Nepean Golf Association
25 Forbes St Emu Plains 2750
Telephone/Facsimile 4735 1730
Email : DougHayne@westsport.com.au
Secretary Doug Hayne
CONSENTING RECOGNITION OF RISKS FORM
ADULTS
To: Secretary Nepean Golf Association
I ………………………………………………
wish to participate in the recreational activity program operated by or called]
by the Nepean Golf Association called Nepean Open Amateur, Nepean Foursomes
Championship, Nepean Presentation Dinner, Nepean Open Amateur and Nepean A,
B, C or Mixed Pennants.
I understand that the activities in which I may participate:
(a) will be physically and emotionally demanding; and (b) may involve a significant
risk of physical harm. (c) my participation in any activity is voluntary and
not compulsory.
I understand certain inherent risks exist in the activities
in which I will be participating. Although the organisation and its members
will provide me with appropriate directions and will endeavour to minimise
my exposure to the risk of harm, these inherent risks are beyond the control
of the Nepean Golf Association, its volunteers and staff and cannot be avoided
by the exercise of reasonable care and skill. Inherent risks include changes
in weather conditions and difficulties in obtaining emergency medical assistance.
I am aware that there are some risks that are common to many or all of the
activities in which I may participate. However, some activities in which I
may participate carry with them risks of harm that are particular to that
activity, such as but not limited to the following:
Recreational and Workshop Activities
(1) being hit by swinging club, bat, racket or sporting utensil;
(2) death;
(3) being hit by a an object at speed
(4) strained muscle, ligaments or cartilages;
(5) broken or dislocated bones or joints;
(6) insect bites &/or animal / reptile bites;
(7) collision with persons or obstacles causing an injury;
(8) slipping / tripping and falling on undulating , wet or slippery surfaces;
(9) foreign material or object entering eyes or skin irritations;
(10) injuries by flora or fauna;
(11) injuries caused by burns, cuts &/or abrasions;
(12) injuries caused by atmospheric conditions;
(13) injuries during travel to or from courses
(14) injuries caused by insecticides, fungicides and/or weedicides.
(15) injuries caused by poisonous substances
(16) injuries caused by fellow competitors, caddies and/or members of the
public
(17) injuries caused by course machinery and or vehicles
(18) injuries caused by motor vehicles when crossing public roads.
(19) Illness/sickness caused by contaminated food
(20) pain and suffering resulting from any other activities conducted by the
NGA.
All details must be filled in and returned to the NGA Secretary
I authorise the Nepean Golf Association to arrange medical treatment
and emergency evacuation services on my behalf and at my cost, in the event
of my injury or illness, as it deems necessary.
When participating in any of these activities, I will ensure that I attend
with the appropriate personal safety gear for the activity
Date.............................................................................................................................................................
Name of Participant.....................................................................................................................................
Name of Program : Nepean Open Amateur, Nepean Foursomes Championship,
Nepean Presentation Dinner, Nepean Open Amateur and Nepean A, B, C or Mixed
Pennants.
Address........................................................................................................................................................
*Email Address..............................................................................................................................................
Phone Nos...................................................................................................................................................
Signature of Participant................................................................................................................................
Witnessed by...............................................................................................................................................
Signature......................................................................................................................................................
*Email address is optional however those with email addresses
wiill become elligible for weekly competition during the running of the pennants.Also
those with registered email addresses will receive weekly result and pointscore
updates.
NGA WEBSITE
www.westsport.com.au
or
www.nepeangolf.org.au