Activity Registration and Consent Form

Please note that some of our events have limited capacity. While we will remove events from the list that are full, there may be an administrative delay while this change is made. We will endeavour to let you know as soon as possible if an event you have registered for is already full, and will let you know if any additional spaces become available.  You can register up to 5 young people with this this form.  

If your child is under 11 years old, it is expected that you will be responsible for their supervision at events unless you have spoken with the Youth Officer or the Libraries team and made alternative arrangements.

PRIVACY STATEMENT

We will handle any personal information you have provided in this form in accordance with the Privacy and Data Protection Act 2014. Our privacy policy contains information about how you may access your personal information and seek correction of such information; as well as how to complain about a breach of the Australian Privacy Principles and how we will deal with such a complaint. For more information, please see our Privacy Policy or contact our team on (03) 5391 4444. Your personal information will not be disclosed to any other party unless Council is required to do so by law, has gained your consent to do so or an information privacy principle exemption applies.

Contact details of parent or guardian must be provided if the attendee is under 18 years of age. 

In registering for this event, attendees must agree to our Code of Conduct.

• Abusive language will not be tolerated.
• No alcohol or drugs are allowed and we will not accept attendees who are affected by alcohol or other drugs consumed prior to the event. 
• Loud or disruptive behaviour won’t be tolerated whilst travelling to and from the venue or during the event.
• Antisocial behaviour (e.g. fighting, verbal abuse, or confrontational behaviour) will not be tolerated.
• Show respect for other people.
• REMEMBER! You are representing your family, your school and your community.
• Bag searches are a condition of entry.
• You are there to have fun and adhering to this Code of Conduct means that our events will be both safe and fun for everyone. 

If participant is under 18 years of age:

I hereby and forever release, discharge, indemnify and hold harmless Hindmarsh Shire Council and its employees and agents for any accidents, harm, loss or damage which my child may suffer or sustain in any way connected to the activities as a part of the Hindmarsh Shire Youth Events. I am aware that the program, in addition to usual dangers and risks inherent, has certain additional dangers and risks, some of which may include: physical exertion for which my child may not be prepared, weather extremes subject to sudden and unexpected change, remoteness to normal medical services, evacuation difficulties if my child is disabled. I authorise staff, in the event of an accident or illness, to obtain all necessary medical assistance and treatment for my child and I agree to meet whatever cost may be incurred in respect of the provision of any necessary medical services.
In the event of my child requiring medical attention I understand that the program workers will endeavour to communicate with me concerning the required action. I also agree that Hindmarsh Shire Council staff are not responsible for theft of clothing or valuables during my child’s involvement in this program. The information I have provided on this form is correct. 

Hindmarsh Shire Council regularly produces photographs of people in its publications, promotional and marketing material and on its website and social media pages in order to promote community and council events, services and projects. These photographs are taken at a variety of locations and at community events, facilities and locations across the Hindmarsh and Wimmera Mallee region.
We are very grateful for your assistance, through the completion of this form. Hindmarsh Shire Council will of course, only utilise material which is enhancing to the profile of Council and the Hindmarsh region. I authorise Hindmarsh Shire Council and any person authorised by them, to reproduce, publish, broadcast or do any of the acts comprised in the copyright subsisting in;
• Photographic images
• Digital media (audio and visual)
• Production stills
• Voice recording
of me, my dependent named above and my property and to use, publish and broadcast them to reproduce, publish, broadcast or do any of the acts comprised in the copyright subsisting in;
• Any country of the world
• Conjunction with my own or a fictitious name
• In colour or otherwise
• Any medium for advertising promotion or trade
• Any altered composite or other form

I do not require inspection of the finished product or the associated wording of any copy or voiceover. I hereby release Hindmarsh Shire Council from all claims, demands, actions, proceedings, costs or expenses relating to or arising out of use of material.

This release is an ongoing commitment.