• Berkman Academy

    Risk Warning and Waiver of Liability
  • Provider Details

    Berkman Academy 271 Bayswater Rd. Bayswater North VIC 3153
  • Participant Details

  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Notice

    The following pages affect your legal rights and obligations. Please read carefully and only sign if you fully understand them. For participants under 18 years of age, the documents must be completed by a parent or legal guardian.
  • Description of Activities

    Equine-assisted sessions provided by Berkman Academy.
  • Berkman Academy delivers sessions at its main location (271 Bayswater Rd, Bayswater North VIC 3153) and at approved partner properties. This Risk Warning and Waiver applies to every Berkman Academy session the participant attends, at any location where the Academy delivers it, until withdrawn in writing. Sessions may be facilitated by Tamir Berkman or by another qualified Berkman Academy practitioner, and this waiver applies regardless of which Berkman Academy practitioner delivers the session.

    Activities may include:

    • Approaching, observing, and interacting with horses on the ground
    • Grooming, leading, feeding, and caring for horses
    • Participating in structured exercises and activities designed to build awareness, communication, emotional regulation, and resilience
    • Engaging in individual or group discussions, reflections, and wellbeing practices facilitated by qualified staff
    • Being present in an outdoor farm environment, which may involve uneven ground, natural obstacles, and exposure to weather conditions
    • No horse riding takes place. All interactions are ground-based.
  • Risk Acknowledgment

    I am aware that by participating in any activities arranged by the Provider, certain risks or dangers may occur, which could include:
    • Outdoor and farm environments may include uneven, wet or slippery ground, natural obstacles, fences, gates, farm infrastructure, equipment, changing weather conditions, physical activity, insects, other animals and other environmental hazards.

    • I understand that horses are large and powerful animals whose behaviour can be unpredictable.

    • Horses may react suddenly to movement, sound, touch, weather, equipment, people, other animals or changes in their environment.

    • Risks associated with being around horses may include being bitten, kicked, struck, stepped on, pushed or knocked over, including while approaching, observing, leading, grooming, feeding, caring for, interacting with or simply being near a horse.

    • I understand that injury may occur through my actions, the actions of another person, the behaviour of an animal, environmental conditions or other circumstances associated with participation.

    • I understand that these risks may exist regardless of my previous experience and despite reasonable precautions taken by Berkman Academy.

    • I understand that Berkman Academy will take reasonable steps to provide a safe environment but that complete safety around horses, animals and farm environments cannot be guaranteed.

    • I voluntarily acknowledge and accept the inherent risks associated with participating in Berkman Academy's horse-related, outdoor and farm activities.

  • Partner Properties, Hosts and Berkman Academy Personnel

    I understand that Berkman Academy activities may take place at properties owned or occupied by third parties.
  • Activities may be facilitated by Tamir Berkman or another appropriately qualified Berkman Academy employee, contractor or practitioner and may involve relevant property personnel.

    To the extent permitted by law, the protections relating to Berkman Academy activities contained in this document are intended to extend to Berkman Academy, its directors, employees, contractors, practitioners and agents, and to the owner and occupier of an approved property and members of their household, in connection with Berkman Academy activities conducted at that property.

  • Equine-Specific Risk Acknowledgment

    In addition to the general risks set out above, I acknowledge and agree that working with and around horses involves unique risks, including but not limited to:
    • Horses are large, powerful, and unpredictable animals that may react suddenly to movement, sound, touch, weather, or other animals.
    • Risks include being bitten, kicked, struck, trampled, stepped on, pushed, knocked down, or injured by sudden movements of a horse.
    • Risks may arise from leading, grooming, feeding, or interacting with horses on the ground, as well as from being in close proximity to horses during group or individual sessions.
    • These risks exist regardless of my level of experience or the precautions taken by the Provider and its staff.

    I understand that while the Provider takes all reasonable steps to create a safe environment, it is not possible to guarantee complete safety when interacting with horses.

    By signing this form, I voluntarily assume and accept all such risks of injury, harm, or damage arising out of my participation in equine-assisted activities with the Provider.

  • Participant Responsibilities

    I agree to:
    • follow reasonable safety instructions provided by Berkman Academy personnel and relevant property staff;
    • wear appropriate closed-toe footwear and any other safety equipment reasonably required;
    • disclose any medical, physical or other condition that could reasonably affect my ability to participate safely;
    • advise Berkman Academy personnel if I become injured, unwell or concerned about my ability to participate safely;
    • behave in a manner that does not unnecessarily endanger myself, another person or an animal; and
    • not participate while affected by alcohol, drugs, medication or another substance to an extent that impairs my judgement or capacity to participate safely.
    • Where reasonably necessary in an emergency, I consent to appropriate first aid being provided and emergency medical assistance being sought.
  • Exclusion of Liability

    I agree to:
    • Release, waive, discharge, and hold harmless the Provider (and its employees, agents, directors, officers) from any claims for personal injury—regardless of cause (negligence, wilful act, breach of contract, statutory duty, error, etc.)
    • Indemnify the Provider against any such claims
  • The release and waiver in this document extend to the owner and occupier of any property where a Berkman Academy session takes place, and to members of their household, in respect of Berkman Academy's activities at that property.
  • Statutory Rights & Exclusions

    If you sign this form, you will be agreeing that your rights to sue the supplier under the Australian Consumer Law and Fair Trading Act 2012 are excluded, restricted or modified in the way set out in this form, if you are killed or injured because the services provided were not in accordance with the statutory guarantees outlined below.
  • Under the Australian Consumer Law (Victoria), several statutory guarantees apply to the supply of certain goods and services. These guarantees mean that the supplier named on this form is required to ensure that the recreational services it supplies to you—

    are rendered with due care and skill; and
    are reasonably fit for any purpose which you, either expressly or by implication, make known to the supplier; and
    might reasonably be expected to achieve any result you have made known to the supplier.
    Under section 22 of the Australian Consumer Law and Fair Trading Act 2012, the exclusion of these statutory guarantees is brought to your attention by this form.

    NOTE: The change to your rights, as set out in this form, does not apply if your death or injury is due to gross negligence on the supplier's part.

    Gross negligence, in relation to an act or omission, means doing the act or omitting to do an act with reckless disregard, with or without consciousness, for the consequences of the act or omission.

    See regulation 5 of the Australian Consumer Law and Fair Trading Regulations 2012 and section 22(3)(b) of the Australian Consumer Law and Fair Trading Act 2012.

  • Cancellation Policy

    We understand that sometimes plans change, and it may be necessary to cancel or reschedule your appointment. We kindly ask for as much notice as possible.

    Cancellations made less than 48 hours before the appointment time, or failure to attend without notice, will incur the full session fee.

    This policy allows us to manage our schedule effectively and offer the time to other clients who may be waiting for an appointment.

  • I have read the information or it has been read to me and I understand the information stated above. I understand the potential risks, benefits, my rights in participating in this form of therapy. I have had the opportunity to ask questions and the answers were discussed to me clearly, understandably, and to my satisfaction.

  • Declaration & Signature

  • I confirm that I have read and understood this Berkman Academy Risk Warning and Waiver of Liability, or that it has been explained to me in a way I understand.

    I understand:

    the nature of the Berkman Academy activities in which I or the participant may take part;
    that activities may be facilitated by Tamir Berkman or another Berkman Academy employee, contractor or practitioner;
    that all horse interactions are ground-based and no horse riding takes place;
    the inherent risks associated with horses, animals, outdoor and farm environments;
    my responsibilities as a participant; and
    that I may decline to participate in an activity.
    I acknowledge that I have had the opportunity to ask questions.

    By signing this form, I voluntarily choose to participate, or consent to the participant participating, in Berkman Academy activities and acknowledge and accept the risks described above.

  • For Participants Under 18 

    As a parent/guardian with legal responsibility, I certify that I acknowledge, understand, and accept all the above. I consent to this release and indemnify the Provider—even if arising from the Provider’s negligence

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: