1. I am aware that the activity’s (including but not limited to dirt bike riding, beach activities, lake activities) offered at Youth Encounter will involve an element of risk and the participant acknowledges the risks involved and participates at their own decision and at their own risk. 2. I am aware that Youth Encounter will not be held responsible for any injury, damage or loss to myself, property or others due to recklessly or intentionally not following activity regulations and/or staff instruction. 3. I am aware that any equipment that I have provided for an activity offered at Youth Encounter I do so at my own risk. And agree to wear all safety gear required by Youth Encounter to participate in the activities. 4. In the event of injury, accident or illness I grant permission for Youth Encounter staff to assist or seek appropriate medical attention for the participant. I will reimburse Youth Encounter any costs that may incur. 5. I am aware that the participant is physically fit and able to participate in the activities and has not be advised otherwise by a qualified medical professional. Youth Encounter has been informed of any medical conditions, previous injuries and any medication the participant is currently on that may affect their ability to undertake the activities. I am aware that it is my responsibility to disclose any conditions that may affect my safety or the safety of others. 6. I give permission for the participant to be transported by Youth Encounter staff and I will not hold the driver or owner of the vehicle responsible for any injury or harm that may occur. 7. Land owners will not be held responsible in the event of an incident or loss of person or property occurring on their land or during the Youth Encounter operations. 8. The participant agrees to abide by Youth Encounters regulations set-out and will accept the consequences if this is not adhered to. This may include being removed from the Youth Encounter programme without any reimbursement. 9. I am aware that if the participant will not be able to take part in any Youth Encounter activity if they are suspected to be under the influence of alcohol or drugs (legal or illegal) that may impact their ability to participate in the activities. 10. Youth Encounter reserves the right to withdraw a participant from an activity if they are endangering themselves or others by their actions. We also reserve the right to cancel any activity if we become concerned for the safety of staff or participant. 11. I agree that photographs or video of the participant as well as non-identifying stories or quotes about the participant, taken during Youth Encounter programmes, may be used for Youth Encounters promotional and social media purposes. 12. Youth Encounter Ministries Trust complies with the Privacy Act 1993 and all files will be kept securely and will remain confidential to the organisation; however, as part of the accreditation process the Ministry of Social Development or Oranga Tamariki may have access to personal information or documentation the organisation holds. 13. You acknowledge that documentation held on you is able to be requested and that all information will be considered confidential and privileged unless you give express consent for specific information to be disclosed to specific persons. 14. That children know that they have the same right to request their information, authorise collection of said information or complain about the disclosure of their information. There is a consideration for those Under 16 as to whether the parent/caregiver are acting as a representative for the child. Youth Encounter is required to obtain consent from the participant prior to any disclosure of information. 15. Youth Encounter may withhold information made by a child or on behalf of the child (Under 16) if it is considered that the release of the information would be contrary to the interests of the child. While there is no requirement for information to be given to a parent/caregiver prior to requesting it, on receiving a request there will be a response as soon as practically possible and no later than 20 working days from date of request. 16. I give permission for the participant to attend and participate in all Youth Encounter programmes and all the information supplied on this form is true and correct and I consent to this information being used for the purpose of running the Youth Encounter programme and that I will advise Youth Encounter promptly of any changes. PARTICIPATION RISK DISCLOSURE & AGREEMENT I have heard and understood the Youth Encounter regulations for this activity, and agree to comply with them. I am aware this activity can be dangerous and that it inherently involves risks and that a major impact, collision, drowning or an unpredictable incident may occur that could cause me serious harm or death. I am physically and mentally fit to participate in this activity, and there is nothing that will affect my ability, or impact the safety of other participants. By signing this I acknowledge that I have heard and understood the risks involved and wish to participate at my own risk.