Basic RC New Member

New Member Candidate Detail

Specific detail about the new Member


Parent / Guardian

Some description about this section

Parent / Guardian

Parent / Guardian

Medical / Additional Information.
Please indicate any medical conditions experienced by your child.

Acknowledgements

Some description about this section

RISK WARNING AND EXCLUSION OF LEGAL LIABILITY This form must be signed by the member or their legal representative prior to services commencing or continuing. This form is designed for members who wish to undertake activities that may cause risk to them. Our Duty of Care is to inform each member of the risks to them if undertaking the activities, if the member wishes to partake in this activity, it is at the member’s risk.

Please carefully read the following acknowledgements and assumptions of risk relating to services provided by the club as outlined above:

I,

1) acknowledge that I have the right to choose who delivers my service.
2) acknowledge that if my position changes that I will notify the club in writing.
3) acknowledge and understand the risk involved is my personal choice.
4) acknowledge that all my questions/concerns regarding the risk have been explained to me and understood and my choice has
been made without coercion.

agree to be bound by the rules of the Rainbow Club of Point Cook Inc. I/We affirm that the member candidate named above has a medically diagnosed disability/is in process of receiving a medically diagnosed disability which is

Photography: I give permission for Rainbow Club Point Cook Inc, to take and use photographs or video of me for purposes such as identifying members on file and promotional material including newsletters and media. I understand that photographs taken by Rainbow Club Point Cook Inc. may be stored and used for promotion purposes from time to time. You are not required to grant
permission - this is a matter entirely within your discretion. Either way it is important that you signify your instructions on this form.

Signature

Some description about this section

I,

confirm that I have read and understood and accept the terms and conditions of the above Indemnity associated with receipt of services.

Sign Here
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