Fly Factory Waiver & Contract

Full Name*
Email*
DOB*
Address*

City*
Does the participant have experience in any of the following:*OtherDanceCircusCalisthenicsGymnasticsNone
Visit Type Birthday/PartyCasual ClassTerm EnrolmentSchool Holiday ProgramOther
If visit type "party", please provide the name of the person hosting the party

Parent/Guardian

Full Name*
Address*

City*
Home Phone
Mobile*
Email*
I give permission for my child to be photographed whilst at Fly Factory and for those photographs to be used for marketing purposes including (but not limited to) the Fly Factory website and Social Media pages:I agreeI do not agree

Emergency contact

Full Name*
Telephone*

Medical History

General Health*ExcellentGoodFairPoor
Please provide details of any relevant Allergies, Medication / Past Injuries:
Family doctor*
Telephone*
Medicare number*
Do you have ambulance cover*YesNo
In the case of an emergency where yourself or any of the above people cannot be contacted, do you authorise a staff member to call an Ambulance and seek required assistance?:*YesNo

Participant Agreement

This Agreement executed the date shown below by and between Flying Trapeze Australia Pty Ltd, hereinafter referred to as FTA, and the Participant, who has caused his/her signature to be affixed hereto, thereafter referred to as Participant.

The Participant hereby engages and employs FTA to teach him/her the art of flying trapeze and/or circus skills and agrees to compensate FTA for instructional service rendered.

The Participant acknowledges as explained to him/her by an FTA employee the procedures and exercises involved in flying trapeze and circus skills instruction, participation and performance. The Participant understands that there is a risk of personal injury involved in said course of instruction and with this knowledge agrees to indemnify and save harmless FTA from all losses caused by accident to the Participant in the event that the Participant is injured in any way during the performance and execution of flying trapeze and all circus skills instruction. Because of the physical demands of flying trapeze and circus skills instructions, the Participant understands that he or she must be in good physical condition to partake in said instruction and hereby certifies that he or she is in good physical condition.

By selecting the "I Accept" button below, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions.

I accept*

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Full Name*
Email*
DOB*
Address*

City*
Home Phone
Mobile*
Does the participant have experience in any of the following:*OtherDanceCircusCalisthenicsGymnasticsNone
Visit Type Birthday/PartyCasual ClassTerm EnrolmentSchool Holiday ProgramOther
If visit type "party", please provide the name of the person hosting the party

Emergency contact

Full Name*
Telephone*

Medical History

General Health*ExcellentGoodFairPoor
Please provide details of any relevant Allergies, Medication / Past Injuries:
Family doctor*
Telephone*
Medicare number*
Do you have ambulance cover*YesNo
In the case of an emergency where yourself or any of the above people cannot be contacted, do you authorise a staff member to call an Ambulance and seek required assistance?:*YesNo

Participant Agreement

This Agreement executed the date shown below by and between Flying Trapeze Australia Pty Ltd, hereinafter referred to as FTA, and the Participant, who has caused his/her signature to be affixed hereto, thereafter referred to as Participant.

The Participant hereby engages and employs FTA to teach him/her the art of flying trapeze and/or circus skills and agrees to compensate FTA for instructional service rendered.

The Participant acknowledges as explained to him/her by an FTA employee the procedures and exercises involved in flying trapeze and circus skills instruction, participation and performance. The Participant understands that there is a risk of personal injury involved in said course of instruction and with this knowledge agrees to indemnify and save harmless FTA from all losses caused by accident to the Participant in the event that the Participant is injured in any way during the performance and execution of flying trapeze and all circus skills instruction. Because of the physical demands of flying trapeze and circus skills instructions, the Participant understands that he or she must be in good physical condition to partake in said instruction and hereby certifies that he or she is in good physical condition.

By selecting the "I Accept" button below, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions.

I accept*

[recaptcha]