WAIVER AND RELEASE OF LIABILITY FORM

WAIVER AND RELEASE OF LIABILITY FORM

TULLAMORE FARM  A.C.N. 010 946 933

EDUCATIONAL AND LEISURE ACTIVITIES

All details must be fully completed.

Name of Participant:  _________________________________________________________________

Name of Guardian (if Participant under 18 years):  ___________________________________________________

Address:  ____________________________________________________________________________

____________________________________________________________________________________

Email:  _______________________________________   Telephone:  ____________________________

Date of Birth (if under 18):  _________________________________

Risks of Farm Educational and Leisure Activities

I understand and acknowledge that:

1. Farms are inherently dangerous. We also have lots of Native Wildlife, Dams & Waterways.
2. Farm animals can be dangerous and can act in sudden and unpredictable ways, especially if frightened or hurt;
3. Wildlife Life & Farm animals can carry diseases and that hand washing is important and any instructions given by Tullamore Farm, it’s employees, partners, volunteers and assigns as to hand washing should be followed;
4. I have read and understood the conditions of entry to Tullamore Farm;
5. That any fenced area may be dangerous and should not be entered into without express permission;
6. Farm equipment is obviously dangerous.

I have voluntarily read this warning, understood this warning, accept, and assume all of the risks inherent or otherwise of participating in farming educational and leisure activities, associated activities of Tullamore Farm.

I understand that I can  choose not to participate in any activity if I feel that it is too dangerous and will do so.

I agree that I PARTICIPATE at my OWN RISK and that the owners of the land upon which Tullamore Farm is situated, Tullamore Farm and their employees, partners, volunteers or assigns shall not be liable for my personal injury, death, loss or damage occasioned to me and/or the children under my care or any loss or damage occasioned to any of my possessions whether such liability arises out of any express or implied term of my participation in the activities or at common law or in any other way.

Conduct

I agree to follow the rules and regulations as set out in the booking package/registration form/conditions of entry for Tullamore Farm and that any misconduct or refusal by me to follow any direction will result in CANCELLATION of my booking and immediate removal from Tullamore Farm NO MATTER where that may occur. I agree to follow all instructions and safety advice given to me by Tullamore Farm, it’s employees, partners, volunteers and assigns.

Medical Treatment Consent

I hereby consent to receive medical treatment that may be deemed advisable in the event of injury, accident and or illness during any farm educational and leisure activities.

Effect of this Document

I understand that my signature to this document constitutes a complete and unconditional release of all liability of Tullamore Farm, its directors, employees, volunteers and assigns to the greatest extent allowed by law in the event of me and/or the children under my care, suffering injury or death.

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Signature of Participant/Guardian Dated