Waiver Form

Waiver Form

This form is to be completed prior to your attending any MountainSphere trip.
Your Name*

First NameLast Name
Which Trip are you Attending?
Select from the list of MountainSphere trips.
Trip Date

DayMonthYear
The scheduled start date of your trip.

Please tick each box below to indicate you have read, understand, and agree with each section.
In voluntarily participating in the {whichTrip} I am aware that this may expose me to risk that could lead to injury, illness or death or to loss of or damage to my property.
Those risks may include but are not limited to the following:
- Snakebite
- Steep and unstable ground, rockfall, landslide
- Bushfire
- Exposure to the elements
- Unfenced cliffs and precipices
- Burns
- Trips and falls
The leader has provided me a risk assessment and has explained the risks, potential dangers and physical demands of the trip adequately.

Link to Risk Assessment document
On the Pantoneys Crown hike those risks may include but are not limited to the following:
- Extremely steep and unstable ground, rockfall, landslide
- Exposed heights, fear and danger of falling
- Snakebite
- Bushfire
- Exposure to the elements
- Unfenced cliffs and precipices
- Burns
- Trips and falls
The leader has provided me a risk assessment and has explained the risks, potential dangers and physical demands of the trip adequately.

Link to Risk Assessment document
On the Red Rocks hike those risks may include but are not limited to the following:
- Extremely steep and unstable ground, rockfall, landslide
- Exposed heights, fear and danger of falling
- Snakebite
- Bushfire
- Exposure to the elements
- Unfenced cliffs and precipices
- Burns
- Trips and falls
The leader has provided me a risk assessment and has explained the risks, potential dangers and physical demands of the trip adequately.

Link to Risk Assessment document
On the Katoomba to Kanangra (K2K) hike those risks may include but are not limited to the following:
- Steep and unstable ground, rockfall, landslide
- Exposed heights, fear and danger of falling
- Snakebite
- Bushfire
- Exposure to the elements
- Unfenced cliffs and precipices
- Burns
- Trips and falls
- Tarros Ladders
The leader has provided me a risk assessment and has explained the risks, potential dangers and physical demands of the trip adequately.

Link to Risk Assessment document
To minimise these risks I will endeavour to ensure that the above activity is within my capabilities and that I am carrying food, water and equipment appropriate for the activity. I agree to advise the activity leader if I am taking any medication or have any physical or other limitations that might affect my participation in the activity.
I will make every effort to remain with the rest of the party during the activity and accept the instructions of the leader of the activity.
I have considered the risks, and I still wish to participate in the {whichTrip}. I agree by submitting this application to waive any claim for damages arising from this activity that I may have against the leader or other participants in tort or contract.
Signature*
Type your name*
Your name, if signature is not legible.
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