I hereby apply for membership to “East Corrimal Boardriders”. In so applying and in consideration of my application for entry to the club being accepted, I acknowledge and agree that:

1. Insurance is in place that provides limited cover to me whilst I am participating in the Event. I understand that this insurance may not cover me for all injury, loss or damage sustained by me and I can, in my own interests, seek and obtain personal insurances over and above the cover provided.
2. Warning: Participation in the Event can be inherently dangerous. I acknowledge that I am exposed to certain risks during the Event including but not limited to physical hazards, unpredictable and dangerous surf and weather conditions, equipment contact and use and actions by other competitors. I acknowledge that accidents can and often do happen which may result in me being injured or even killed, or my property being damaged. I have voluntarily read and understood this warning and accept and assume the inherent risks in the Event.
3. Exclusion of Liability: I acknowledge that where I am a consumer of recreational services, as defined by any relevant law, certain terms and rights usually implied into a contract for the supply of goods or services may be excluded. I acknowledge that these implied terms and rights and any liability of the Event Organiser flowing from them, are expressly excluded to the extent possible by law, by this declaration. To the extent of any liability arising, the liability of the Event Organiser will, at the discretion of the relevant organisation, be limited to the resupply of the services or payment of the cost of having the services supplied again.
4. Release and Indemnity: In consideration of the Club Organisers accepting my application for entry to the Event I: (a) release and will release the Event Organiser from all Claims that I may have or may have had but for this release arising from or in connection with my participation in the Event; and (b) indemnify and will keep indemnified the Event Organiser to the extent permitted by law in respect of any Claim by any person arising as a result of or in connection with my participation in the Event.
5. Rescue, First Aid & Medical Treatment: I consent to receiving any rescue assistance, first aid, or medical treatment that the Event Organiser or authorised representatives consider necessary or desirable during the Event. I agree to abide by the relevant advice and care of the appointed qualified first aid officer at the event or authorised representative. I agree to reimburse the Event Organiser for any costs or expenses incurred in providing me with medical treatment.

I have read, understood, acknowledge and agree to the above declaration including the warning, exclusion of liability, release and indemnity. I acknowledge that if my application to enter the Event is successful I willbe entitled to participate in the Event.

Date of Birth:

Division:

Signature:

Parent/Guardian:

Membership Paid:

Yes
No