PARTICIPANT DECLARATION

INDEMNITY SIGN OR WAIVER FORM.

For your upcoming event, please read and fill out the form below.

In consideration of the Mourne Shack accepting my application to participate in the Program, below I acknowledge, understand and agree that:

1. Warning: I understand and acknowledge that outdoor activities can be dangerous and there are inherent risks which may result in serious injury to myself. Additionally, weather can act in a sudden and unpredictable (changeable) way. Terrain can also be unfamiliar and care must be taken.

2. I declare that I do not have any fitness, medical or physical conditions that would affect my participation in the activity. (e.g. please advise instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc.)

3. I agree not to drink alcohol or take prohibited drugs before or during Mourne Shack activities.

4. I will at all times comply with the instructions and safety procedures of the Mourne Shack.

5. I authorise the Mourne Shack to arrange medical or hospital treatment as necessary and I agree to pay for all associated costs.

6. I understand that the information provided by me in this form is necessary for the operation of the Program. I acknowledge and agree that the information will only be used for the objects of the Mourne Shack and to provide me with information pertaining to the program. I understand that I will be able to access my information through the Mourne Shack upon request. If the information is not provided I might not be permitted to participate in the Program.

7. Release and Indemnity: Mourne Shack Limited accept liability for loss, damage, illness or injury resulting from negligence, wrongful act or default on their behalf, limited per the terms of their public liability insurance. I understand that my signature to this document constitutes a complete and unconditional release of all liability of the proprietors of the Mourne Shack and its employees and agents to the greatest extent allowed by the law in the event of me and/or the children under my care, suffering injury or death from negligence, wrongful act or default on my behalf.