Participation Form Once you have filled it out we will bring it along on the day for you to sign. 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Please discuss this with the Project Manager and complete the declaration of medical conditions questions form below.If you are registering for a Whitewater Activity I am a member of Paddle NSW I am not a member of Paddle NSW What is your membership number?If you are not a member of Paddle NSW and would like to participate in white water activities, we will need to ensure we have additional insurance to cover you to participate in these activities.Greater Sydney Landcare Network - Conditions of Participation: In applying and in consideration of my application for membership or to participate in activities being accepted I acknowledge and agree that: I have notified the Project Manager and First Aid officer of any relevant medical conditions and pre-existing injuries, and I consent to the Project Manager rendering or authorising such medical treatment as necessary and accept responsibility for all associated expenses. I am a volunteer and not an employee of the Committee. I will not smoke, consume or store alcohol or illicit drugs while working on a project site. I shall respect the rights, feelings and property of all others associated with projects. I shall cooperate with the Project Manager to ensure a safe, happy and hygienic team environment. My placement on all projects is at the discretion of the Project Manager. Photographs or videos taken of me on a project may be used by the Committee and sponsors for promotion of conservation activities. Photographs or videos taken by me on a project and given to a committee member may be used by the Committee for promotional purposes. Greater Sydney Landcare Network has Insurance is in place that provides limited cover to me whilst I am performing or participating in Landcare activities including paddling on flat water but not Whitewater rafting activities. (For insurance details ask the team leader or go to our web site.) To participate in white water activities you must either be a member of Paddle NSW or ensure the team leader has organised personal injury insurance for you for the activity Warning: Paddling can be inherently dangerous. Serious accidents can and often do happen which may result in me being injured or even killed. I have voluntarily read and understood this warning and accept and assume the inherent risks in paddling. Please also note that there are additional skills needed for negotiating the various levels of white water and before embarking on these trips, check with the trip leader whether you have the required skill. Exclusion of Liability: Except where provided or required by law and such cannot be excluded, I agree that it is a term of my temporary membership (if accepted) that Greater Sydney Landcare Network is absolved from all liability however arising from injury or damage however caused (whether fatal or otherwise) arising out of my membership and/or participation in any Greater Sydney Landcare Network activity. Fitness to Participate: I declare that I am and must continue to be medically and physically fit and able to participate in Greater Sydney Landcare Network activities. I am not and must not be a danger to myself or to the health and safety of others. I have provided the information required and I warrant that all information provided is true and correct. Privacy: I understand that the information I have provided elsewhere in the membership application is necessary for the Objects of Greater Sydney Landcare Network. I acknowledge and agree that the information disclosed by me to Greater Sydney Landcare Network will only be used for the Objects of Greater Sydney Landcare Network. I understand that I will be able to access my information directly from Greater Sydney Landcare Network. If the required information is not provided my membership application may be rejected. Declaration:I hereby declare that I have: Read and agree to Greater Sydney Landcare Network Conditions of participation and I understand that failure to comply with any of these conditions may result in the Project Manager requesting me to leave. I understand that Greater Sydney Landcare Network has limited volunteer’s workers injury insurance for our Landcare activities including flat water paddling under a group policy arranged by the Greater Sydney Local Land Services and this insurance does not cover white water activities. So I have to arrange insurance through Paddle NSW for white water activities. SIGNATURE____________________________________________________________________DATE:______________________________Declaration of Medical conditions that may affect participation in ActivitiesPARENT/LEGAL GUARDIAN CONSENT (To be completed by the Parent or Legal Guardian of an Applicant under the age of 18 Years) Name____________________________________________________________Signature____________________________________________ If any pre-existing medical conditions, allergies or past injuries are declared, the following questions need to be discussed with the project manager or committee representative.1. More information on the condition:E.g. How serious is the condition? What are the symptoms? What aggravates the condition? How often do episodes occur? When was the most recent episode?2. Based on responses to Question 1, how might the declared condition affect participation?E.g. What other relevant activities does the volunteer undertake on a regular basis? 3. What is the management plan to minimise the likelihood of aggravating the declared condition?E.g. Medication to be taken on the project, avoid allergy triggers, rotate activities and/or carer to accompany volunteer.4. If unsure please consult the Committee Executive.A Doctor's Certificate may be necessary.5. What is the Emergency Management Plan?E.g. Seek medical attention or administer medication. How quickly do these need to be undertaken?Volunteer Signature: Name: Date: Committee Representative Signature: Name: Date: This iframe contains the logic required to handle Ajax powered Gravity Forms.