I, the undersigned, wish to participate in this activity/event.

I understand that although the organisers, Benevolent Society, have made attempts to minimise risk of personal injury, participation in an activity program involves inherent risks of injury that may arise due to my participation in this workshop.

I choose to participate in this activity/event at my own risk and that I should seek advice from my GP prior to commencing any new physical activity program.

Benevolent Society does not accept responsibility for the loss or damage to my personal property arising prior to, during or after the activity/event. It is my responsibility to take out insurance for all items in my possession should it be necessary.

In the event of emergency, I authorise the activity program leaders (Carer Gateway Team), where communication cannot be made with me to arrange for me to receive medical treatment as it may be deemed necessary.