The Happiness Cycle Event Participant Waiver

Transcription

1 The Happiness Cycle Event Participant Waiver To be eligible to participate in The Happiness Cycle Event, you must be over 13 years of age and, if you are aged between 13 and 17, have your parent or legal guardian s consent to participate. You must also be able to ride a bicycle. Please note that completion of this form does not guarantee a place in the Event. You will be advised if you have been allocated a place by prior to the event. Participants are prioritised and selected based on the following criteria: Priority given to applicants who are currently years old and residing in the Council area where the Event will take place. Priority given to applicants who do not currently own a bicycle. Otherwise spaces will offered on a first come, first served basis. The Happiness Cycle Event consists of gifting participants with a bike and equipment, assembly of the bikes, bicycle training clinics, bike and road safety briefings and a group bike riding exercise. All bike skills training will be run by qualified instructors, bike assembly staff will oversee and assist with bike assembly, and bike riding will be overseen by staff and a first aid officer. Events will run for approximately 4 hours. Following the event, participants who have opted to receive further communication during the registration process will be invited to complete an survey from time to time about their attitudes towards cycling and the use of bikes in their community. REGISTRATION: First Name: Surname: Address: Suburb: State: Postcode:

2 Mobile Phone Number: Date of Event: Gender: Date of Birth: School Name: Male Female Event Location: Age: EMERGENCY CONTACTS: The person(s) who may be contacted in case of an emergency and to whom the participant may be released: Parent/Guardian Name: Phone Number: In case the above person cannot be reached, we can contact and release the participant to: Relative/Friend Name: Phone Number: PROGRAM DECLARATION: In consideration of the Organisers accepting my application to participate in the Event, below I acknowledge that I understand and agree that: 1. Definition: Organisers for the purpose of this declaration means the organisers of The Happiness Cycle event (the Event ) and includes Coca-Cola South Pacific Pty Ltd (CCSP) and Bicycle Network. 2. Warning: Participating in the Event can be inherently dangerous. I acknowledge that I may be exposed to certain risks during the Event including but not limited to physical hazards and unpredictable and sometimes dangerous actions of other participants. 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 participating in the Program. 3. Physical Fitness: I understand that I must not participate in the Event if I have any injury, disability, medical or health condition that may increase the risk of me becoming injured unless I have provided documentation from my medical practitioner which authorises me to participate. I declare that I am medically and physically fit and able to participate in the Event and I will immediately notify the Organisers of any change to my fitness and ability to participate. 4. Instructions & Conduct: I will at all times comply with the instructions and safety procedures of the Organisers. I understand that my participation may be terminated at the discretion of the Organisers should I fail to adhere to the instructions and safety procedures provided.

3 5. Bicycle Rules: I will at all times when riding at the Event, wear an approved bicycle helmet securely fitted and fastened. The Organisers will provide you with a cycling helmet that meets the current Australian and New Zealand standard (AS/NZS 2063:2008). You will receive a bicycle to keep that is in working, serviceable condition and complies with all relevant standards. You will receive a lock to be used to secure your bicycle, to avoid possible theft. You agree that when you use this equipment you must comply with all current and relevant laws and regulations in place at the time of use and take due care to ensure the equipment is used safely and appropriately at all times. You agree that you are solely responsible for the bicycle, helmet, front light, rear light and bicycle lock immediately upon receipt of the equipment. The Organisers are not responsible for the maintenance, use, service or repair of the equipment. You agree that this equipment cannot be sold or gifted to another person of group of person while you are active in the Program. 6. Medical Treatment: If required, the Organisers will arrange medical or hospital treatment (including ambulance transportation) for me. I authorize such actions being taken by the Organisers and agree to meet all costs associated with such action. 7. Insurance: Insurance is in place that provides limited cover to you whilst participating in the Event. This insurance may not cover you for any injury, loss or damage sustained by you. You may seek and obtain personal insurance over and above the cover provided by the Organisers. 8. Exclusion of Implied Terms: I acknowledge that this is a free recreational service therefore certain terms and rights normally 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 or the Organisers (or any of them) flowing from them, are expressly excluded to the extent possible by law by this declaration. To this extent a\of any liability arising, the Organisers will not be required to resupply the services or payment of the cost of having the services supplied again. 9. Release & indemnity: My participation in the Program is entirely at my own risk and I agree to the extent permitted by law to: a. Release and forever discharge the Organisers from all liability and Claims that I have or may have had but for this release arising from or in connection with my participation in the Event; and b. Indemnify and hold harmless the Organisers to the extent permitted by law in respect of any Claim by any person including but not only another participant in the Event arising as a result of or in connection with my participation in the Program. In this clause 9 Claims means and includes any action, suit, proceeding, claim, demand, damage, cost or expense however arising including but not limited to negligence but does not include a claim against the Organisers under any right expressly conferred by their respective constitutions or regulations. 10. Photography & Identity: I understand photographic images and video footage will be taken by the Organisers of my participation in the Event. I understand these images will forever become the property of CCSP, without monetary or other liability to me, and that CCSP may choose to distribute and make these images available to the public domain via (but not limited to) Facebook, the Happiness Cycle website, the Coca-Cola Australia website and to Bicycle

4 Network to use across their corporate websites and social media. CCSP may also use these images for general promotion of its activities. In addition, the Organisers will select certain individuals on the Event day, with the individuals consent, for further content capture in the months following the Event. The purpose of this content is to track and share the impact of the Program with the public. The participant will be asked to consent to the Organisers making contact in the months following the Event to capture images, audio and video content or statements. If the participant is selected for further content capture, the participant acknowledges the terms above in regard to ownership of content. 11. Personal Belongings: CCSP does not accept responsibility for participants personal belongings before, during or after the Event. Loss, damage or theft of personal belongings is each participant s responsibility. 12. Cancellation Policy: The Event will be held outdoors and will proceed even if the weather is poor, provided it is still practicable to do so. The Organisers are not liable to you for any loss, damage or expense of any kind in the event of cancellation. When extremely poor weather makes running the Event impracticable, the Organisers may modify, reschedule or cancel the Program or Event at its discretion. All cancellations by you must be received in writing or via . If you do not attend on the day of the Event you will forfeit the bicycle, helmet, lock, front light and rear light offered for participation in the Event. 13. Privacy: I understand that the information provided by me in this form is necessary for the operation of the Event. I acknowledge and agree that the information will only be used for the objects of the Organisers and to provide me with information pertaining to the Program in accordance with CCSP s Privacy Policy, Severance: If any provision of this declaration is invalid or unenforceable in any jurisdiction, the phrase or clause is to be read down for the purpose of that jurisdiction, if possible, so as to be valid and enforceable. If the phrase or clause cannot be so read down it will be severed to the extent of the invalidity or unenforceability. Such severance does not affect the remaining provisions of this declaration or affect the validity or enforceability of it in any other jurisdiction. 15. Data for research: The Happiness Cycle would like to use the information you voluntarily provide to measure how effective the Program is. If you have opted in to receive follow up surveys during the registration process and by completing these surveys, you consent to the information you provide being used for research purposes which will be published in the public domain. Your identity will be removed from any data used in this way. You may opt out of receiving these surveys at any time.

5 I have read, understood, acknowledged and agree to the above declaration including the warning, release and indemnity. Signed:.. Date: Where the applicant is under 18 years of age this form must also be signed by the applicant s parent or legal guardian. I,.. am the parent or legal guardian of the applicant. I expressly agree to be responsible for the applicant s behaviour and agree to personally accept the conditions set out in this application and declaration including the provision by me of a release and indemnity in terms set out above. Parent/Guardian Signature:.. Date:. Parent/Guardian Mobile Phone: