Waiver & Media Consent

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1. Participant Details

Child / Participant Full Name *

Date of Birth *

Age *

Parent / Guardian Full Name *

Phone *

Email *

2. Liability Waiver

I understand that participation in gymnastics, parkour, movement classes and related activities involves inherent risks including falls, collisions, strains, sprains, fractures and, in rare cases, more serious injury.

I voluntarily assume all risks associated with participation and release Movement Literacy Charters Towers, Gabriel El Hanbli, and Blackheath & Thornburgh Hall from liability except in cases of gross negligence.

I confirm the participant is physically fit to take part and authorise emergency medical treatment if needed. I accept responsibility for any resulting medical costs.

This waiver does not exclude liability for gross negligence or any liability that cannot be excluded under Australian Consumer Law.

I have read and agree to the Liability Waiver above *

3. Media Consent

Movement Literacy may take photos and videos during classes for use on social media, the website, flyers and promotional materials. Names are not normally published with images.

I GIVE CONSENT for photos and videos of the participant to be used for club promotion. I DO NOT GIVE CONSENT. Please make reasonable efforts to exclude the participant from promotional images.

Any special requests or restrictions (optional)

4. Declaration & Signature

I am the parent/legal guardian of the participant (or an adult participant). I understand this form and the choices I have made.

Type your full name as signature *

Date *

1. Participant Details

2. Liability Waiver

3. Media Consent

4. Declaration & Signature

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