Chix Surf School Participation Declaration

Please ONLY complete this form if you have made a booking with Chix Surf School. If you have not yet booked in, you can BOOK IN HERE.

Step 1 of 4

Participant's Name*
First Last
Age
Please enter a number from 5 to 100.
Age must be supplied if participant is under 18 years old.
Phone Number*
Email*
Where the participant is under 18 years of age this form must be signed by the participant’s parent or legal guardian.
I am the parent or guardian of the applicant. I expressly agree to be responsible for the applicant’s behaviour and agree to personally accept the conditions set out in this application.
Address
Street Address Suburb State Postcode Country

Safe Surfing Declaration & Risk Warning Waiver*
I have read, understood, acknowledge and agree to the below declaration including the warning, release and indemnity.
In consideration of Chix Surf School and Development Program (‘Chix Surf School ‘) accepting my application to participate in the Program, below I acknowledge, understand and agree that:

Warning: Participating in the lessons and programs provided by Chix Surf School (‘the Program’) can be inherently dangerous. I acknowledge that I am exposed to certain risks during the Program including but not limited to physical hazards, unpredictable and sometimes dangerous surf and weather conditions and actions of other people and things in and near the I acknowledge that accidents can and often do happen which may result in me being injured or even killed, or my property being damaged. I have voluntarily read and understood this warning and accept and assume the inherent risks in participating in the Program

Surfer's Myelopathy: There is a condition called Surfer's Myelopathy that can result in paralysis below the neck. It is extremely rare and appears to result when the spine is extremely arched. It is not conclusive who may be affected, although cases have been in adults. Prior to onset, legs may feel weak, there is back or leg pain and discomfort. Possible tingling may occur with the discomfort and pain intensifying. Any of these symptoms should be immediately reported to the surfing coach during the surf session.

Physical Fitness & Condition: I declare that I can swim 50 metres (150 feet). I must not participate in the Program if I have any injury, disability, medical or health condition that may increase the risk of me becoming injured unless I have told Chix Surf School about it and they have authorised me to participate. I declare that I am medically and physically fit and able to participate in the Program and I will immediately notify Chix Surf School of any change to my fitness and ability to participate. I agree not to drink alcohol or take prohibited drugs before or during surf activities

Instructions & Conditions: I will at all times comply with the instructions and safety procedures of Chix Surf School. I understand and acknowledge that surf activities are dangerous and that there are inherent risks which may result in serious injury to Additionally, waves/ ocean can act in a sudden and unpredictable (changeable) way.

Medical Conditions & Treatment: I declare that I do not have any medical or physical conditions that would affect my participation in the (e.g. Please advise the instructor of asthma, previous broken bones, dislocated joints, diabetes, allergic reactions, wear contact lenses/hearing aids, any disabilities, etc) If required, Chix Surf School will arrange medical or hospital treatment (including ambulance transportation) for me. I authorise such actions being taken by Chix Surf School and agree to pay for all costs associated with such action.

Exclusion of Implied Terms: I acknowledge that where I am a consumer of recreational services, as defined by any relevant law, certain terms and rights usually implied into a contract for the supply of goods or services may be excluded. I acknowledge that these implied terms and rights and any liability of Chix Surf School (or any of its agents and employees) flowing from them, are expressly excluded to the extent possible by law, by this declaration. To the extent of any liability arising, the liability of Chix Surf School will (at the discretion of the relevant Organiser) be limited to the resupply of the services or payment of the cost of having the services supplied again.

Release & Indemnity: My participation in the Program is entirely at my own risk and I agree to the extent permitted by law to: release and forever discharge Chix Surf School from all liability and Claims that I may have or may have had but for this release arising from or in connection with my participation in the Program; indemnify and hold harmless Chix Surf School to the extent permitted by law in respect of any Claim by any person including another participant in the Program arising as a result of or in connection with my participation in the Program.
In Clause 7 “Claims” means and includes any action, suit, proceeding, claim, demand, damage, cost or expense however arising including but not limited to negligence.

Identity: Photographic and or visual images taken by Chix Surf School of my participation in the Program may be used for general promotion of its activites.

Privacy: 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 Chix Surf School and to provide me with information pertaining to the Program. I understand that I will be able to access my information through Chix Surf School upon request. If the information is not provided I might not be permitted to participate in the

Severance: If any provision of this declaration is invalid or unenforceable in any jurisdiction, the phrase or clause is to be read down for the purpose of that jurisdiction, if possible, so as to be valid and enforceable. If the phrase or clause cannot be so read down it will be severed to the extent of invalidity or Such severance does not affect the remaining provisions of this declaration or affect the validity or enforceability of it in any other jurisdiction. I have read, understood, acknowledge and agree to the above declaration including the warning, release and indemnity.

Covid 19: I declare i do not have COVID19 or flu symptoms and agree to abide by social distancing at all

I ACCEPT THE RISKS INVOLVED and will be responsible for my own actions and/or involvement. I understand that my signature to this document constitutes a complete and conditional release of all liability of the proprietors of Chix Surf School and its employees and agents to the greatest extent allowed by the law in the event of me and/or the child under my care, suffering injury or death. Where the applicant is under 16 years of age this form must also be signed by the applicant’s parent or legal guardian.
Signature*
We just need to check you're a real person...

Our surfing lessons and programs cover not only the technical skills of surfing but areas such as first aid and oceanography. As a nationally approved surf coaching centre, we are recognised and supported by the Australian Sports Commission and all of our programs are delivered by qualified Surfing Australia instructors. Soft surfboards, rash shirts and wetsuits (where necessary) are provided.