2017 HYPOACTIVE MURRAY TO MOYNE TEAM CYCLING EVENT

Registration Release and Waiver of Liability Document

By signing this you will waive certain legal rights, including the right to sue.

PLEASE READ CAREFULLY

 

I , __________________________________________________________ (the “ Participant” ) sign

on the _______ day of _____________, 20______ this RELEASE AND WAIVER OF LIABILITY (the “ Release” ) in favour of HypoActive, a non-profit organisation, and its directors, officers, employees and agents.

 

In consideration of HypoActive permitting me to participate in HypoActive’s programmes, I hereby freely, voluntarily, and without duress execute this release under the following terms:

 

1. WAIVER and RELEASE: I hereby waive any and all claims, demands, damages, actions or causes of action to which I may become entitled for any loss, injury or damage to their person or property incurred while participating in HypoActive’s programmes and I hereby release and forever discharge and holds harmless HypoActive, its directors, officers, employees and agents and their respective successors and assigns (collectively, the “Releasees”) from any and all liability, claims, demands, actions, damages, costs and expenses of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from my participation within HypoActive, though the same may have contributed to or have been caused by the negligence, gross negligence, breach of contract by the Releasees or breach of any statutory or other duty of care. I understand that this release discharges the Releasees from any liability or claim that I may have against any of the Releasees with respect to any bodily injury, personal injury, illness, death, property damage or any other liability, claim or damage that may result from my participation in HypoActive’s programmes. I also understand that the Releasees do not assume any responsibility for or obligation to provide financial assistance or other assistance, included but not limited to medical, health or disability insurance.

 

2. MEDICAL TREATMENT: I hereby release and forever discharge the Releasees from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment or services rendered in connection with my participation in HypoActive’s programmes. I understand that I am responsible for securing appropriate medical insurance coverage.

 

3. ASSUMPTION of RISK: I understand that there are inherent hazards and risks associated with physical activity, including but not limited to:

  1. Risk of illness or injury from the activity and equipment utilised, including the potential for permanent disability and death.
  2. All "acts of nature," including but not limited to avalanche, rock fall, inclement weather, thunder and lightning, severe and or varied wind, temperature and other weather conditions.
  3. Risks associated with crossing, climbing or down-climbing of rock, snow and/or ice.
  4. Possible equipment failure and/or malfunction of my own or others' equipment, which may have been rented, borrowed or personally owned.
  5. Cold weather and heat related injuries and illness including but not limited to frostnip, frost bite, heat exhaustion, heat stroke, sunburn, hypothermia and dehydration.
  6. Attack by or encounter with insects, reptiles and/or animals.
  7. Health: overexertion, dehydration, fatigue, lack of fitness or conditioning.
  8. Accidents or illness occurring in remote places where there are no available medical facilities.

Initials ………………………

   9. Risk of property loss or damage.

 10. My conduct and conduct of other persons which may increase the risk of damage, loss, personal injury or death.

 11. I understand that the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness or death. I hereby expressly and specifically assume the risk or harm in my activities and release the Releasees from all liability from injury, illness, death or property damage resulting from the activities of my participation in HypoActive’s Programmes. HypoActive retains the right to limit or prohibit my participation in the activities of any programmes if HypoActive determines that such participation will not be in the best interest of HypoActive or me. I understand that I will be responsible for the payment of any expenses incurred as a result of application of this section.

 

4. INDEMNITY: I agree to hold blameless and indemnify the Releasees from any and all liability for any damage, loss, expense or injury to any third party resulting from my participation in fitness programmes.

 

5. PHOTOGRAPHIC RELEASE: I hereby grant and convey unto HypoActive all right and title, and interest in any and all photographic images and video or audio recording made by HypoActive during the duration of any programme. I further agree and consent to the use of my name, video image, voice and/or photograph in publication issued in support of or by HypoActive without restrictions, further notification or compensation.

 

6. OTHER: I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of Victoria and the Federal laws of Australia applicable thereto and that this Release shall be governed by and be interpreted in accordance with the laws of the State of Victoria and the Federal laws of Australia applicable thereto. I agree that in the event that any clause or provision of this Release shall be held to be invalid by any Court of competent jurisdiction, the invalidity of such a clause shall not otherwise affect the remaining provision of the Release which shall continue to be enforceable. This agreement shall be effective and binding upon my heirs, next of kin, executors, administrators and assigns in the event of my death or incapacity.

 

IN WITNESS WHEREOF, I have executed this Release as of the day and year first above written after first receiving advice from the qualified Legal Practitioner referred to herein.

 

I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY

SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY

HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE

AGAINST THE RELEASEES.

 

 

 

 

 

 

Initials ………………………

 

 

I HAVE CONSULTED A QUALIFIED LEGAL PRACTITIONER HOLDING A CURRENT PRACTISING CERTIFICATE WHO HAS EXPLAINED THE MEANING AND CONSEQUENCES OF THIS DOCUMENT TO ME AND ALSO HAS WITNESSED MY SIGNATURE AND HAS COMPLETED AND SIGNED THE ATTESTATION SECTION BELOW.

 

Name of Participant: _______________________________________________________________

Address:_________________________________________________________________________

Postal Code:________   Phone:______________________________________________________

 

Signature of Adult Participant:_______________________________________________________

 

I …………………………………………………………………………….. OF ……………………………………………………………….. AM A QUALIFIED LEGAL PRACTITIONER HOLDING A CURRENT PRACTISING CERTIFICATE IN THE STATE OF VICTORIA.  I CONFIRM THAT I HAVE THOROUGHLY EXPLAINED THE MEANING AND BOTH THE LEGAL AND PRACTICAL SIGNIFICANCE TO ……………………………………………………………………………… WHO CONFIRMED UNDERSTANDING AND ACCEPTANCE OF SAME AND THEN SIGNED IT IN MY PRESENCE.

 

 

Solicitor’s Name:__________________________________________________________________

 

Solicitor’s Signature:_______________________________________________________________

 

Witness Signature :________________________________________________________________