but is not limited to:
    • injuries, pain or recent surgery
    • pregnancy or if you have recently given birth
    • respiratory or heart conditions or high blood pressure
    • physical condition or lack of mobility which may prevent safe use of the equipment
  • agree to notify the Owner and its Representatives (staff members) if you experience any pain throughout the session and will immediately stop participating in the session if requested by the Owner or its representatives
  • acknowledge that, based on information you provide, the Owner may decide not to allow you to participate in a session or activity, or use a certain piece of equipment, or may require you to provide a medical certificate affirming that you are able to participate in a session or activity or use a certain piece of equipment before allowing you to join, at the Owner’s sole discretion
  • acknowledge that recommendations or instruction provided by the Owner or Representatives may not be tailored for your particular skill or ability level and it is your responsibility to assess whether you are able or want to participate in all or part of a session or activity
  • acknowledge you are solely responsible for ensuring that your physical environment is suitable for your participation in any session or activity; and
  • agree that sessions may be recorded by the Owner for quality control or promotional purposes. If you do not consent to the Owner using video or still images taken during the session for promotional purposes, please notify the Owner in writing.

 

To the extent permitted at law, you release and hold the Owner (and where applicable its, directors, employees and representatives) harmless from any liability, cost, expense, damages or claims (including claims of negligence) arising from or which may be suffered or incurred in connection with your participation in any sessions or activities provided by the Owner.