Program Participant 2022
ASSUMPTION OF RISK, WAIVER and INDEMNITY (“Document”)
NOTE: THIS IS AN IMPORTANT DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS AND OBLIGATIONS.
PLEASE READ IT CAREFULLY AND DO NOT SIGN/SUBMIT IT UNLESS YOU ARE SATISFIED THAT YOU UNDERSTAND IT.
For participants aged under 18 years of age, this Document must be completed by a parent or legal guardian on their behalf.
Please list activities that will be entered into in the Detail Activities section. Depending on the nature of the Work, Performance additional OHS documentation may be requested.
In consideration of the Cyr and German Wheel Club (“CGWC”) permitting me to participate in, take part, or complete the Activity in any way, I, the undersigned, for myself, my personal representatives, heirs and next of kin:
Scheduled Activities Cyr & German Wheel Club may include any of the following activities: rope skipping, solo or double, or group work and intensive training on German Wheel or Cyr Wheel, acro-balance, handstands, tumbling, partner acro pyramids, mini-trampoline, trampoline, physical movement, comedy, flexibility training, strength-building exercises, games, and other physical activities.
Acknowledgment that the intended activities that make up the Activity (as referred to under “Scheduled Activities” above) are inherently dangerous and may result in serious personal injury (including permanent disability) and/or death and/or property damage.
1. Give permission for Cyr & German Wheel Club to seek appropriate medical attention in the event that I am/my child is injured.
2. Understand that any personal injuries I incur may be compounded or increased by not only my actions but from the actions, omissions or negligence of others.
3. Acknowledge, agree to, and voluntarily assume all risks (including, but not limited to, those identified in the section “Scheduled Activities”) of any harm, injury or damage that I may suffer to my person or my property whether foreseen or unforeseen in connection with the Activity.
4. Agree to indemnify Cyr & German Wheel Club from any liabilities, claims, and causes of action that may be brought against Cyr & German Wheel Club as a result or in connection with my negligent act, omission, failure or error as a participant in the Activity.
5. Acknowledge and agree that Cyr & German Wheel Club liability under the statutory right or any condition or warranty implied by the Fair Trading Act, (VIC) or Australian Consumer Law or other relevant legislation which cannot be lawfully excluded is, to the extent permitted by law, limited at the option of Cyr & German Wheel Club to:
* the re-supply of the Activity by Cyr & German Wheel Club; or
* Payment by Cyr & German Wheel Club of the cost of having the Activity supplied again.
6. Acknowledge and confirm that the information I have provided in the Document is true and correct and I have read and understood this Document and that I am of lawful age and legally competent to sign this Document.
7. Acknowledge that I have signed this Document on my own free will and without any representation or inducement by Cyr & German Wheel Club, their agents or employees.
8. Agree that if any provision of this Document is found unenforceable or invalid, that provision shall be severed from this Document and the remainder of this Document shall, notwithstanding, continue in full legal force and effect.
9. I understand that I may consult a medical advisor if I have concerns regarding any pre-existing medical condition which may affect my health and safety or that may be provoked by participation in the above activity.
10. I agree to have my/my child’s photograph and/or video footage containing my/my child’s image taken by the Cyr & German Wheel Club (CGWC). I agree that Cyr & German Wheel Club will have full ownership of my/my child’s image and give my full permission for their use of the image in marketing and training purposes only. Please advise Cyr & German Wheel Club staff if you do not wish your/your child’s image to be used.
Note: Participants are responsible for any medical costs arising from participation in Cyr and German Wheel Club activities.