as we edge closer to our year 7 camp please see the below ......rock climbing abnt instructors will...

21st February, 2020

Dear Parents/Guardians

Re: Year 7 Camp Permission Letter

As we edge closer to our Year 7 camp please see the below information specific to your child’s camp group. The camp

will be split into two groups over 5 days, with your child’s class being within cohort 1:

Cohort 1: 7 Weinert and 7 Taylor/Wentzel: Monday 18th May to Wednesday 20th May

Departure: 8am, Monday 18th May

Location: Chrisp St Bus Stop

Return Time: 2:25pm, Wednesday 20th May

Location: Chrisp St Bus Stop

Specifics

The Camp program has been finalized by Mr. Kyle Lomas-Budd in conjunction with Adventure Bound NT and our

Year 7 teachers: Adam Roth, Karlie Weinert, Mandy Boots, Rochelle Taylor and Heike Wentzel. The facility is

approximately 1.5hrs from Darwin.

Program

On this camp Kyle Lomas-Budd, Year 7 Staff and Adventure Bound NT have developed a program to focus on real-

world skills such as problem solving, leadership, critical thinking and teamwork. Activities may include bush walking,

team building activities, navigation skills and adventure activities. The activities that have been programmed for this

camp are detailed in the attached itinerary.

Student Behaviour

As with all excursions, we look forward to all students participating fully and respecting the rights of others at all

times. Our Camp Behaviour Policy is attached. Teachers will discuss the Behaviour Policy with their classes prior to

camp. We would appreciate your support discussing this policy at home prior to your child returning the signed policy

form. Please ensure it is signed by both the child and parent/guardian.

Accommodation and Meals

Students will stay in tents with two people per tent with designated areas for male tents and female tents. Outdoor

Education Group will be providing all meals on camp, should your child have any dietary requirements we ask that you

send the appropriate food or inform us as early as possible so that we can cater for it. Students will need to bring a

packed morning tea and lunch on Monday 18th May.

Staffing

Kyle Lomas-Budd (First Aid, Sports, Excursions and Camps Coordinator) will be in charge of the camp with the

assistance of Year 7 teacher Adam Roth and two staff to be confirmed.

Medication

All medication needs to be clearly labelled with the child’s name, dosage, when it needs to administered and given to

their teacher prior to leaving for the Camp. The teacher of the child will be responsible for the administration of the

medication.

Forms Required and Payment

Please find attached the required camp consent and permission forms as prescribed by the camp provider in addition to

a behavior contract prescribed by the school. (Please complete the forms as indicated by the camp provider)

Please ensure these are completed and returned to the EEC Reception no later than Friday 27th March.

The cost of the Camp is $300.00 per student, this will be added to your school account in the billing cycle to be issued

in April, 2020 and must be paid prior to the camp taking place. The cost covers Adventure Bound NT’s services, food

and transport.

Please find attached the following forms:

Attachment A Camp Requirements

Attachment B Behaviour Contract/Camp Focus

Attachment C Adventure Bound NT Permissions

Should you have any queries please do not hesitate to contact Kyle Lomas-Budd, Sports, Excursions and Camps

Coordinator, on Phone: 8985 0121 or email: [email protected]

Yours sincerely,

Kyle Lomas-Budd

Sports, Excursions and Camps Coordinator

Please Note:

Should your child not be able to attend Music Lessons due to this program, please notify the Music Teacher as soon as

possible or tuition fee for missed lessons will be charged to your account.

mailto:[email protected]

Privacy Notice: The Department of Education collects the information on this form in accordance with the Excursions Policy, and may disclose this information to third parties in

connection with this excursion. Failure to provide this information may result in your child being unable to attend the relevant school excursion. For further information, or to access the

information you provide on this form please contact your child's school.

DEPARTMENT OF EDUCATION

Parent Consent Form

PERMISSION FOR STUDENT TO ATTEND YEAR 7 CAMP – ADVENTURE

BOUND NT, BASECAMP WALLAROO

School Name: The Essington

International School

Darwin

Class/Year/Subject:

Year 7

Teacher in Charge: Mr Kyle Lomas-Budd Type of

excursion/destination:

Adventure Bound NT –

Basecamp Wallaroo

Likely number of

children participating:

Maximum 45 Likely number of staff

participating: Minimum 4

Anticipated ratio of

educators to children:

1:15 (Additional

instructors supplied

during adventure

activities)

A risk assessment has been prepared for this excursion

and is available upon request

Details of each Activity

Please note: All adventure activities increase the staff to child ratio, the camp provider will provide qualified

instructors to meet these ratios and conduct any adventure activities during the program.

Mountain Biking

Led by Adventure Bound NT (ABNT) instructors we will head out along the designated bike track around the

edges of camp, the beginner track will give our students the opportunity to take in the environment from a

different perspective.

Abseiling

ABNT instructors will lead us through a progressive abseiling challenge of varying heights which will push our

students to test their teamwork skills and promote encouraging behaviour to get everyone through each stage.

Rock Climbing

ABNT instructors will lead us through a progressive rock-climbing challenge of varying heights which will push

our students to test their teamwork skills and promote encouraging behaviour to get everyone through each stage

with the end goal of conquering ‘The Crack’.

Low Ropes

On a low to ground challenge course our teams will test their initiative, problem solving and teamwork skills to

navigate through physical and more mental challenges.

Bush Skills/Walking

On some of the tracks beginning from the camp ground we will go on some beginner bush walks around the

edges of our camp to explore the variety of butterfly species and overlook the lake.

ATTACHMENT A

of 7 www.education.nt.gov.au

Initiative Games

Throughout camp there will be a variety of exciting age appropriate team building games for our groups to

participate in, the games are designed to promote adventure based learning and teamwork.

Team Challenge

To accompany initiative games these activities will build on the skills learnt through a variety of challenge

stations placed throughout the camp ground for our groups to work together and complete.

Swimming

This involves students’ voluntary participation in swimming in the swimming pool within the camp ground,

students would be accompanied by bronze medallion holders at all times.

Free Time

During free time activities will be available such as team sports and general group games.

Accompanying adults

Name Position Name Position

Kyle Lomas-Budd Sports, Excursions and

Camps Coordinator

Adam Roth Year 7 Teacher

Heike Wentzel Head of Year 7 Freddie Webb Additional Supervisor

ABNT Instructors Leaders of Adventure

Activities

Times and Dates of Activity/ies

From: 8am Monday 18th May To: 2.25pm Wednesday 20th May

Student Requirements

Morning Tea and lunch on Monday 18th May

Clothing List (supplied by students)

Quantity Compulsory or

suggested

General Clothing item

1 Compulsory Broad-brimmed-hat

1 Compulsory Sturdy shoes with grip for bush-walking and around camp: must be

lace up, ideally walking boots

2-3 Compulsory Shirts (preferably long sleeve if possible)

2-3 Compulsory Shorts – quick dry are best (not short running shorts)

3 Compulsory Socks


3 Compulsory Underwear - as required for the day duration

1 Compulsory Pyjamas

1 Compulsory Swimwear that is sun-smart including a rash vest

1 Compulsory 2 Towels – one for swimming and one for showering

1 Optional Jumper, Light-weight

1 Suggested Long pants - cargo style, loose fitting, tough and comfortable (not

jeans)

1 Suggested Thongs/sandals

Equipment (supplied by students)

Quantity Compulsory

or suggested

Equipment supplied by students

2 Litres Compulsory Water – 2 litres carrying capacity minimum, in at least two

different containers (For example, one camel-back and one 1L

bottles)

1 Compulsory Small torch and spare batteries (preferably a head-torch)

1 set Compulsory Mess kit – bowl, plate, mug, knife, fork and spoon

1 Compulsory Washing up sponge/scourer (do not bring detergent)

3-4 Compulsory Plastic bags (rubbish, dirty/wet clothes)

1 Compulsory Sheet/Sleeping bag - adequately rated for season/conditions

1 Suggested Bike helmet (there are helmets available for students who do not

have their own)

Compulsory Personal medication and basic first-aid (eg asthma puffer, blister

kit, band-aids, bandage, etc.)

1 set Compulsory Toiletries (e.g. toothbrush, personal hygiene products)

1 Compulsory Insect repellent (if particular brand preferred)

1 Compulsory Sunscreen (if particular brand preferred)

1 Compulsory Small back-back

1 Suggested Poncho

1 Suggested Sunglasses

1 Suggested Camera (tough and water-resistant recommended – no smart

phone)

1 Suggested Waterless hand wash

1 Suggested Goggles


Equipment List supplied by school

Quantity Compulsory

or Suggested

Equipment Supplied by school

1 Compulsory Sleeping mat (own or supplied by school)

1 (per 2

people)

Compulsory Tent (supplied by school)

1 Compulsory Personal floatation devices (PFD’s) are supplied by the school

Do not bring

Singlet tops, crop tops and sleeveless shirts do not provide an appropriate level of sun protection or

shorts that’s length does not surpass the middle finger when your arm is by your side.

Jeans/denim shorts are not suitable for Outdoor Recreation

Energy Drinks/Soft Drinks

Valuables including mobile phones, iPads, laptops etc. Please make sure that your child has all personal

items labelled so that if they are misplaced they have a chance of them getting returned.

Planned Transport

School

Bus Hire

Bus Town Bus

Staff/

Parent

Vehicle

Student’s Own

Vehicle Walking Other

Costs associated with activity

Excursion costs: $300 Suggested spending money: $NIL

Parents: please complete all details below and return to your classroom teacher by

Friday 27th March. Failure to do so may result in your child being unable to participate in the activity.

Kyle Lomas-Budd

Sports, Excursions and Camps Coordinator


Student details

Student’s Family

Name:

Student’s Given Names:

Student’s Date of Birth: Gender: Male Female

Parent/Caregiver’s

Name:

Preferred

Contact:

( )

Alternate Contact

Numbers:

(W) (H) (M)

Emergency Contact’s

Name:

Preferred

Contact:

( )

Alternate Contact

Numbers:

(W) (H) (M)

Student medical details

Known allergies

(drug reactions etc.)

Dietary restrictions:

Date of last tetanus

injection:

Medication: Is the student under medication? (If yes, name medication and attach

instructions)

Medical conditions: Has your child any special medical condition, physical or psychological

limitations or cultural restrictions which may affect her/him whilst taking part

in any activities? Please provide full details (attach information if necessary).

Please provide any other information which you believe may help staff provide

the best possible care.

Child’s Swimming Ability

In relation to the proposed swimming activity (please read carefully, tick appropriate response and

sign):

In my opinion, my child is:


A non-swimmer: my child is unable to swim;

A weak swimmer: my child is comfortable and confident in shallow water but is not very

strong or confident in deep water. My child cannot swim more than 10 meters;

An average swimmer: my child is a reasonable swimmer and can swim 25 metres and is

confident in deep water;

A strong swimmer: my child is a strong swimmer and can swim more than 50 metres and is

confident in deep water.

My child is not permitted to go in the

water

My child is permitted to go in the

water

Parent/Guardian’s

Signature:

Date:

My child has achieved Level in the RLSSA Swim and Survive Program on / / (leave

blank if you do not know)

In addition to parental assessment of a student’s swimming ability, assessment of an

individual’s swimming proficiency is conducted by the school/teacher before participating in

any aquatic program or activity.

Parental Consent

Your attention is drawn to the following important points:

Students are under the teacher’s/supervisor’s authority for the duration of the excursion. A student

may be returned home at the expense of the parent/caregiver if the teacher/supervisor considers that

circumstances warrant such action.

The Department of Education has a duty of care for students engaged in school related activities,

including excursions and sporting events under its direction or supervision. All reasonable steps will

be taken to protect students against reasonably foreseeable risks of injury or harm.

Financial responsibility for medical and other costs incurred in emergency situations or where a

decision is taken to return a student home, rests with the parent/guardian of the student. Parents may

wish to take out additional insurance to cover such costs.

Liability for loss, theft or damage to student property is the responsibility of the parent/guardian of

the student.

Students are not permitted to transport other students in vehicles regardless of written permission

being provided.

Permission is given to attend this excursion. YES NO

Permission is given for school staff to administer first aid if required YES NO

Permission is given to secure medical attention in case of illness/accident whilst

on this excursion and I accept responsibility for any costs involved including

ambulance transport if applicable.

YES NO

I agree to pay the excursion costs outlined above. YES NO


Where the excursion involves aquatic activities, I consent to my child swimming

with supervision.

YES

NO

Parent/Caregiver Name

Parent/Caregiver Signature

/ /

Date

Attachment B

BEHAVIOUR CONTRACT

Year 7 Outdoor Education Camp 2020

Adventure Bound

This adventure and team building Year 7 Outdoor Education camp program is aimed at the personal

development of each student as an extension of our school curriculum and philosophy. It focuses on

learning by doing. As well, the camp seeks to extend the students’ self-reliance, self-confidence and

independence. Teamwork within and across groups is encouraged.

In order for the camp community to be a happy, safe and worry-free environment, basic rules have been

established for all students. Whilst on camp, students are expected to behave appropriately. The issue has

been discussed with your child and the following behaviour contract has been compiled. To acknowledge

their support and yours, we require both parents and student to co-sign this agreement.

Kyle Lomas-Budd is the designated Camp Leader with the final say on all camp decisions relating to the

safety and welfare of all participants.

As a participant on this camp, I will endeavour to:

o Listen and co-operate with the teachers and instructors at all times.

o Stay with my group or in the camp area at all times.

o Show respect for others, their property and the environment.

o Treat others as I would like to be treated.

o Only enter my own tent and take responsibility for all my items

o Show patience when waiting my turn and use my manners

o Not engage in any activities that would not be acceptable or prejudice the safety of myself or others.

o No engage in any unsafe or antisocial behaviour.

o Show respect to the environment and cause no damage to it.

o Be positive and show leadership and work as part of a team.

o Speak only to those adults and students directly involved with our camp.

o I understand that if my behaviour is deemed unacceptable that my parents will be notified and will need

to collect me from the camp

Parent/Guardian Signature(s): ___________________ _____________________

Parent/Guardian Name(s): ___________________ _____________________

Student’ Signature ___________________

Student’ Name ___________________

Name of Participant: ...................................................

Please list any medical conditions that Adventure Bound NT staff should

know about, otherwise please write ‘NIL; (eg asthma, epilepsy, diabetes,

heart conditions, etc)

Medical condition particulars

PARENT / GUARDIAN

Names: _______________________________________________________________________________

Address: ______________________________________________________________________________

Ph (home): Ph (work): ____________________

Signed: Date:

MEDICAL

ADVISORY FORM

EMERGENCY CONTACT:

ADDRESS:

Ph (home): Ph (work):

PO Box 2470

Darwin 0801

Ph/Fax: (08) 8942 2872

Camp: (08) 8978 8884

Email: [email protected]

CONSENT FORM

I hereby give my full and

unconditional consent for my child/children to

attend a camp program at Basecamp Wallaroo delivered by Adventure Bound NT

I understand that my child/children will be participating in the adventurous activities that are

outlined in the Camping Program. Whilst attending the camp my child/children will be

supervised by qualified and experienced instructors from Adventure Bound NT (who follow

recommended industry guidelines) and School staff. I acknowledge that I have read and

understood the activity outlines provided by Adventure Bound NT (specifically covering

activities involving exposure to height, bushwalking, swimming) and I agree that I have been

advised and thoroughly informed of the inherent risks involved in each of these activities.

Damage to equipment which occurs through normal wear and tear will not incur a cost,

however, if wilful damage to the facility or equipment has occurred, an assessment of the cost

will be made by ABNT and school staff. The person damaging the facility or equipment will

be billed through the school.

In the event of an accident or emergency, I authorise the School Staff and/or Adventure

Bound NT to carry out first aid and to seek emergency / medical assistance if required. In

the event of such an incident, I understand that school staff will notify parents immediately.

I do/do not give permission for my child/children’s name, age, photograph to be used in

publicity for Adventure Bound NT.

Signed: Date:

PARENT / GUARDIAN

Names:


EMERGENCY CONTACT:

ADDRESS:


Attachment C

PERMISSION FORM FOR ACTIVITIES

PUSHBIKE RIDING

Parental Liability Release and Voluntary Assumption of Risk

READ THIS FIRST!

The purpose of this document is to inform you of some potential risks involved with PUSHBIKE RIDING and of the conduct required of

your child/children during the activity. The operator conducting this activity has procedures and systems in place to ensure a safe and enjoyable

experience for all participants. It is an accepted fact that there are risks in everything we do in life – for example driving your car or flying in a plane involves some risk. The operator of this activity has a strategy to manage risk and this document forms a part of that risk management strategy. You

should not be alarmed by this document as it is simply standard business practice to inform participants of any potential risks no matter how remote

they are. Your signing of this document does not affect your consumer rights or your rights to sue – and the operator of this activity cannot escape liability for acts of gross negligence or statutory duty by virtue of your signing of this document. Be that as it may, your signature on this document

indicates that you have consented to those risks (however remote they are) and is required in order for your child/children to participate in the planned

activities.

Please read carefully, fill in all blanks and initial each paragraph before signing.

I,____________________________________________________________________________ (Parent name), being

the legal parent/guardian of ______________________________________________________ (1st child)

______________________________________________________ (2nd child if applicable) ______________________________________________________ (3rd child if applicable)

of, ________________________________________________________________________________(Parent address)

hereby acknowledge that I have been advised and thoroughly informed of the inherent risks of activities involving exposure to height and give my full and unconditional consent to my child/children participating in the planned activities.

My child/ children have had experience in riding push bikes and can ride a pushbike responsibly (please tick 1) YES NO

In particular, I acknowledge that I have been advised and have carefully considered: (initial each clause)

____1. That since my child/children is/are below the legal age (ie a minor), the operator of the activity cannot enter into a contract with him/her/them that is legally binding. I can accept that the operator conducting my child’s/children’s activity is conducting a

business and is concerned about the growing incidence of court action for almost any incident (no matter how trivial) and the

tendency to quickly blame others for ones own mistakes. I can also accept that the operator wants to explain ‘in writing’ what their legal concerns are and have me consider and then accept each and every concern which is documented in the form of ‘clauses’ in

this contract. (there are 19 clauses in this contract)

____2. That Pushbike Riding has certain inherent risks and those risks can never be completely eliminated. I realise there is some

risk in every aspect of daily life. I accept that just as there is always a risk of injury when playing sport there is also some risk

involved when undertaking Pushbike Riding activities. I realise that it would not be practical or realistic to shield my child/children from every conceivable risk since I would need to keep my child/children at home at all times. I understand that the

operator will try to create opportunities for my child/children to develop through a range of adventure activities that encourage

interaction with others and the application of problem solving skills. I acknowledge that the operator conducting my child’s/children’s activities has an obligation and duty of care to assess those risks which are foreseeable and has taken precautions to control each of those risks.

____3. That the inherent risks referred to in 2 above may give rise to injuries which could require treatment in a medical facility or hospital. I realise that the operator conducting my child’s/children’s activity does not want accidents to happen, but sometimes,

despite everyone’s best efforts, accidents can still occur (eg through acts of God such as earth quake).

____4. That activities at height may be conducted at a site that is remote either by time and/or distance from a medical facility or hospital.

I accept that the Australian bush can provide my child/children with a unique opportunity to interact with nature and the natural

elements. I realise that public hospitals are usually built in cities or urban areas and not in remote locations. In consideration of the potential distance from the nearest medical facility or hospital, I am still willing to allow my child/children to participate in the

planned activities.

____5. That pushbike riding may be physically demanding and in such susceptible individuals may cause panic or hyperventilation. I can

accept that some children may behave differently to others and that in some cases, a child may start to panic or breathe rapidly. I

acknowledge that the operator conducting my child’s/children’s activity will not force my child/children to do something if he/she/they is/are completely unwilling.

____6. That pushbike riding involve the use of equipment that could malfunction, giving rise to risk of injury. I can accept that it is a

fact of life that equipment can fail. I realise that the operator conducting my child’s/children’s activity will take every possible

precaution to visually check the equipment prior to the planned activity and isolating from use any item of equipment that is found to be faulty.

____7. That pushbike riding necessarily involves exposure to the natural elements including but without limiting the generality hereof storm, tempest, wind, sun, loose rock and wild animals. Such exposure brings with it attendant risk of injury. I realise that the

operator conducting my child’s/children’s activity can’t control wild animals or control the weather. I also realise that most wild

animals are afraid of humans and will try to move out of the way. I realise that if my child/children torment, wound or corner a

Attachment C

wild animal, that animal may try to protect itself or attack in retaliation.

____8. That the planned activity is designed to provide my child/children with a safe introduction to pushbike riding.

I further understand and agree that prior to undertaking any pushbike riding, my child/children must be thoroughly

instructed in the use of equipment under the direct supervision of a qualified instructor to become a trained competent user(s).

____9. That the enjoyment and excitement pushbike riding activities is derived in part from the inherent risks incurred by participation in an

activity where risks are greater than the accepted level of safety of life at home or work.

____10. I further state that I am of lawful age and legally competent to sign this liability release. I understand that the terms herein are

contractual and not a mere recital; and that I have signed this document of my own free act.

____11. I further state that my child/children will listen carefully to directions and respect the advice of those supervising my

child’s/children’s activities. I realise that if my child/children does/do not listen to or completely ignores the safety instructions given by those persons who are conducting my child’s/children’s activity, injuries could result from this.

I also realise that the operator conducting my child’s/children’s activity will try to be brief and use simple, easy to understand

language when giving safety instructions. I accept that the operator has the right to remove children from the activity who deliberately or consistently fail to follow safety instructions. I accept that if it is judged necessary to remove my child/children from the activity, I will forfeit any

entitlement to a refund.

____ 12. I further state that my child/children will not use offensive language or be abusive towards those person’s who are supervising my

child’s/children’s activities. I agree that my child/children should be respectful of adults/teachers and behave in a way that does not interfere or disrupt the planned activities. I understand that such behaviour could distract those person’s conducting the activity

and potentially create a risk of injury. I accept that the operator has the right to remove children from the activity who are

deliberately being abusive or offensive to others (particularly to adults). I acknowledge in particular that bullying is not tolerated at any time from any child. I accept that if my child/children is/are judged to be creating a risk to others, he/she/they will be removed

from the activity and I will forfeit any entitlement to a refund.

____13. I further state that if my child/children wilful damage any facility or equipment while on camp, my child/children will replace or repay

the new price of the facility or equipment damaged. The child/children damaging the facility or equipment will be billed to the parents,

through the school.

____14. I further state that my child/children does/do not have a pre-existing medical condition that could pre-dispose him/her/them to

potential injuries/illness on account of his/her/their participation in the planned activities (eg brittle bones, heart problems). My child/children does/do not currently have an infectious disease which could harm other children on the planned activity. I realise

that there is always a risk of being exposed to airborne diseases/bacteria or bodily fluids (eg children spitting at each other) and

that my child/children could become ill as a result. I will take precautions to notify appropriate personnel of any prescribed medication that my child/children require from time to time to manage any ongoing medical condition (eg asthma or allergy

related drugs). In consideration of these medical risks, I am still willing to allow my child/children to participate in the planned

activities.

____15. I can accept that safety rules are designed to protect people from injury. I agree that should my child/children require medical

evacuation as a consequence of his/her/their own fault, careless act or deliberate violation of safety rules, I agree to pay any costs incurred on my child’s/children’s behalf and authorisation is hereby granted to make medical and transport arrangements as may

be determined necessary or desirable to assure my child’s/children’s health and safety.

____16. I further acknowledge that having been advised of the risks associated with pushbike riding, I want my child/children to

undertake the activity with Adventure Bound NT Staff (name of person conducting activity)

and hereby release and hold harmless Adventure Bound NT Staff (name of person conducting activity)

from any suit, demand or claim arising as a consequence of death or injury received by my child/children during

his/her/their participation in the said activity.

____17. I further acknowledge that I have been advised by the principals, servants and/or agents of Adventure Bound NT (name of facility)

of the risks associated with pushbike riding and to the maximum extent permitted by law, hereby release and hold harmless

Adventure Bound NT (name of facility) its principals, servants and/or agents from any suit, demand or claim arising as a consequence of death or

injury received by my child/children during participation in the said activity, or during my child’s/children’s participation in any push bike riding following

completion of said activity.

____18. I understand that nothing in this contract limits or excludes provisions made in the Trade Practices Act (Cwth) 1974 and that

despite my signing of this contract I will still have the benefit of consumer protection and certain rights implied under the said Act

which cannot be waived. I further understand that the operator conducting the activity cannot escape liability for acts of gross negligence and that my signing of this contract has not affected my rights to sue.

____19. I also understand that the operator conducting my child’s/children’s activities cannot escape liability for failing to discharge any special duties imposed by statute (ie Statutory Duty) and that my signing of this contract has not enabled the operator to avoid

responsibility for the commission of an offence.

____20. I further acknowledge that this document may be relied upon in any proceedings instituted in any Court by me or my heirs,

executors and assigns.

Attachment C

© Professional Association of Climbing Instructors Pty Ltd.

PERMISSION FORM FOR ACTIVITIES INVOLVING EXPOSURE TO HEIGHT*


READ THIS FIRST!

The purpose of this document is to inform you of some potential risks involved with exposing your child to height* and of the conduct required of your child/children during the activity. The operator conducting this activity has procedures and systems in place to ensure a safe and enjoyable

experience for all participants. It is an accepted fact that there are risks in everything we do in life – for example driving your car or flying in a plane

involves some risk. The operator of this activity has a strategy to manage risk and this document forms a part of that risk management strategy. You should not be alarmed by this document as it is simply standard business practice to inform participants of any potential risks no matter how remote

they are. Your signing of this document does not affect your consumer rights or your rights to sue – and the operator of this activity cannot escape

liability for acts of gross negligence or statutory duty by virtue of your signing of this document. Be that as it may, your signature on this document

indicates that you have consented to those risks (however remote they are) and is required in order for your child/children to participate in the planned

activities.



the legal parent/guardian of ______________________________________________________ (child)


hereby acknowledge that I have been advised and thoroughly informed of the inherent risks of activities involving exposure to

height and give my full and unconditional consent to my child/children participating in the planned activities.


____1. That since my child/children is/are below the legal age (i.e. a minor), the operator of the activity cannot enter into a contract with

him/her/them that is legally binding. I can accept that the operator conducting my child’s/children’s activity is conducting a

business and is concerned about the growing incidence of court action for almost any incident (no matter how trivial) and the tendency to quickly blame others for one’s own mistakes. I can also accept that the operator wants to explain ‘in writing’ what their

legal concerns are and have me consider and then accept each and every concern which is documented in the form of ‘clauses’ in this contract. (there are 19 clauses in this contract)

____2. That activities at height involve certain inherent risks and those risks can never be completely eliminated. I realise there is some risk in every aspect of daily life. I accept that just as there is always a risk of injury when playing sport there is also some risk

(however remote) when undertaking activities at height. I realise that it would not be practical or realistic to shield my

child/children from every conceivable risk since I would need to keep my child/children at home at all times. I understand that the operator will try to create opportunities for my child/children to develop through a range of adventure activities at height (e.g.

abseiling, climbing, flying foxes, ropes courses etc.) that encourage interaction with others and the application of problem solving

skills. I acknowledge that the operator conducting my child’s/children’s activities has an obligation and duty of care to assess those risks which are foreseeable and has taken precautions to control each of those risks.


despite everyone’s best efforts, accidents can still occur (e.g. through acts of God such as earth quake).

____4. That activities at height may be conducted at a site that is remote either by time and/or distance from a medical facility or hospital.


elements. I realise that public hospitals are usually built in cities or urban areas and not in remote locations. In consideration of the

potential distance from the nearest medical facility or hospital, I am still willing to allow my child/children to participate in the

planned activities.

____5. That activities at height may be physically demanding and in such susceptible individuals may cause panic or hyperventilation. I

can accept that some people are afraid of heights and that it is a perfectly normal feeling to have. I can accept that some children

may behave differently to others and that in some cases, a child may start to panic or breathe rapidly. I acknowledge that the operator conducting my child’s/children’s activity will not force my child/children to do something if he/she/they is/are

completely unwilling.

____6. That activities at height involve the use of equipment that could malfunction, giving rise to risk of injury. I can accept that it is a



____7. That activities at height necessarily involves exposure to the natural elements including but without limiting the generality hereof storm, tempest, wind, sun, loose rock and wild animals. Such exposure brings with it attendant risk of injury. I realise that the

Attachment C




____8. That the planned activity is designed to provide my child/children with a safe introduction to: Flying Fox, Abseiling, Rock Climbing,

Low Ropes, High Ropes, Challenge Course, Mountain Biking, Team Building Activities. The activity is not intended to train my child/children as a competent user(s). I further understand

and agree that prior to undertaking any further activities at height, my child/children must be thoroughly instructed in the use of

equipment in a training course under the direct supervision of a qualified instructor to become a trained competent user(s).

____9. That the enjoyment and excitement of activities at height is derived in part from the inherent risks incurred by participation in an





child’s/children’s activities at height. I realise that if my child/children does/do not listen to or completely ignores the safety instructions given by those persons who are conducting my child’s/children’s activity, injuries could result (e.g. running and

tripping over when told not to run). I also realise that the operator conducting my child’s/children’s activity will try to be brief and

use simple, easy to understand language when giving safety instructions. I accept that the operator has the right to remove children

from the activity who deliberately or consistently fail to follow safety instructions. I accept that if it is judged necessary to remove

my child/children from the activity, I will forfeit any entitlement to a refund.

____ 12. I further state that my child/children will not use offensive language or be abusive towards those persons who are supervising my

child’s/children’s activities. I agree that my child/children should be respectful of adults/teachers and behave in a way that does

not interfere or disrupt the planned activities. I understand that such behaviour could distract those person’s conducting the activity and potentially create a risk of injury. I accept that the operator has the right to remove children from the activity who are

deliberately being abusive or offensive to others (particularly to adults). I acknowledge in particular that bullying is not tolerated at

any time from any child. I accept that if my child/children is/are judged to be creating a risk to others, he/she/they will be removed from the activity and I will forfeit any entitlement to a refund.

____ 13. I further state that if my child/children wilful damage any facility or equipment while on camp, my child/children will replace or repay the new price of the facility or equipment damaged. The child/children damaging the facility or equipment will be billed to the parents,

through the school.


potential injuries/illness on account of his/her/their participation in the planned activities (e.g. brittle bones, heart problems). My

child/children does/do not currently have an infectious disease which could harm other children on the planned activity. I realise that there is always a risk of being exposed to airborne diseases/bacteria or bodily fluids (e.g. children spitting at each other) and

that my child/children could become ill as a result. I will take precautions to notify appropriate personnel of any prescribed

medication that my child/children require from time to time to manage any ongoing medical condition (e.g. asthma or allergy related drugs). In consideration of these medical risks, I am still willing to allow my child/children to participate in the planned activities.

____15. I can accept that safety rules are designed to protect people from injury. I agree that should my child/children require medical evacuation as a consequence of his/her/their own fault, careless act or deliberate violation of safety rules, I agree to pay any costs

incurred on my child’s/children’s behalf and authorisation is hereby granted to make medical and transport arrangements as may

be determined necessary or desirable to assure my child’s/children’s health and safety.

____16. I further acknowledge that having been advised of the risks associated with activities at height, I want my child/children to undertake the activity

with Adventure Bound NT Staff and hereby release and hold harmless Adventure Bound NT Staff from any suit, demand

or claim arising as a consequence of death or injury received by my child/children during his/her/their participation in the said activity.

____17. I further acknowledge that I have been advised by the principals, servants and/or agents of Adventure Bound NT of the risks associated

with activities at height and to the maximum extent permitted by law, hereby release and hold harmless Adventure Bound NT its principals,

servants and/or agents from any suit, demand or claim arising as a consequence of death or injury received by my child/children during participation in the said activity, or during my child’s/children’s participation in any activities at height following completion of said activity.

____18. I understand that nothing in this contract limits or excludes provisions made in the Trade Practices Act (Cwth) 1974 and that despite my signing of this contract I will still have the benefit of consumer protection and certain rights implied under the said Act

which cannot be waived. I further understand that the operator conducting the activity cannot escape liability for acts of gross negligence and that my signing of this contract has not affected my rights to sue.

____19. I also understand that the operator conducting my child’s/children’s activities cannot escape liability for failing to discharge any special duties imposed by statute (i.e. Statutory Duty) and that my signing of this contract has not enabled the operator to avoid responsibility for the commission of an offence.

____20. I further acknowledge that this document may be relied upon in any proceedings instituted in any Court by me or my heirs, executors and assigns.

*Activities at height include; abseiling, rock climbing (artificial walls or outdoor), cannoning, rope courses, flying foxes, and any activity that involves exposure to risk of falls from height.

Attachment C

PERMISSION FORM FOR ACTIVITIES

Bushwalking Day/Half day trips, orienteering


READ THIS FIRST!

The purpose of this document is to inform you of some potential risks involved with BUSHWALKING and of the conduct required of your child/children during the activity. The operator conducting this activity has procedures and systems in place to ensure a safe and enjoyable

experience for all participants. It is an accepted fact that there are risks in everything we do in life – for example driving your car or flying in a plane

involves some risk. The operator of this activity has a strategy to manage risk and this document forms a part of that risk management strategy. You should not be alarmed by this document as it is simply standard business practice to inform participants of any potential risks no matter how remote

they are. Your signing of this document does not affect your consumer rights or your rights to sue – and the operator of this activity cannot escape

liability for acts of gross negligence or statutory duty by virtue of your signing of this document. Be that as it may, your signature on this document indicates that you have consented to those risks (however remote they are) and is required in order for your child/children to participate in the planned

activities.



the legal parent/guardian of ______________________________________________________ ( child)


hereby acknowledge that I have been advised and thoroughly informed of the inherent risks of activities involved in BUSHWALKING and give my full and unconditional consent to my child/children participating in the planned activities.


____1. That since my child/children is/are below the legal age (i.e. a minor), the operator of the activity cannot enter into a contract with

him/her/them that is legally binding. I can accept that the operator conducting my child’s/children’s activity is conducting a

business and is concerned about the growing incidence of court action for almost any incident (no matter how trivial) and the

tendency to quickly blame others for one’s own mistakes. I can also accept that the operator wants to explain ‘in writing’ what their

legal concerns are and have me consider and then accept each and every concern which is documented in the form of ‘clauses’ in

this contract. (there are 19 clauses in this contract)

____2. That bushwalking involve certain inherent risks and those risks can never be completely eliminated. I realise there is some

risk in every aspect of daily life. I accept that just as there is always a risk of injury when playing sport there is also some risk involved in bushwalking I realise that it would not be practical or realistic to shield my child/children from every conceivable risk since I would need to keep my child/children at home

at all times. I understand that the operator will try to create opportunities for my child/children to develop through a range of adventure activities that

encourage interaction with others and the application of problem solving skills. I acknowledge that the operator conducting my child’s/children’s activities has an obligation and duty of care to assess those risks which are foreseeable and has taken precautions to control each of those risks.


despite everyone’s best efforts, accidents can still occur (e.g. through acts of God such as earth quake).

____4. That bushwalking may be conducted at a site that is remote either by time and/or distance from a medical facility or hospital.


elements. I realise that public hospitals are usually built in cities or urban areas and not in remote locations. In consideration of the potential distance from the nearest medical facility or hospital, I am still willing to allow my child/children to participate in the

planned activities.

____5. That bushwalking may be physically demanding and in such susceptible individuals may cause panic or hyperventilation. I

can accept that some people are afraid of heights and that it is a perfectly normal feeling to have. I can accept that some children

may behave differently to others and that in some cases, a child may start to panic or breathe rapidly. I acknowledge that the operator conducting my child’s/children’s activity will not force my child/children to do something if he/she/they is/are

completely unwilling.

____6. That bushwalking involve the use of equipment that could malfunction (compass, GPS, phones etc.). I can accept that it is a



____7. That bushwalking necessarily involves exposure to the natural elements including but without limiting the generality hereof storm, tempest, wind, sun, loose rock and wild animals. Such exposure brings with it attendant risk of injury. I realise that the


Attachment C



____8. That the planned activity is designed to provide my child/children with a safe introduction to bushwalking. The activity is not intended to train my child/children as a competent user(s). I further understand and agree that prior to undertaking any further activities, my child/children must be thoroughly instructed in the use of

equipment in a training course under the direct supervision of a qualified instructor to become a trained competent user(s).

____9. That the enjoyment and excitement of bushwalking is derived in part from the inherent risks incurred by participation in an





child’s/children’s activities. I realise that if my child/children does/do not listen to or completely ignores the safety

instructions given by those persons who are conducting my child’s/children’s activity, injuries could result (e.g. running and tripping over when told not to run). I also realise that the operator conducting my child’s/children’s activity will try to be brief and

use simple, easy to understand language when giving safety instructions. I accept that the operator has the right to remove children

from the activity who deliberately or consistently fail to follow safety instructions. I accept that if it is judged necessary to remove my child/children from the activity, I will forfeit any entitlement to a refund.

____ 12. I further state that my child/children will not use offensive language or be abusive towards those persons who are supervising my

child’s/children’s activities. I agree that my child/children should be respectful of adults/teachers and behave in a way that does

not interfere or disrupt the planned activities. I understand that such behaviour could distract those person’s conducting the activity and potentially create a risk of injury. I accept that the operator has the right to remove children from the activity who are

deliberately being abusive or offensive to others (particularly to adults). I acknowledge in particular that bullying is not tolerated at

any time from any child. I accept that if my child/children is/are judged to be creating a risk to others, he/she/they will be removed from the activity and I will forfeit any entitlement to a refund.

____ 13. I further state that if my child/children wilful damage any facility or equipment while on camp, my child/children will replace or repay the new price of the facility or equipment damaged. The child/children damaging the facility or equipment will be billed to the parents,

through the school.


potential injuries/illness on account of his/her/their participation in the planned activities (e.g. brittle bones, heart problems). My

child/children does/do not currently have an infectious disease which could harm other children on the planned activity. I realise that there is always a risk of being exposed to airborne diseases/bacteria or bodily fluids (e.g. children spitting at each other) and

that my child/children could become ill as a result. I will take precautions to notify appropriate personnel of any prescribed

medication that my child/children require from time to time to manage any ongoing medical condition (e.g. asthma or allergy related drugs). In consideration of these medical risks, I am still willing to allow my child/children to participate in the planned

activities.

____15. I can accept that safety rules are designed to protect people from injury. I agree that should my child/children require medical

evacuation as a consequence of his/her/their own fault, careless act or deliberate violation of safety rules, I agree to pay any costs

incurred on my child’s/children’s behalf and authorisation is hereby granted to make medical and transport arrangements as may be determined necessary or desirable to assure my child’s/children’s health and safety.

____16. I further acknowledge that having been advised of the risks associated with bushwalking, I want my child/children to

undertake the activity with Adventure Bound NT Staff (name of person conducting activity)

and hereby release and hold harmless Adventure Bound NT Staff (name of person conducting activity) from any suit, demand or claim arising as a consequence of death or injury received by my child/children during

his/her/their participation in the said activity.

____17. I further acknowledge that I have been advised by the principals, servants and/or agents of

Adventure Bound NT (name of facility) of the risks associated with bushwalking and to the maximum extent permitted by law,

hereby release and hold harmless Adventure Bound NT (name of facility) its principals, servants and/or agents from any suit, demand or claim

arising as a consequence of death or injury received by my child/children during participation in the said activity, or during my child’s/children’s participation in bushwalking following completion of said activity.

____18. I understand that nothing in this contract limits or excludes provisions made in the Trade Practices Act (Cwth) 1974 and that despite my signing of this contract I will still have the benefit of consumer protection and certain rights implied under the said Act

which cannot be waived. I further understand that the operator conducting the activity cannot escape liability for acts of gross

negligence and that my signing of this contract has not affected my rights to sue.

____19. I also understand that the operator conducting my child’s/children’s activities cannot escape liability for failing to discharge any

special duties imposed by statute (i.e. Statutory Duty) and that my signing of this contract has not enabled the operator to avoid responsibility for the commission of an offence.

____20. I further acknowledge that this document may be relied upon in any proceedings instituted in any Court by me or my heirs, executors and assigns.

as we edge closer to our year 7 camp please see the below ......rock climbing abnt instructors will...

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