Festival of Summer Indemnity Form

An application for tickets to any/all activities for the below listed participants may only be submitted if the parent/guardian of each participant agrees to the conditions set out below:

Please read all information carefully.

FESTIVAL OF SUMMER RULES

 

By purchasing tickets to a Festival of Summer activity, the Participant’s Parent/Guardian agrees that that:

(a) for outdoor activities all participants must wear enclosed shoes (beach activities excluded), sun safe protective clothing and the use of sunscreen is recommended;

(b) participants must be courteous and respectful of others;

(c) participants must act in a safe and responsible manner and not cause harm to any person;

(d) participants must follow the directions of GRC staff; and

(e) at the conclusion of activities, participants must be collected by their parent or guardian, unless prior alternative arrangements have been made with the Activity co-ordinator.

CONSENT, WAIVER AND INDEMNITY

In consideration of GRC accepting the Participant’s entry to Festival of Summer Activity, I as parent or guardian of the Participant:

1 ACKNOWLEDGE AND AGREE THAT:

1.1 The Participant participates in the Activity at his/her own risk;

1.2 GRC does not provide sickness or accident insurance for participants and I will be responsible for any and all costs for medical treatment, ambulance transportation or hospitalisation for the Participant should the Participant fall ill or suffer any injury during the Activity;

1.3 If GRC cannot contact me, or in case of emergency, I consent to the provision of emergency care, medical treatment, or administration of medication by medical professionals as required;

1.4 Some activities may require a moderate level of fitness; and

1.5 The Participant will while participating in the Activity comply with the Festival of Summer Rules:

2 WARRANT AND REPRESENT TO GRC THAT:

2.1 The Participant has no pre-existing injuries or medical conditions that would affect the Participant undertaking the Activity and the Participant has the physical ability to complete the Activity; and

2.2 If the Participant experiences any pain or discomfort while participating in the Activity the Participant will immediately cease participation and advise the Activity co-ordinator.

3 I and the Participant release GRC and indemnify GRC against all claims for damages, loss, injury or death arising from the Participant’s participation in all or any part of the Activity however caused.

4 Definitions:

“the Activity” means all and any activity in Festival of Summer in which the Participant is registering to participate,

“GRC” means Gladstone Regional Council, its successors and assigns, elected Councillors, officers, managers, employees, contractors and subcontractors.

 

PHOTOGRAPHIC CONSENT

By purchasing tickets for an Activity, I agree on behalf of the Participant that the Participant:

(a) gives GRC, its employees and those acting with its authorisation, the right and permission to take photographs and video footage and to use and/or publish photographs and/or video of Participant on GRC’s website and social media channels;

(b) waives any right to inspect or approve the finished video, photographs, advertising copy, or printed matter before use;

(c) consent to the Participant’s personal information being published on GRC’s website and social media and acknowledge that these sites may be accessed from outside Australia and may not be subject to privacy laws which provide the same level of protection as Australia.

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1 Step 1
I confirm I have read and agreed to be bound by all of the above conditions.
Please read all information carefully.
Participant 1
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D.O.BPlease select your date of birth
date_range
UploadProof of Age
cloud_uploadProof of Age
Participant 2
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D.O.BPlease select your date of birth
date_range
UploadProof of Age
cloud_uploadProof of Age
Participant 3
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D.O.BPlease select your date of birth
date_range
UploadProof of Age
cloud_uploadProof of Age
Participant 4
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D.O.BPlease select your date of birth
date_range
UploadProof of Age
cloud_uploadProof of Age
Participant 5
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D.O.BPlease select your date of birth
date_range
UploadProof of Age
cloud_uploadProof of Age
Address
Phone Number
phone
Email Address
mail
Emergency Contact 1Name and Phone Number
Emergency Contact 2Name and Phone Number
How did you hear about Festival of Summer?
What would you like to see in Festival of Summer 2021?
PARTICIPANTS MEDICAL INFORMATION
Please list any allergies or medical conditions requiring medication (e.g. asthma)
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Are there any medical sensitivities (i.e.) allergies, religious beliefs etc.) that would impact on any potential medical treatment?If yes, please list and include participants
If yes, please list details of condition including medication if applicable.
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PARTICIPANTS DIETARY REQUIREMENTS
Please list any specific dietary requirements the participants may have (please note, diets or dislikes are a lifestyle choice, not a dietary requirement).
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