2017 Australian National Broomball Championships
Broomball Association of South Australia (BASA) & South Australian Ice Sports Federation (SAISF) Liability Waiver
The participant hereby,
- Agrees that prior to participating, if present, will inspect the facilities and equipment, and, if anything is believed to be unsafe will immediately advise officials or personnel of such conditions.
- Acknowledges and fully understands that participating is voluntarily in activities that involve risk of injury, including catastrophic injury, or death, which might result not only from own actions, inactions, or negligence, but the actions, inactions, or negligence of others, the rules of play, the conditions of the premises, or any of the equipment used. This includes any risks not reasonably foreseeable to BASA and the SAISF.
- Assumes all the foregoing risks as a condition of participation and accepts personal responsibility for the damages following any such injury.
- Unconditionally releases, waives and consents not to sue BASA, SAISF, The IceArenA Ice Rink, officers, directors, administrators, agents, coaches, other employees, and volunteers of BASA and SAISF, IceArenA, sponsoring agencies, sponsors, advertisers, The Australian Sports Commission and the State of South Australia, for any and all liability to the undersigned, undersigned heirs and next of kin. This is for any claims or losses on account of injury, including death, or damage to property, while participating in any and all of the BASA/SAISF/IceArenA official or unofficial activities, events or competitions.
- Accepts responsibility for decision to continue participation if suffering from injuries.
- Gives permission for medical data to be used anonymously in medical education and published studies of injury statistics and analysis. Consent to use, without compensation, picture, name, voice or likeness for promotional, television, radio or film coverage of BASA/SAISF/IceArenA events.
Permission to Administer Medical Care
- Accepts total responsibility for all medical expenses incurred whether or not covered by insurance.
- Authorises the on-site volunteer medical/first aid staff to provide appropriate medical treatment.
- If in an emergency transport is deemed necessary, authorises the same to summon an ambulance for transport to the hospital.
- Requests and authorizes physicians, athletic trainers, technicians, first aid personnel, nurses and dentists to perform any diagnostic treatment or operative procedures or x-ray with no guarantee as to the results of examination or treatment. I have read and fully understand the above release and grant my permission to administer medical care.
I have read and fully understand the above release and grant my permission to administer medical care.