We the undersigned Participant and parents/guardian of the Participant (if the Participant is under 18):
1. Permit the Participant to participate in all of the activities of the Movement whether organised or
run by the Movement on its own or with or as a part of any other organisation or organisations
(including but not limited to, weekly meetings, camps, (both within the State and interstate),
functions, parties, social, cultural or educational events, excursions and outdoor, adventure or
sporting events) (“Activities”);
2. Acknowledge the existence of inherent risks in the Activities and confirm that we are voluntarily
taking on and assuming those risks;
3. Release and forever discharge, to the extent permitted by law, the Movement’s officers, directors,
members, volunteers, employees, representatives, agents, Shlichim (including their families),
executive members and counsellors (each a "Released Party") from any and all causes of action,
suits, proceedings, claims, demands and liabilities in any way directly or indirectly arising out of or in
connection with the Participant’s participation in or expulsion from the Activities (including those
arising out of death, injury, loss of or damage to property or involving financial or any consequential
loss), whether or not arising out of or by reason of the negligence, action or inaction or otherwise of
any Released Party (“Claims”), together with any costs fees and expenses (including legal fees) that
may be incurred as a result of any such Claim;
4. Agree to abide by all the rules, regulations, and instructions given by or on behalf of the
Movement from time to time, governing the Activities (“Rules”);
5. Indemnify each Released Party from and against any Claims suffered or incurred or brought or
made against the Released Party:
a. by the Participant; or
b. by any other person as a result of the Participant’s action and/or failure to comply with the Rules,
together with any costs, fees and expenses (including legal fees on an indemnity basis) that may be
incurred as a result of any such claim.
6. Agree that if the Participant breaches or does not abide by any of the Rules, the Participant can be
asked to leave such Activity, which they will immediately do, and we agree to reimburse and
indemnify the Movement and each Released Party for all loss and damage arising from any such
breach or failure to abide;
7. Consent to any photographs or videos of the Participant being taken during the course of the
Activities for marketing and/or publicity purposes by the Movement
8. Permit any photograph(s) of the Participant to be taken during the Activities for and be displayed
on any official medium of the Movement;
9. Acknowledge that we voluntarily entered into this Release and Disclaimer and have read and
understood all of its terms and agree to be bound by all such terms; and
10. Agree that this Release and Disclaimer will be binding on us and our executors, administrators,
heirs, next of kin, successors and assigns.
This Release and Disclaimer is provided for the benefit of each Released Party and an indemnity
provided for the benefit of the Movement and each Released Party.
To the extent that this Release and Disclaimer applies to Victorian law, the following warning must
be provided:
WARNING UNDER THE AUSTRALIAN CONSUMER LAW AND FAIR TRADING ACT 2012
Under the Australian Consumer Law (Victoria), several statutory guarantees apply to the supply of
certain goods and services. These guarantees mean that the supplier named on this form is required
to ensure that the recreational services it supplies to you:
- are rendered with due care and skill; and
- are reasonably fit for any purpose which you, either expressly or by implication, make known to the
supplier; and
- might reasonably be expected to achieve any result you have made known to the supplier.
Under section 22 of the Australian Consumer Law and Fair Trading Act 2012, the supplier is entitled
to ask you to agree that these statutory guarantees do not apply to you. If you sign this form, you
will be agreeing that your rights to sue the supplier under the Australian Consumer Law and Fair
Trading Act 2012 if you are killed or injured because the services provided were not in accordance
with these guarantees, are excluded, restricted or modified in the way set out in this form.
NOTE: The change to your rights, as set out in this form, does not apply if your death or injury is due
to gross negligence on the supplier’s part. Gross negligence, in relation to an act or omission, means
doing the act or omitting to do an act with reckless disregard, with or without consciousness, for the
consequences of the act or omission. See regulation 5 of the Australian Consumer Law and Fair
Trading Regulations 2012 and section 22(3)(b) of the Australian Consumer Law and Fair Trading Act 2012.
