EBFC Travel Policy Acknowledgement and Consent 2025

EBFC Travel Policy Acknowledgement and Consent 2025
Participant Name

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Date of Birth

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Address

Street Address

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Phone Number
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Email
example@example.com
Emergency Contact Name

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Emergency Contact Phone Number
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Relationship to Paricipant
Activity Description:

Participation in Boxing Training, Development Days and Competitions at venues outside of Emerald Boxing and Fitness Club, including travel by road. Venues include, but are not limited to Blackwater, Rockhampton, Dysart, Middlemount and Clermont. For overnight trips more detailed individual Consent Forms will be used.
Medical Information:
Please list any medical conditions or allergies that the club organizers should be aware of.
Acknowledgement of Risks:

1.         The Participant acknowledges that they are voluntarily participating in the above-mentioned sporting activity/trip, and that this activity involves certain risks and dangers.

2.         The Participant is aware that these risks may result in serious injury, disability, or death and they voluntarily assume all risks associated with their participation.

3.         The Participant assumes all risk and responsibility of any injury arising from their participation in the above-mentioned sporting activity/trip.

Waiver and Release:

I also agree that in the event that I am injured or suffer damage, I will bring NO claim, legal or otherwise against “Emerald Boxing & Fitness Club Inc”, its staff or families in respect of that injury or damage.

Indemnification:

I further agree to indemnify and hold harmless the released parties from any loss, liability, damage, or costs that they may incur due to my participation in the activity, whether caused by their negligence or otherwise.

Medical Treatment Authorisation:

I authorise “Emerald Boxing & Fitness Club Inc” and its representatives to consent to any emergency medical treatment or hospital care that may be necessary for me as a result of any injury or illness during my participation in this activity, if I am unable to consent to such treatment myself.

Photographic Release:

I grant “Emerald Boxing & Fitness Club Inc” the right to take photographs and/or video of me in connection with this activity. I authorize “Emerald Boxing & Fitness Club Inc” to use and publish these images in print and/or electronically for promotional, educational, or other purposes that support the mission of the organization.

I have read and understand the EBFC Travel Policy and agree to abide by it.

I have read and understand this document and know signing it affects my legal rights.
Participant's Signature

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Parent/Guardian's Signature (if the Participant is under 18 years of age)

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