Assumption of Risk, Waiver and Indemnity Form
Note: This is an important document that affects your legal
rights and obligations. Please read carefully and sign only
when you are satisfied you understand it 
For participants less than 18 years, a parent or legal guardian
must complete this Document.
Participant Name (s):
DOB:
Class (Time and Day):
Scheduled Activities: Class courses may include the following: solo, partner and group acro balance,
acrobatics, tumbling, gymnastics, handstands, mini tramp, juggling, rope climbing, solo and double
trapeze / cloud swing, tissue, hula hoops, slack line, hoop diving, pyramids, unicycle, spinning plates,
diablo, devil sticks, stilts for participants over 8 years, slapstick, clowning and physical comedy, mime,
games, flexibility training, strength exercises and other physical activities.
In consideration of Castlemaine Circus and coaches, for permission to participate in classes in any
way, I, the undersigned, for myself, my personal representation, heirs and next of kin:
1.
Acknowledge that the intended activities that make up the classes (see ‘Scheduled
Activities’) are inherently dangerous and may result in serious personal injury (including
permanent disability) and / or death and / or property damage.
2.
Give permission for coaches to seek appropriate medical attention in the case of injury.
3.
Acknowledge, agree to, and voluntarily assume all risks (including, but not limited to,
those associated with activities in the section ‘Scheduled Activities’) of any harm, injury, or
damage suffered whether foreseen or unforeseen in connection with the Class course.
4.
Agree to indemnify Castlemaine Circus Inc and coaches from any liabilities, claims, and
causes of action that may be brought against the above as a result of, or in connection with a
negligent act, omission, failure or error as a participant in the Class course.
5.
Acknowledge and confirm that the information I have provided on this Document is true
and I have read and understand this document and that I am of a lawful age and legally
competent to sign this Document.
6.
I understand that I may consult a medical advisor if I have concerns regarding any preexisting medical condition, which may affect the health and safety of the participant or be
provoked by participation in the above activity.
7.
I have completed an enrolment form indicating Emergency Contacts and participant
medical conditions.
Note: Students are responsible for any medical costs arising from participation in class
activities.
Participants (over 18years) or Parent / Guardians full name:
Signature:
Date: