Risk Warning and Waiver of Liability

Risk Warning and Waiver of Liability

PROVIDER[1]: Adventure Out Loud Pty Ltd | ABN 85 124 320 529 1207 Kandanga Creek Rd KANDANGA QLD AUSTRALIA 4570
Name of participant*

First NameLast Name
Participant DOB:*

DayMonthYear
Participant (or group) email*
example@example.com
Address of participant*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Group bookings:

Couples and families may complete one waiver form for their booking, provided they are travelling on the same itinerary and the person signing this form has legal authority to sign on behalf of the other participants listed (i.e. a parent signing for the family, etc). If you do not have legal authority (i.e. you are travelling with a group of friends), each person must complete their own waiver form.
To complete a waiver form for your group, select your group size:

1 (group booking not applicable - continue to the next section)2345678910
Participant #2*

First NameLast NameRelationship to you?
Participant #3*

First NameLast NameRelationship to you?
Participant #4*

First NameLast NameRelationship to you?
Participant #5*

First NameLast NameRelationship to you?
Participant #6*

First NameLast NameRelationship to you?
Participant #7*

First NameLast NameRelationship to you?
Participant #8*

First NameLast NameRelationship to you?
Participant #9*

First NameLast NameRelationship to you?
Participant #10*

First NameLast NameRelationship to you?
The following pages affect your legal rights and obligations. Please read these carefully and only sign if you fully understand their contents. For Participants under 18 years of age, these documents must be completed by a parent or legal guardian.
Select your activities[2]:*

KilimanjaroSafariGorilla trekChimp trekGolden MonkeysSheldrick Elephant OrphanageNairobi Giraffe CentreSwimming with whale sharksMafia IslandZanzibarCultural immersion with one of our charity partnersOther activities listed in your itinerary
Risk warning
I am aware that by my participation in any activities arranged by the Provider[1], certain risks or dangers may occur which could include:
- Physical, bodily or psychological injury or death.
- Physical exertion to which I am not accustomed.
- Failure of equipment or use of inadequate equipment.
- There may be no or inadequate facilities for treatment or transport to treatment if I am injured.
- The conditions in which the activities are conducted may vary without warning.
- I may cause injury to other persons and/or other persons may cause injury to me.
- I may be injured or die due to the negligence, breach of contract or breach of statutory duty or guarantee of the provider.
- During cultural immersion experiences (i.e. the Kibera Slums or St Jude Immersion, etc.), I may be offered food that has not been prepared under hygienic circumstances. I have been briefed about these risks and by consuming this food, I accept these risks.
I acknowledge that the activities are being undertaken for the purposes of recreation, enjoyment or leisure, and involve a significant degree of risk of physical harm.

I acknowledge that the Activity may be undertaken with one or more other persons as part of a group and that the Provider is not liable for the actions of other participants in the group activity.

By signing below, I acknowledge, agree and understand that the risks associated with the Activities and/or recreational services have been explained to me. I undertake any such risk voluntarily and at my own risk.

I acknowledge that the risk warning above constitutes a “risk warning” in accordance with the Civil Liability Act 2003 (QLD).
Participant’s warranties
I agree to abide by any of the Provider’s rules, and any direction or instruction given to me by the Provider during the course of the Activities. I agree to use and/or wear any equipment given or recommended to me by the Provider.

I declare that I am medically and physically fit and able to participate in the Activities. I acknowledge that I must, and agree that I will, disclose any pre-existing medical or other condition, injury or concern that may affect the risk that either I or any other person will suffer injury, loss or damage during the course of the Activities and notify the Provider of any injuries, illness or concerns that may arise during the Activity. I will not engage in any reckless, negligent or foolish behaviour or any other behaviour that is likely to cause injury to me, any other participant or person.

I agree that if I suffer any injury or illness, the Provider may provide evacuation, first aid and/or medical treatment at my expense and that my acceptance of these terms and conditions constitutes my consent to such evacuation, first aid and/or medical treatment.
Exclusion of liability
I agree to and unconditionally release, waive, discharge and forever hold harmless, the Provider or any of its employees, agents, directors or officers, from any claims as a result of any personal injury sustained, whether caused by the Provider’s negligent act or wilful act or omission, breach of contract, breach of statutory duty, error, or otherwise in connection with or arising out of the Activities.

I agree that the Provider will not be liable for any claims for personal injury that may be brought against it as a result of or in connection with any act, omission, default, failure or error on the part of the Provider, and agree to indemnify and keep indemnified the Provider in respect of any such claims.
Waiver
It is possible for a supplier of recreational services to ask you to agree that the statutory guarantees under the Australian Consumer Law(which is schedule 2 to the Competition and Consumer Act 2010 (Cth)) do not apply to you. If you sign this form, you will be agreeing that your rights (or the rights of a person for whom or on whose behalf you are acquiring the services) to sue the Provider in relation to the Provider’s services or the activities that you undertake because the services or activities provided were not in accordance with the guarantees are excluded, restricted or modified as set out below.
By signing this form, you agree that the liability of the Provider in relation to the activities (as defined by the Competition and Consumer Act 2010 (Cth), the Consumer Affairs and Fair Trading Act (QLD) and the Australian Consumer Law) and recreational activities (as defined by the Civil Liability Act 2003 (QLD) for any:
1. Deaths;
2. Physical or mental injuries (including the aggravation, acceleration or recurrence of such an injury);
3. The contraction, aggravation or acceleration of a disease;
4. The coming into existence, the aggravation, acceleration or recurrence of any other condition, circumstance, occurrence, activity, form of behaviour, course of conduct or state of affairs in relation to an individual:
  1. That is or may be harmful or disadvantageous to you or the community; or
  2. That may result in harm or disadvantage to you or community;
That may be suffered by you (or a person for whom or on whose behalf you are acquiring the services) resulting from the supply of the recreational services or recreational activities is excluded.

You acknowledge and agree that the above provision operates to exclude the liability of the Provider as a result of a breach of an express or implied warranty that the recreational services will be rendered with reasonable care and skill in accordance with the Civil Liability Act 2003 (QLD).
Agreement to exclude, restrict or modify your rights:
I agree that the liability of the Provider for any personal injury that may result from the supply of the recreational services that may be suffered by me (or a person for whom or on whose behalf I am acquiring the services) is excluded.
Declaration and signatures
I have read carefully and understand this risk warning and waiver of liability and sign it feely and voluntarily without inducement of any kind.

Note: electronic signatures are accepted. Please use your finger/mouse to sign.
Signature of participant*

Clear
Signature of witness*

Clear
Date:*

MonthDayYear
Name of witness*

First NameLast Name
For Participants under age 18
This is to certify that I, as a parent/guardian with legal responsibility for the Participant, acknowledge, understand and accept all of the above and consent to his/her release as provided above. I release and agree to indemnify and hold harmless the Provider from any and all liabilities arising from my minor child’s involvement or participation in the Activities and/or recreational services, even if arising from the negligence of the Provider.
Name of legal guardian*

First NameLast Name
Signature of legal guardian*

Clear
Please verify that you are human*
Footnotes

[1] Provider includes the officers, employees, agents, contractors, franchisees and assigns of the Provider.

[2] Activities includes all activities and services ancillary to or associated with the named Activity, both before and after the Activity, including transportation to and from the location of the Activity whether provided by the Provider or not, briefings, inductions, training, and the provision of information in all manuals, safety guidelines and other documentation provided to or made available to the Participant with respect to the Activity, familarisation with clothing or equipment and methods of operation of equipment and the wearing and removal of any clothing or equipment associated with the Activity. Unless otherwise specified, a reference to an Activity is a reference to a recreational service or a recreational activity as defined in relevant legislation referred to herein.
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