• EXPRESSION OF INTEREST FORM

  • Dhinawan Dance Program

    Brought to you by Birrelee MACS

  • PROGRAM DETAILS

    ADD DETAILS OF DAYS DATES AND TiMES HERE

    This program is for students from 10 - 12 year old children only.

    Registration Forms, Consent Forms and Program Activities will be sent once confirmation is received.

    **Please note that bookings will be confirmed once assessed and staffing allocated**

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  • PRIVACY NOTICE AND DISCLAIMER

    PRIVACY NOTICE

    The purpose of collecting your personal information, including your health information, is to enable the Birrelee MACS to:

    (a) assess whether it is appropriate for you to take part in the School Holiday Program; and

    (b) provide medical assistance to you in the case of emergency.
    Your information will be supplied to staff of the Birrelee MACS, and, in the case of emergency, any health professionals involved in your care.

    The supply of the information is voluntary. Please be aware that the Birrelee MACS require you to provide accurate details of your health conditions and contacts so that appropriate care can be provided to you, and so the appropriate person can be contacted in the case of emergency.

    The Birrelee MACS reserve the right to suspend you from the School Holiday Program if any of the information you supplied about your medical history is found to be false.

    You are entitled to access the information you have provided to the Birrelee MACS by writing to any of the Responsible Parties. Your information will be stored at the premises of the relevant Birrelee MACS for 21 years. If you have a complaint about any breach of your privacy in regard to the information you have supplied, please contact any of the Responsible Parties to discuss.

    DISCLAIMER

    ACKNOWLEDGMENTS:
    I acknowledge and understand:

    • The Dhinawan Dance Program includes physical activity, and accidents can happen which may result in injury or death.
    • Participation in the program is voluntary and undertaken in the knowledge that injury or death might result from my participation.
    • Birrelee MACS may refuse, at their absolute discretion and at any time, to allow me to participate.
    • Birrelee MACS may amend, alter, or change, at their absolute discretion, any part of the program.
    • Birrelee MACS can, at their absolute discretion, cease the program at any time, with or without notice to participants.

    RELEASE: I agree to discharge and release the Birrelee MACS, their directors, employees, agents, or contractors in respect of all liability for my death or bodily injury, or any loss or damage that may be sustained or incurred by me as a result of my participation in the program. This release covers all liability for my death or bodily injury, or any loss or damage, whether sustained or incurred as a result of negligent acts or omissions (including gross negligence), breach of contract (including fundamental breach), or any other breach at law or statute by the Birrelee MACS to the extent the law permits.

    INDEMNITY: I indemnify the Birrelee MACS from all actions, suits, proceedings, claims, demands, losses, damages, penalties, fines, costs, and expenses however arising that I may have or may have had but for the foregoing release arising from or in connection with my participation in the program. This indemnity is in respect of all liability for my death or bodily injury, or any loss or damage, whether sustained or incurred as a result of negligent acts or omissions (including gross negligence), breach of contract (including fundamental breach), or any other breach at law or statute by Birrelee MACS.

    FITNESS TO PARTICIPATE: I declare that I am medically and physically fit and free from impairment and able to participate in the program.

     

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