Kids Form

TO: WAYNE BURNS and LORELAI BURNS trading as
Burns Outdoor Obstacle Training
ABN: 76 833 404 409
25 Dwyer Road
Bringelly NSW 2556

In consideration of you allowing my son/daughter/child in my care,( named below) to take part in your “boot camp” fitness and training sessions activities, including any associated obstacle course, conducted by you, your employees and/or contractors at 25 Dwyer Road, Bringelly (“The Venue”) I, the adult person whose full name, address and signature appear below, hereby agree, confirm and acknowledge that:

1. My child will use all equipment and facilities at the Venue entirely at their own risk;
2. My child will take part in all “bootcamp” activities described above, and will undertake any obstacle course at the Venue, entirely at their own risk;
3. Before undertaking any such activities, I confirm, to the best of my knowledge, that my child does not have any physical or medical condition or illness that may affect their ability to do so with safety;
4. My child will comply with your directions and instructions given before or while they undertake any activity at the Venue;
5. If my child fails to comply with any such directions or instructions they may be required to leave the Venue immediately;
6. I, on behalf of my child release you from all liability for any death, accident, injury, incapacity, loss or damage that they may suffer during or arising directly or indirectly from any activity described above;
7. I, on behalf of my child release you from all liability for any loss or damage to any property that they may incur while taking part in any activity described above;
8. I, on behalf of my child will indemnify and keep you indemnified against all actions or claims for compensation or damages arising from any accident, injury, incapacity, loss or damage described in paragraph 6 above;
9. The benefit of the releases and indemnity in this document will extend to your employees, agents and contractors; and
10. I am over the age of 18 years and I fully understand the legal effect of this document that I am signing on behalf of my child.

*

I agree to all information provided

Parent, Legal Guardian*

First NameLast Name

Email

example@example.com

Parent / Guardian Phone Number*

0400000000

Parent / Guardian Address*

Street Address

Suburb

Post code

I am the Parent, Legal Guardian of First Name* Last Name* Who is under the age of 18 years.

Childs Birth Date

MonthDayYear

Extra participants

I consent to the taking part in the activities named in paragraphs 1 and 2 on this document.

I DO AGREE. PLEASE TICK*

On behalf of the participant/s, I provide you with the releases and indemnity described in paragraphs 6,7 and 8 on this document.

I DO AGREE. PLEASE TICK*

If you are attending with a group? If so who is the organizer, school group or team **

If not please type NO

I hereby give permission for images of my child captured during regular and special activities through video and digital camera to be used solely for the purposes on Burns Outdoor Obstacle Training promotional material, publications, and websites and wave any rights of compensation or ownership thereto. Last name of minors will not be given or posted on the website. I have carefully read this agreement and fully understand its contents.*

I AGREEI DON'T GIVE PERMISSION

Date*

Date

Parent / Guardian Signature*

Clear

Kids Form

I also have extra minors under my gaurdianship for this visit

PHOTO RELEASE