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COMBINED PROBUS CLUB OF SYNDAL Inc

 

DECLARATION FORM FOR CLUB ACTIVITIES

 

PARTICIPANT’S DECLARATION

I ______________________________________ (NAME OF MEMBER OR VISITOR) hereby apply to participate in the activities of the club which may involve outings and tours and in so doing agree that while participating:

(a) I understand that I am the person who is fully responsible for the state of my health and I undertake to do all that is necessary so as not to place other participants under stress or duress or to put them in danger because of the state of my health or my behaviour.

(b) I hereby declare that to the best of my knowledge I am fit enough to undertake club activities and agree to advise the Leader immediately should my state of health change. I confirm that I am carrying and taking any medication necessary for the activity concerned

(c) I hereby declare that I will only participate in activities where I am physically capable.

(d) I understand that any member or guest with a disability must have a carer/companion and I accept that it is not the role or responsibility of the club or a club member to act as a carer.

 

(e) I agree that by signing this form to waive any claim for damages arising from this activity that I may have against the club, the leader or other persons in tort or contract, from this activity

 

(f) I understand this declaration is effective from the date of signing.

 

MEMBER’S SIGNATURE _____________________________________ DATE: _______________

OR

VISITOR’S SIGNATURE _____________________________________ DATE: _______________

 

 

DECLARATION FORM FOR CLUB ACTIVITIES 

PARTICIPANT’S DECLARATION

I ______________________________________ (NAME OF MEMBER OR VISITOR) hereby apply to participate in the activities of the club which may involve outings and tours and in so doing agree that while participating:

(a) I understand that I am the person who is fully responsible for the state of my health and I undertake to do all that is necessary so as not to place other participants under stress or duress or to put them in danger because of the state of my health or my behaviour.

 (b) I hereby declare that to the best of my knowledge I am fit enough to undertake club activities and agree to advise the Leader immediately should my state of health change. I confirm that I am carrying and taking any medication necessary for the activity concerned

 (c) I hereby declare that I will only participate in activities where I am physically capable.

(d) I understand that any member or guest with a disability must have a carer/companion and I accept that it is not the role or responsibility of the club or a club member to act as a carer.

 (e) I agree that by signing this form to waive any claim for damages arising from this activity that I may have against the club, the leader or other persons in tort or contract, from this activity

(f) I understand this declaration is effective from the date of signing.

 

MEMBER’S SIGNATURE _____________________________________ DATE: _______________

OR

VISITOR’S SIGNATURE _____________________________________ DATE: _______________