Naru Goori Groms *APRIL 2021*
We are ensuring we are safe for our Community and request all questions be answered truthfully.
Young Person's Details
First Name
Middle Name
Last Name
How old is your child?
Please Select
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Name
First & Surname
Parent/Guardian Mobile Number
Format: (000) 000-0000.
In consideration of the Organiser accepting my application to participate in the Naru Holiday Gathering, I acknowledge and agree that I am Aboriginal or/and Torres Strait Islander. Proof of Aboriginality: By entering my child into this activity I declare that I am of Aboriginal OR Torres Strait Islander decent. If I do not provide a proof of Aboriginality OR Torres Strait Islander descent event I will be denied entry.
*
Yes I am known and accepted as Aboriginal and/or Torres Strait Islander within the Coffs Harbour Aboriginal Community.
Have you or anyone from your household tested positive for COVID19 with the past month?
yes
no
would you like to receive updates from us in regards to future events? if yes, please submit email address.
example@example.com
Is your child a competent swimmer?
yes
no
How many times has your Child Surfed before?
Never
1-2 times
3-6 times
7+ times
Any notes about your Childs Surfing experience so far with surfing?
Please note- this is not a drop your child/ren off activity. We require all parents/guardians to be on site supervising child/ren for the duration of the activity. If your Child/ren is under the age of 10 please be prepared to supervise in the water with your child.
I have read and understand that I need to be present at the beach for the duration of my Childs time at Goori Groms
DECLARATION: In applying to participate in a learn to surf clinic I ACKNOWLEDGE that there are inherent dangers associated with the sport of surfing and my participation in the clinic and may lead to serious accidents or injury. To the full extent permitted by law, I agree to absolve and indemnify Naru INC/Naru Goori Groms and their directors, officers and volunteers from and against any and all liability, loss or damage however caused arising out of my participation in the event. I agree to release and forever discharge Naru INC from all claims that I may have or may have had but for this release arising from participation in the clinic. I agree that Naru INC retain the right to utilize images of my participation in the clinic for purpose of promoting the event for their future events and programs. By entering the clinic I agree that I may be filmed and that footage may be broadcast on television. I acknowledge this event is a DRUG & ALCOHOL Free Clinic. I have read, understood, acknowledged and agree to the declaration including the warning, release and indemnity.
I have read and agree.
If you do not consent to your child/rens photo being taking please inform our team.
Submit Application
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