Participant Waiver (Guardian Authorisation)

Big Air School Participant Waiver (Guardian Authorisation) Big Air School ABN: 50 705 834 632 DATE:…………………….

Participant Details:

Name:………………………………………. Age:………..

Discipline (Scooter, skate or BMX) Existing Injuries or medical condition: (Y/N)

If yes, please describe injuries or medical condition:……………………………………… ………………………………………………………………………………………………………... PARENT/GUARDIAN Details:

NAME: ......

PHONE:...... EMAIL ADDRESS:………………………………….

ADDRESS:……………………………......

...... …………………………………………………………………..

RELATIONSHIP TO PARTICIPANT: ...... Parent Responsibilities and Authorisations

I hereby consent for my child to participate in the 2012 BIG AIR SCHOOL conducted by Jemima Key Events. I understand that Jemima Key Events takes no responsibility for accident, loss or injury suffered by myself or my child during the course of activity.

I hereby authorise Jemima Key Events staff to organise medical or hospital treatment as they see necessary at my expense.

By Signing the disclaimer form, I acknowledge and agree that:  Unless this form has been signed by my parent or guardian, I am over the age of 18 years  Usage of the skatepark, or alternate venue including but not limited to scooting, skateboarding, bike riding, inline skating, parkour as well as spectating, and participation in the events involves skill and ability; there is every possibility that Icould be injured as a result of my own actions, or those of others.  I accept the consequences of any injuries sustained to me.  I participate in skateboarding, scootering, BMX bike riding inline skating, parkour or any other related activity during BIG AIR SCHOOL workshops and accept the possibility of injuries, and the consequence thereof.

IF YOU ARE PARTICIPATING IN PARKOUR, YOU MUST HAVE READ THE REVERSE OF THIS FORM AND BY SIGNING BELOW YOU AGREE TO THOSE TERMS.

I indemnify Jemima Key Events from and against all actions, claims, costs, losses, expenses and damages (including the costs of defending or settling any action or claim) in respect to: 1. Loss of, or damage to property; or 2. Personal injury (including death) or illness to any person or loss of/ loss of use of, or damage to any property, 3. Resulting from or by reason of anything done or omitted to be done by me arising out of the my activities undertaken at or near the skatepark.

I give permission for my child/ren to be photographed whilst attending BIG AIR SCHOOL I give consent for the photographs to be used for promotional purposes (please draw a line through this if you DO NOT give this consent)

I am happy to receive information relating to upcoming events or services relevant to this event (please draw a line through this if you DO NOT consent to receiving further information.

Signature ...... Date ......

Parent/Guardian ...... Date ......