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Acknowledgment of risk-youth.doc

Acknowledgment of Risk
- CONDITIONS for YOUTH -

Warning – This is an important document which may affect your legal rights and obligations, please
read it carefully. If you have any questions please call our office on 8165 2033.

I, (Parent’s name) ___________________ acknowledge that Venture Corporate Recharge (Aust) Pty Ltd
will provide my son/daughter (Child’s Name) ___________________ with access to a variety of activities
which will be supervised by employees of Venture Corporate Recharge (Aust) Pty Ltd (“the activities”).
I acknowledge that these activities may have inherent danger or risk involved and I acknowledge
responsibility for my child participating in these activities.
I acknowledge that during all such times whilst my child is participating in the activities I will not hold Venture
Corporate Recharge (Aust) Pty Ltd
liable for any personal injury or loss of property whatsoever and I agree
to indemnify and keep indemnified Venture Corporate Recharge (Aust) Pty Ltd against all such injury or
loss except to the extent that such personal injury or loss of property is occasioned by neglect, default or
omission by Venture Corporate Recharge (Aust) Pty Ltd or their consultants, employees, contractors or
agents (as the case maybe).
I agree that I will pay any reasonable cost of repair or replacement to equipment or facilities that may be
damaged by actions of my child beyond that of normal wear and tear.
I agree to instruct my son / daughter to follow the rules of activity participation and to follow instructions given
for Venture Corporate Recharge (Aust) Pty Ltd and contractors facilities. I also agree to provide necessary
warning information if my son/daughter has demonstrated signs of mental health conditions that will cause
harm to property themselves or others.
I hereby authorise Venture Corporate Recharge (Aust) Pty Ltd staff and consultants to obtain any
necessary medical assistance for my child ___________________ should any medical problem or accident
occur and I expressly agree to be responsible for all such medical expenses incurred.
In the event that a teacher/staff person cannot, I ___________________ give permission for Venture
Corporate Recharge (Aust) Pty Ltd
, staff or consultants to administer to my child ___________________
medication as instructed. I acknowledge that I will provide all such medication to Venture Corporate
Recharge (Aust) Pty Ltd
in clearly labelled doses or original containers.
I ___________________ do/don’t give permission for my child _________________ to be a part of group
photos or video footage taken of their participation within the activities by Venture Corporate Recharge
(Aust) Pty Ltd
for use in brochures, school newsletters, or other promotional material.
I ___________________ give permission, in the case of an emergency, for my child _______________
to be transported to hospital by Ambulance and I expressly agree to be responsible for all costs associated
with such transportation to and hospital admission.
I ___________________ give permission for Venture Corporate Recharge (Aust) Pty Ltd staff or
consultants to provide my child with VENTOLIN if required in an emergency by a trained Asthma first aid
person.
Please send me information about the VCR adventure club: yes / no Email address: _________________________________________- (People will be sent information as a default response if a response is not indicated) All personal information will be filed in accordance with the Privacy Act, 1988.

Source: http://magill.myscoutgroup.org/system/datas/61/original/Acknowledgment_of_Risk-Youth.pdf

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