Please join us in our pursue to raise money for cystic fibrosis and together we can make a difference.
COMPLETE THIS FORM AS PROOF THAT YOU HAVE PERMISSION TO PARTICIPATE IN BOUNCE TO BREATHE FROM YOUR PARENT/ GUARDIAN AND ORGANISATION
In completing a registration for Bounce to Breathe, and by signing the declaration and acknowledgement below, you acknowledge that you understand the activities to be performed by the person named include bouncing on a trampoline and performing manoeuvres on a trampoline.
In completing a registration for Bounce to Breathe, and by signing the declaration and acknowledgement below, you acknowledge that you are physically capable of completing the activities and understand that the activities carry inherent and unavoidable risks involved in participating; and agree, in consideration of permission for the person named above to participate in the activities, to release and indemnify Cystic Fibrosis Queensland, its officers, employees and volunteers and all sponsors from and against all liabilities, claims, damages, suits, expenses, causes of action, injuries, losses or inconvenience of any description whatsoever arising in any way from the participation of the person named in the activities, including in negligence, to the maximum extent permitted by law. You, as the parent or guardian charged with legal care of the person named under the age of eighteen years grant permission for that person to participate.
Use of image and voice
You also give permission, and hereby grant an irrevocable, perpetual licence for Cystic Fibrosis Queensland to use the name, image and voice of the person named in any broadcast, or any other account in any media, relating to Bounce to Breathe.
There are inherent risks that people with cystic fibrosis (CF) face when attending Cystic Fibrosis Queensland (CFQ) corporate and community events. As a member of the CF community, before you decide to attend an event, please read this warning very carefully.
Any event organised by CFQ is open to our members and therefore will be attended by members of the CF community for the primary purpose of their enjoyment, information, recreation and the opportunity to mix at the venue with other members of the CF community.
If you (or any children under 18 years of age who will attend with your permission) have CF, there may be a real serious and inherent risk that by attending the event you (or your children) will be exposed to pathogens that might severely harm you (or your children's) health. These pathogens could include (but are not limited to): Burkholderia cepacia, methicillin-resistant Saphylococcus aureus, Pseudomonas aeruginosa, human respiratory syncytial virus, human parainfluenza viruses, influenza viruses or other pathogens that are currently unknown. For people with CF, exposure to these pathogens could lead to serious illness, injury or even death.
If you, or your accompanying children, attend a CFQ event, then reducing physical contact (e.g. kissing, shaking hands) is likely to reduce the risk of cross-infection, but there is no reliable or effective way to eliminate all risk of transfer of a pathgenix infection. You should also practice good public health hygiene (e.g. hand washing, covering your mouth if you cough) to reduce the risk for others.
If on the day of the event you or any accompanying children have an illness that is infectious (such as a common cold or flu) you will exclude yourself from participating.
I, as parent or guardian of the child named on this form, acknowledge that the supervision of that child must comply with the following requirements under law:
- Children under the age of 16 using the online services must do so under the supervision of an adult.
- Children under the age of 12 using the online services must do so under the direct supervision of an adult.
- Or, I over the age of 18 and comply with the requirements as my own legal guardian.
Please ensure that before returning this form you have read the Bounce to Breathe Terms and Conditions of Website usage on our website and acknowledge this below (tick):
I hereby grant permission for the person named above to participate in Bounce to Breathe.