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PARTICIPANT NAME: _________________________ LIABILITY WAIVER AND RELEASE FORM IMPORTANT - THIS IS A RELEASE OF LEGAL RIGHTS. READ AND UNDERSTAND FULLY BEFORE SIGNING. ACKNOWLEDGEMENT, WAIVER AND RELEASE (SECTION 5M CIVIL LIABILITY ACT 2002) WARNING: THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR RIGHTS. PLEASE READ THE ENTIRE DOCUMENT CAREFULLY. ALL PARTICIPANTS, PARENTS AND GUARDIANS, MUST ACCEPT THE CONDITIONS THAT ARE SET OUT IN THIS DOCUMENT. 1. I understand that the Event may involve travel over uneven terrain, wall climbs, water related activities, running in the bush. I am aware that my participation in this event may or will have to potential to cause injury (including serious injury, paralysis, drowning, cardiac arrest and death) and also some damage to their property, including shoes, clothing, and anything on their person while participating in The Event. The hazards include, but are not limited to: cuts and scrapes, inclement weather causing cold or hypothermia, death or injury by drowning, heat exhaustion, wildlife, falls from climbing an apparatus, participant or traffic related actions, slips and falls, sunburn, failure or suitability of participant equipment and distance from medical aid. I judge myself to be fully capable and of sufficient competence to participate safely in the relevant Event activities and all such activities that are sponsored or otherwise presented by the organizers and their affiliates. 2. I certify that I am of reasonable physical fitness, and that I have received adequate instruction and training to participate in the event. I also certify that I have not received instruction from a qualified medical professional to NOT participate in this event and that I have taken every opportunity to prepare themself for the vigorous physical challenges that will arise during the event. I have been given the opportunity to attend a pre event briefing of the course and understand what I am going to undertake. 3. In consideration of me being allowed to participate in the Event, I (on my own behalf and on behalf of their executors, administrators, heirs, next of kin, successors and assigns): a. WAIVE, RELEASE AND DISCHARGE from any and all liability for death, disability, personal injury, property damage, property theft and all other risks, claims or actions of any kind (including breach of contract, acts of negligence to the fullest extent permitted by law) whatsoever and however occurring, together with any legal fees incurred as a result of any such claim whether it is valid or not, which I at any time had or have as a result of or in connection with, directly or indirectly, my participation in and my traveling to and from the Event the following person or entities, Zaidee’s Rainbow Powder Stomp, Event sponsors, Event producers, volunteers, community organizations, all State, Federal and Local Government authorities in which the Event may be staged and the owners, licensees or occupiers of any property upon which they enter and their (its) respective officers, directors, employees, independent contractors, sponsors, representatives, agents, members and volunteers, including medical and paramedical personal appointed for the Event; b. INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned in paragraph 3(a) from any and all liabilities, claims or actions (including negligence) whatever or however caused arising as a result of or in connection with, directly or indirectly, my participation in and traveling to and from the Event, including any claim by myself (or my team's) support crew or any person assisting me or my team; 4. I certify that the medical information supplied by me on my entry form is true and I consent to and authorize that information to be provided to any medical practitioner, ambulance officer or any person involved or associated with any medical treatment or assistance that may be given to me as a result of my participation in the Event, regardless of whether the treatment is given. 5. I understand that the Event organizers have adequate first aid and communications, and will undertake to utilize the system for assistance where possible. I understand that I am responsible for my own first aid and any first aid of other competitors, in the first instance. As a participant or member of the support team, I am responsible for my timely removal from the site for any first aid treatment, or to an Ambulance attendee where needed. I give my consent to receive any first aid PARTICIPANT NAME: _________________________ LIABILITY WAIVER AND RELEASE FORM IMPORTANT - THIS IS A RELEASE OF LEGAL RIGHTS. READ AND UNDERSTAND FULLY BEFORE SIGNING. and medical treatment which may be deemed advisable in the event accident, injury and/or illness as a result of my involvement in the Event. 6. I acknowledge that I am completely responsible for my belongings and personal possessions during the event, and that organisers are not responsible for lost or stolen property. 7. I acknowledge that any photograph or video footage of me, or any other media relating to the event, remains the property of Zaidee’s Rainbow Powder Stomp and may be used without my consent at any time for marketing purposes or on the website. I further understand that the event organiser, as sole owner, has the full right to sell and/or profit from the commercial use of such Recordings or to transfer or assign the rights to use such Recordings to any entity without restriction. 8. I acknowledge that the Event arranged insurance covers public liability and not myself whilst participating in this event. I am responsible for my personal accident insurance and ambulance cover. 9. I acknowledge that the organizers reserve the right to alter the advertised course if conditions warrant. I agree that the organizers reserve the right to cancel the Event due to weather conditions, natural disaster, acts of god, terrorism, war or any other reason so deemed by the organizers, and that my entry fee will be non-refundable. 10. If conditions warrant the cancellation or postponement of the Event, no refunds will be issued. 11. I agree to follow the rules of the Event as set out by the organizers and race stewards on the day and to respect and follow any instruction provided. I agree that if the race stewards or organizers feel that any behaviour or action in which I partakes breaks any of the rules or brings the Event into disrepute that I can be evicted and their entry forfeited without prejudice. I agree that the organizers also have the right to refuse entry for any reasonable reason that they see fit. 12. I acknowledge and agree to abide by the following specific rules: 1) I am aware that clothing, equipment, and props that pose a risk to participants, event organisers, council staff, or spectators are not permitted; 2) I acknowledge wheeled conveyances and pets are not allowed on the Course at all; 3) urination and defecation is only permitted in designated toilet areas; and 4) I know I must obey civil, criminal and traffic laws. 13. I certify that I am not, and on the date of the event will not be, under the influence of alcohol or any drugs, recreational or prescribed, that may impair my ability to participate safely in the event. I also, understand that I may be removed from the event, should I fail to comply with such. 14. I again affirm that I have read this document fully and agree to the conditions contained prior to registering for the event. Participant Name: _________________________ Participant Signature: _________________________ Date: _________________________ Emergency Contact Details Primary Name: _________________________ Mobile #: ___________________________ Secondary Name: _________________________ Mobile #: ___________________________