PRIVACY STATEMENT:  The Event Organisor and Skate Australia Inc collect the personal information on this form to enable the efficient provision and marketing of the Event.  The Event Organisor and Skate Australia will only use and disclose the personal information collected for the purposes of (or purposes reasonably incidental to) providing and marketing the Event.  If you have any privacy concerns or would like to verify information we hold about you please contact Skate Australia at admin@skateaustralia.org.au.  Skate Australia’s Privacy Policy sets out our personal information management practices.

“Event” means participation in 2023 Northern Rivers Revolt at Cavanbah Centre, Byron Bay.  ”Event Organiser” mean "Tweed Valley Rollers", "Northern Rivers Roller Derby", “SkateNSW” and “Skate Australia” means Skate Australia Pty.Ltd., PO Box 161 | Kedron | Queensland | 4031, and includes all directors, officers, members, agents and sponsors of that organisation.

In consideration for, and as a condition of my registration into the Event, including participating in any or all pre or post Event activities and social activities I hereby

1. Warrant that I am medically fit (including physically and mentally) to compete in the event and that I have not been advised otherwise by a medical practitioner.
2. Agree that I am participating in Event at my own risk and acknowledge that all Skate Australia activities including skateboarding and/or roller/inline skating are risky and inherently dangerous and may result in serious personal injury including permanent disability and/or death to me as a participant in the Event and that may or will involve the risk of severe economic or property loss and damage and I understand that such injury or loss may result not only from my actions but from the actions, omissions or negligence of others.
3. Warrant that I will inspect the competition area and all fixtures, fittings, equipment, and other things supplied, provided or used in or related to the conduct of the Event and agree that I will not participate in the Event unless I am completely satisfied with the adequacy and conditions.
4. Agree to abide by the rules and regulations of the Event and Skate Australia and I will abide by all written and verbal instructions as may from time to time be given by the Event Organisor and/or their appointed personnel.  I agree that failure to comply with any rule may result in disqualification from the event.  I agree that I will at all times participate in the event with fair play and sportsmanship.
5. Agree that except where provided or required by law and such cannot be excluded, it is a term of my participation in the Event (if accepted) that Skate Australia and the Event Organiser are each absolved from all liability and claims however arising from injury or damage however caused (whether fatal or otherwise) arising out of my participation in the Event.  I acknowledge that where I am a consumer of recreational services, as defined by any relevant law, certain terms and rights implied into a contract for the supply of goods or services may be excluded.  I acknowledge that these implied terms and rights and any liability of Skate Australia and / or the Event Organiser flowing from them, are expressly excluded by this registration form.
6. Release and forever discharge Skate Australia and the Event Organiser from all and any claim, right or cause of action however arising, whether or not presently ascertained, immediate, future or contingent, which I may otherwise have for or arising out of loss of my life or injury, damage or loss of any description whatsoever and howsoever caused which I may suffer or sustain in the course of or consequent upon my participation in the Event.
7. Indemnify and keep indemnified Skate Australia and the Event Organiser against any claim, right or cause of action howsoever arising, whether or not presently ascertained, immediate, future or contingent which I may have for or arising out of loss of my life or injury, damage or loss of any description whatsoever and howsoever caused which I may suffer or sustain in the course of or consequent upon my participation in the Event.
8. Agree that the exclusion of liability, release and indemnity contained in paragraphs 5, 6 and 7 above may be pleaded as a complete bar to any claim, notice, demand, action, proceeding, litigation or judgment which has or may be brought or made or recovered against Skate Australia or the Event Organiser.
9. Agree that, without limitation to the waiver, release and discharge contained in paragraph 5 above and the indemnity contained in paragraph 6 above, the liability of the Event Organisor and Skate Australia will be limited to that part of the Event which is located at or held on its premises and the Event Organiser will not be liable in any circumstances or to any extent for any action arising in relation to that part of the Event which is located at or held on the premises of another Event Organiser; and

                 I have read carefully and understand this declaration, warrant, waiver and release, and having done so, I sign voluntarily.

PUBLICITY RELEASE: I hereby unconditionally assign to Skate Australia all right, title and interest I/My Child may have in any and all audio, audio visual and/or photographic recording of me/My Child in the Event/Session and grant to Skate Australia permission to use, display, licence, sell and publish or otherwise deal with the audio, audio visual and/or photographic recording of me/My Child, including for the purpose of advertising, promotion or otherwise. I further agree that any such recording(s) will remain the property of Skate Australia Inc.

MEDICAL RELEASE: I consent to receiving any medical, such as first aid, treatment that Skate Australia or the Event Organiser considers reasonably necessary during or after the activities. 

EXCLUSION OF LIABILITY: Except to the extent that the Trade Practices Act 1974(Cth) or other legislation applies, and cannot by contract be excluded, I agree that as a term of my membership that I absolve Skate Australia 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 Skate Australia authorized recognized activity in any way due to any negligent act, breach of duty, default and/or omission one on the part of Skate Australia

PROTECTIVE EQUIPMENT: As an activities participant I hereby agree to wear suitable protective equipment, as requested, at all times whilst I am taking part in any roller skating activities.

DECLARATION FOR ADULTS: I warrant and certify that I am the person named below and am capable of participating in the Event/Session. I confirm that I have read and understand the above declaration, warranty and release and that I agree, to be bound by each of those conditions having done so, I sign voluntarily.

DECLARATION FOR MINORS:  If you are under 18 years of age on the day this declaration is signed, the declaration must be signed by your parent or guardian.  I warrant and certify that I am the parent or guardian of the child named below (“My Child”) who will be under 18 years of age on the date of the Event and that he/she has my consent and is capable of participating in the Event.  I confirm that I have read and understand the above declaration, warranty and release and that I agree, on behalf of My Child, to be bound by each of those conditions having done so, I sign voluntarily.