Everyone participating in club activities off campus must first sign an indemnity form reproduced below — see the attached PDFs for a downloadable version of the form and description of risks associated with ANUMC activities. You should have signed this indemnity form when you joined.
WARNING OF POTENTIAL HARM ASSUMPTION OF RISK FORM
(Both the applicant student and a parent or guardian must read carefully and sign if student is under 18.)
ACTIVITY: (Student must list all Australian National University sports programs in which he or she will participate, including Intervarsity events such as EUG’s, AUC’s and AUG’s).
I am aware that playing or practicing to play or participate in any physical activity can be dangerous in nature involving MANY RISKS OF INJURY. I understand that the dangers and risks of death, serious neck and spinal injuries which may result in complete or partial paralysis, brain damage, serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other aspects of the muscular skeletal system, serious injury to virtually all internal organs, and serious injury or impairment to other aspects of my body, general health and well-being. I understand that the dangers and risks of playing, or practicing to play or participate in the above may result not only in serious injury, but in a serious impairment of my future abilities to earn a living, to engage in other business, social and recreational activities, and generally to enjoy life.
Because of the dangers of participating in the above activities, I recognize that the rules and regulations which govern the said activity exist to provide a safe environment for all participants and agree to abide by those same rules for my own safety as well as those around me.
(initials)
In consideration of the ANU Sport and Recreation Association, in permitting me to try out / participate in each of the activities / programs listed above and to engage in all activities related to the programs, including, but not limited to, trying out, practicing or playing/participating in that activity program, I hereby assume all of the risks associated with participation and agree to hold the ANU Sport and Recreation Association, its employees, agents, representatives, coaches, and volunteers harmless from any negligence and all liability, actions, causes of action, debts, claims, or demands of any kind and nature whatsoever which may arise by, or in connection with my participation in any activities related to the ANU Sport and Recreation Association.
The terms hereof shall serve as a release and assumption of risk for my heirs, estate, executor, administrator, assignees, and for all members of my family.
By signing this form, I acknowledge I have read, understand, and will comply with its intent and purpose.
STUDENT: GUARDIAN (if student under 18): DATE: / /
Risks associated with ANUMC activities
Mountain Biking
Risks associated with mountain biking and cycle touring include falling off and/or riding into obstacles such as trees and rocks resulting in abrasions, cuts, sprains, broken bones, concussion and other serious injuries or death. Riding can be physically demanding and completed in remote locations and varying weather conditions, which could lead to dizziness, heat stress, dehydration, sunburn, blisters, insect bites or hypothermia. Travel to and from bike tracks could involve collisions with other vehicles. Unattended bikes and equipment could be stolen. Participants should ensure that their bike is well maintained and suitable for the terrain which they are riding. Wear a helmet that meets Australian standards while riding, ride within your limits and walk the bike when not confident. Wear bright clothing and use lights at night. Carry bike repair and a first aid kit.
Mountaineering
Broadly, mountaineering risks break down into exposure and trauma. The origins of these risks are either subjective (human error) or objective (environmental, which may be minimized but not eliminated). Exposure risks (generally arising from inadequate clothing, nutrition, hydration and exertion) include, but are not limited to, sunburn, windburn, dehydration, hypothermia, asphyxiation, altitude sickness, pulmonary and cerebral edema, and frostbite. Trauma risks (generally arising from climber falls, or debris falls, including avalanches) involve lacerations, broken bones, fractures, punctures, concussion, rope burn, and bruising. In turn these may result in brain damage, permanent disability or death.
Climbing
Risks include, but are not limited to sunburn, hypothermia, dehydration, bites from snakes, spiders, insects or other animals, rope burn, strangulation or other injuries due to entanglement in climbing equipment, tendinitis or tendinosis, abrasions, cuts, lacerations, exposure to blood transmitted diseases such as hepatitis or HIV, muscle strains, sprains, broken bones, spinal injuries, brain damage, temporary or permanent disability or death.
Climbing wall
Risks include, but are not limited to rope burn, strangulation or other injuries due to entanglement in climbing equipment, tendinitis or tendinosis, abrasions, cuts, lacerations, exposure to blood transmitted diseases such as hepatitis or HIV, muscle strains, sprains, broken bones, spinal injuries, brain damage, temporary or permanent disability or death.
Inland and sea kayaking
Risks include, but are not limited to drowning, physical injuries (including muscle strains, sprains, broken bones, spinal injuries, shoulder dislocations, bruising, abrasions, cuts, lacerations, falls), bites or attacks from sharks, snakes, spiders, insects or other animals, hot weather hazards (including sunburn, heat stress, heat stroke); cold weather hazards (including exposure and hypothermia), becoming lost in a winter wilderness environment and driving in hazardous conditions.
Cross Country Skiing
Risks of cross country skiing include but are not limited to cold weather hazards (including hypothermia and frost injury), falling or colliding while skiing, becoming lost in a winter wilderness environment, failure of equipment, sunburn or snow blindness, avalanches, and driving in hazardous conditions.
Bushwalking
Risks of bushwalking include but are not limited to hot weather hazards (including sunburn, heat stress, heat stroke and bushfires), exposure and hypothermia, fatigue and cramps, dehydration, falling in rough terrain (including areas with cliffs), being struck by falling objects, bites and stings from flora and fauna (e.g. snake bite may lead to severe illness or death), being split from the group and becoming lost/delayed.
Snow shoeing
Risks of snow-shoeing include but are not limited to cold weather hazards (including hypothermia and frost injury), falling, exposure and dehydration, fatigue and cramps, becoming lost in a winter wilderness environment, failure of equipment, sunburn and snow blindness, avalanches, and driving in hazardous conditions.
Canyoning
Risks may include, but are not limited to sunburn, hypothermia, dehydration, drowning, becoming trapped in enclosed spaces, bites from snakes, spiders, insects or other animals, rope burn, strangulation or other injuries due to entanglement in climbing equipment, tendinitis or tendinosis, abrasions, cuts, lacerations, exposure to blood transmitted diseases such as hepatitis or HIV, muscle strains, sprains, broken bones, spinal injuries, brain damage, temporary or permanent disability or death.
Rogaining and orienteering
Ricks may include, but are not limited to hot weather hazards (including sunburn, heat stress, heat stroke), cold weather hazards (including exposure and hypothermia), bites and stings from flora and fauna, abrasions, cuts, lacerations, fatigue, mental confusion, cramps, dehydration, falling in rough terrain (including areas with cliffs), being struck by falling objects, muscle strains, sprains, broken bones, spinal injuries, brain damage, temporary or permanent disability or death, becoming lost in remote wilderness conditions, driving in hazardous conditions and participating in an activity which may be many hours from or completely inaccessible for medical assistance.
Attachments
Downloadable versions of the material on this page:
