Get2Go Challenge Medical/Consent Form
Please fill in a separate form for each team that you are bringing to the event.
School Name (or names if combining with another school)
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Team name/number
Please include a unique name/number for this team, if you are bringing more that one team to the event.
Please choose the event location for which you are filling in this form.
*
28 July - Northland
30 July - Rotorua
4 August - Auckland/Counties Manukau
6 August - Waitakere/North Harbour
11 August - Waikato
13 August - Hawkes Bay
18 August - Wellington
20 August - New Plymouth
9 September - Christchurch
11 September - Dunedin
14 September - Queenstown
16 September - Nelson
Name of manager accompanying the team
*
First Name
Last Name
Phone number of accompanying manager
*
Email of team manager
*
example@example.com
Participant details
We need to know the following information for every student attending the event. Each students name and email (will be added to our alumni database) and any medical conditions and/or pre-existing injures that might affect their participation in the event. Also, if the student is currently taking any medication and is confident in the water and able swim at least 50m.
Student details
Student Name
Student Email
Medical conditions (detail)
Pre-existing injuries (detail)
Taking medication (detail)
Can swim 50m (Y/N)
1
2
3
4
5
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7
8
Disclosure of Risk
The Get2Go Challenge is a non-profit event organised by Hillary Outdoors Education Centres with the help of sports clubs and organisations around the country. The sports clubs and organisations based in the communities where the events take place assist by setting up and running their sports challenge on the day and providing volunteers to manage the safety and scoring. Hillary Outdoors coordinates the entries from schools and provides event information to the registered teams and clubs and organisations assisting with each event. It also provides the assisting clubs with generic hazard management and briefing information and the framework for scoring the challenges.Each Get2Go Challenge regional event is slightly different but the students could be involved in some, or all of the following activities - Orienteering, Kayaking and/or Standup paddling and Mountain biking, with Problem Solving and/or Indoor rock-Climbing also included in some events.These activities contain some element of risk. This risk is countered by comprehensive safety briefings and by supervising the activities with experienced adults. It is important for safety purposes that students follow instructions given to them in the briefings.Participation in all activities at the Get2Go event is voluntary. It should also be realised that because of the changeable and unpredictable nature of the outdoors, that the risk can never be reduced to zero. Hazards exist in these activities that may result in serious injury or even death. The types of hazards include:slippery conditions, uneven ground, heights, cold and changeable weather, high winds, hypothermia, hyperthermia, sunstroke/sunburn, dehydration, water, moving at speed e.g. when cycling and vehicle travel (to/from and around the event)
Acknowledgement of Risk
It is understood that there are certain risks associated with outdoor activities in the Get2Go Challenge regional events that cannot be reduced to zero. We know that we are able to ask any questions of Hillary Outdoors or the experienced adults running each challenge to gain a better understanding of the activity before deciding whether to take part, and that the final decision about whether to take part or not, is over to each individual. If we decide to take part, we understand that the experienced adult running each challenge will identify any hazards that are likely to arise and disclose the correct procedures to deal with these, and that it is necessary for us to follow these. If the experienced adult has taken all reasonable precautions to ensure our safety, and we act outside of this advice, then we acknowledge that we do so at our own risk and we release Hillary Outdoors and all members of the assisting clubs and organisations from liability for the consequences of our actions. It is understood that photos and/or videos may be taken of us during the event and possibly used for general promotion and in social media posts by Hillary Outdoors and event sponsors.
Team manager please add your name here to acknowledge that you have read and understood the risks associated with this event and that your students have been briefed on these risks prior to participation.
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First Name
Last Name
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