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Sydney Trapeze School Pty Ltd - Acknowledgement Release and Assumption of Risk
 

 
Acknowledgement of Risks, Injury and Obligations
 
This is an important document which affects your legal rights and obligations. Read it carefully and sign.

I ACKNOWLEDGE that the activities* I am about to undertake at Sydney Trapeze School Pty Ltd is a potentially dangerous activity and that by participating in it I am exposed to certain risks.

I  ACKNOWLEDGE and UNDERSTAND that whilst participating in such activities*:
  • I may be injured physically or mentally, or even fatally.
  • My personal property may be lost or damaged.
  • Other persons participating in such activity may cause me injury or may damage my property.
  • I may cause injury to other persons or damage their property.
  • I may be injured or suffer fatality or damage to my property as a result of my own negligence or breach of contract of Sydney Trapeze School Pty Ltd.
  • I assume the risk of and responsibility for any injury, fatality or property damage resulting from my participation in the activity.
  • I acknowledge I am physically and mentally healthy, I assume all responsibility of my personal fitness in participating in this activity.
  • I must advise a staff member before class if I am not healthy in any way.
*Activities: FLYING TRAPEZE, AERIAL ARTS, JUMPING STILTS, TRAMPOLINE and TRAPEZE CONDITIONING CLASSES

Any students of an advance level or above wishing to do the above activities without safety lines will be doing so at their own risk and acknowledge that this is against the proper safety instructions, protocol and advice of Sydney Trapeze School Pty Ltd. and its staff. I agree to release and indemnify Sydney Trapeze School Pty Ltd from any injury, loss, damage or fatality that may be caused by my decision to do these activities without safety lines..

In consideration of permitting me to participate and use the facilities and equipment at Sydney Trapeze School Pty Ltd, I AGREE TO RELEASE AND INDEMNIFY Sydney Trapeze School Pty Ltd as follows:
  • I participate in the activity at my sole risk and responsibility.
  • I release, indemnify and hold harmless Sydney Trapeze School Pty Ltd, its Directors, employees and agents, from and against all and any actions or claims which may be made by me or on my behalf or by other parties for or in respect of or arising out of any injury, loss, damage or fatality caused to me or my property by my own negligence, breach of contract or in any way whatsoever.
  • I also AGREE that in the event that I am injured or my property is damaged, I will bring no claim, legal or otherwise, against Sydney Trapeze School Pty Ltd in respect of that injury or damage. Before signing this document I have read and understood it and know that it affects my legal rights.
 


Student Details (Feilds Marked with an * are required)

First Name:* Last Name:*
DOB:           Gender:*  Male    Female

   Only use the "+ Add Another Student" if you are a parent or guardian of the additional students.



Address Details

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State: Postcode:
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Contact Details* (Please enter at least 1 phone number)

Email*: (Please enter "na" or "Na" if you don't have an email)
Mobile: Work: Home:
  eg: 0416133127 (10 digits)   eg: 95579668 (8 digits)   eg: 95579668 (8 digits)


Emergency Contact Details*

Emergency Contact:* Emergency Phone:*


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I request to use the facility above and agree that as a new Sydney Trapeze School student, I must be instructed by Sydney Trapeze School Pty Ltd staff on proper technique and safety measures and follow their instruction and advice only and agree to Sydney Trapeze School terms and conditions.



Signature - Please Sign inside the box below   

HOW TO SIGN: Simply click and draw your Signature with the Mouse/Trackpad (desktop or laptop) OR use your Finger (smartphone or tablet)



Name:   Date: 18/12/2018