COME & TRY NIPPERS OPEN DAY

Sunday 16th November 2025

10am - 11:30am
Ulverstone Surf Life Saving Club Beach Road Ulverstone

Please complete a registration form for each child who will be attending.

If YES, please provide details of the medical condition or health problem below.

If a medical emergency could occur, please provide any further relevant information?

Does your child take any prescribed medication (including inhalers)?

Is this medication required to be brought to the event?

If YES, then a parent must be in attendance to administer the medication at the event.

Please name any prescribed medication (including inhalers) taken by your child:

*Note: Any medication needed should be available during activities, with written notes of your child’s name, medication, dose, etc.

By signing on behalf of my child, I:

(a) agree to waive and release, and will release, the Club and its personnel from any claims including but not limited to any negligent or reckless act or omission, that I may have, or may have had, but for this release arising from or in connection with my participation in any Surf Life Saving activity conducted by the Club and/ or SLSA; (b) agree that I/my child(ren) are not covered by any Personal Accident Injury Insurance whilst participating in surf life saving activities conducted by the club; (b) consent to the appointed doctors, coaches, staff, and other officials of the Club to provide first aid to me and if required deliver me for treatment to the nearest operating and available medical facility if I am injured as a result of my participation in any Surf Life Saving activity conducted by the Club and/or SLSA; and (c) consent to the Club and SLSA, using my name, image, likeness and also my performance in or of any Surf Life Saving activity at any time to promote the Objects of the Club and/or SLSA, by any form of media. I waive any rights I might have to or in such use of my name, image, or likeness by the relevant SLS organisation. By providing yours and your child’s personal information to SLSA, you consent to its use, storage and disclosure in accordance with SLSA Privacy Policy.

WARNING: SLS Activities can be inherently dangerous. I acknowledge that I or my child is exposed to certain risks during SLS Activities including but not limited to physical exertion, contact with surf lifesaving equipment, body contact, surf, sea, tidal and weather conditions and exposure to potential or actual medical conditions, infections, and/or illnesses. I acknowledge that accidents can and often do happen which may result in me or my child being injured or even killed, or my or my child’s property being damaged. I have voluntarily read and understood this warning and accept and assume for myself and for my child the inherent risks of my child participating in SLS Activities. SLS Activities means performing or participating in any capacity in any activity, event or function organised by an SLS Organisation.