PARTICIPANT INTAKE FORM

Act Believe Achieve reserves the right to claim payment from the participant for Cancellations and No-Shows. When Act Believe Achieve cancels a scheduled service, no fee will apply. Charges may be waived if you experience a catastrophe, e.g. hospitalisation or death in the family. 

A cancellation is a short notice cancellation if the participant:

• Does not show up within a reasonable time. (1 hour)

• Has given less than 48 hours notice.

How to notify us, to cancel or reschedule with us

Call - 08 9594 0010 (Office)

Email - info@abawa.com.au

In case of Illness or accident- If a situation arises, which requires emergency action, an ambulance will be called and the participant will be taken to an accident or emergency department, the cost of which will be met by the participant. 

I authorise the staff of Act Believe Achieve in charge to administer basic first aid and call an ambulance. 

I agree to bear any cost thereby incurred.

The following pages affect your legal rights and obligations.  Please read these carefully and only sign if you fully understand their contents.  For Participants under 18 years of age, these documents must be completed by a parent or legal guardian.

If yes, please provide details relevant to support delivery or safety (optional):

Animal Care & Husbandry

• Feeding and watering livestock

• Checking animal health

• Cleaning shelters, pens, and stables
  

• Other relevant maintenance tasks

Crop & Pasture Management

• Preparing and planting crops

• Irrigation and watering systems maintenance

• Weeding, pruning, and pest control

• Harvesting fruits, vegetables, or grains

Fencing & Property Maintenance

• Building and repairing fences

• Clearing overgrown areas and removing debris

• Maintaining pathways and driveways

• Repairing farm buildings, sheds, and equipment

Machinery & Equipment Operation

• Using tools for construction and repairs

General Farm Duties

• Checking and maintaining water supplies

• Managing waste and composting

• Observing and recording farm operations

• Ensuring farm safety protocols are followed

Risk Warning

I am aware that by my participation in any activities arranged by the Provider, certain risks or dangers may occur which could include:

Physical, bodily or psychological injury or death.

Physical exertion to which I am not accustomed.

Failure of equipment or use of inadequate equipment.

There may be no or inadequate facilities for treatment or transport to treatment if I am injured.

The conditions in which the activities are conducted may vary without warning.

I may cause injury to other persons and/or other persons may cause injury to me.

I may be injured or die due to the negligence, breach of contract or breach of statutory duty or guarantee of the provider.

I acknowledge that the activities are being undertaken for the purposes of recreation, enjoyment or leisure, and involve a significant degree of risk of physical harm.

I acknowledge that the activity may be undertaken with one or more other persons as part of a group and that the Provider is not liable for the actions of other participants in the group activity.

By signing below, I acknowledge, agree and understand that the risks associated with the activities and/or recreational services have been explained to me.  I undertake any such risk voluntarily and at my own risk. 

I acknowledge that the risk warning above constitutes a “risk warning” in accordance with the  Civil Liability Act 2002 (WA).

I agree to abide by any of the Provider’s rules, and any direction or instruction given to me by the Provider during the course of the activities.  I agree to use and/or wear any equipment given to me by the Provider.

I declare that I am medically and physically fit and able to participate in the activities.  I acknowledge that I must, and agree that I will, disclose any pre-existing medical or other condition, injury or concern that may affect the risk that either I or any other person will suffer injury, loss or damage during the course of the activities and notify the Provider of any injuries, illness or concerns that may arise during the activity.  I will not engage in any reckless, negligent or foolish behaviour or any other behaviour that is likely to cause injury to me, any other participant or person.

I agree that if I suffer any injury or illness, the Provider may provide evacuation, first aid and/or medical treatment at my expense and that my acceptance of these terms and conditions constitutes my consent to such evacuation, first aid and/or medical treatment.

I declare that I have not consumed any alcohol or mind-altering substance, or medication that may impact my judgement or physical capacity, before or at the time of engaging in the activities.

I agree to and unconditionally release, waive, discharge and forever hold harmless, the Provider or any of its employees, agents, directors or officers, from any claims as a result of any personal injury sustained, whether caused by the Provider’s negligent act or wilful act or omission, breach of contract, breach of statutory duty, error, or otherwise in connection with or arising out of the Activities.

I agree that the Provider will not be liable for any claims for personal injury that may be brought against it as a result of or in connection with any act, omission, default, failure or error on the part of the Provider, and agree to indemnify and keep indemnified the Provider in respect of any such claims.

It is possible for a supplier of recreational services to ask you to agree that the statutory guarantees under the Australian Consumer Law (which is schedule 2 to the Competition and Consumer Act 2010 (Cth)) do not apply to you. If you sign this form, you will be agreeing that your rights (or the rights of a person for whom or on whose behalf you are acquiring the services) to sue the Provider in relation to the Provider’s services or the activities that you undertake because the services or activities provided were not in accordance with the guarantees are excluded, restricted or modified as set out below.

For Queensland, New South Wales, Western Australia, Tasmania, Northern Territory and Australian Capital Territory and Commonwealth

By signing this form, you agree that the liability of the Provider in relation to the activities (as defined by the Competition and Consumer Act 2010 (Cth), the Consumer Affairs and Fair Trading Act (NT) and the Australian Consumer Law) and recreational activities (as defined by the Civil Liability Act 2002 (NSW) and the Civil Liability Act 2002 (WA)) is waivered.

Physical or mental injuries (including the aggravation, acceleration or recurrence of such an injury);

The contraction, aggravation or acceleration of a disease;

The coming into existence, the aggravation, acceleration or recurrence of any other condition, circumstance, occurrence, activity, form of behaviour, course of conduct or state of affairs in relation to an individual:

That is or may be harmful or disadvantageous to you or the community; or

That may result in harm or disadvantage to you or community;

That may be suffered by you (or a person for whom or on whose behalf you are acquiring the services) resulting from the supply of the recreational services or recreational activities is excluded.

You acknowledge and agree that the above provision operates to exclude the liability of the Provider as a result of a breach of an express or implied warranty that the recreational services will be rendered with reasonable care and skill in accordance with section 5J of the Civil Liability Act 2002 (WA) and section 5N of the Civil Liability Act 2002 (NSW).

Excluding, restricting or modifying your rights:

Under section 42 of the Fair Trading Act 1987, the supplier of recreational services is entitled to ask you to agree to exclude, restrict or modify his or her liability for any personal injury suffered by you or another person for whom or on whose behalf you are acquiring the services (a third party consumer).

If you sign this form, you will be agreeing to exclude, restrict or modify the supplier's liability with the result that compensation may not be payable if you or the third-party consumer suffer personal injury

You do not have to agree to exclude, restrict or modify your rights by signing this form. The supplier may refuse to provide you with the services if you do not agree to exclude, restrict or modify your rights by signing this form. Even if you sign this form, you may still have further legal rights against the supplier.

A child under the age of 18 cannot legally agree to exclude, restrict or modify his or her rights. A parent or guardian of a child who acquires recreational services for the child cannot legally agree to exclude, restrict or modify the child's rights.

Agreement to exclude, restrict or modify your rights:

I agree that the liability of Act Believe Achieve [the Provider] for any personal injury that may result from the supply of the recreational services that may be suffered by me (or a person for whom or on whose behalf I am acquiring the services) is excluded.

Further information:

Are rendered with due care and skill; and

Are reasonably fit for any purpose which you, either expressly or by implication, make known to the supplier; and

Might reasonably be expected to achieve any result you have made known to the supplier.

Under section 22 of the Australian Consumer Law and Fair Trading Act 2012, the supplier is entitled to ask you to agree that these statutory guarantees do not apply to you.  If you sign this form, you will be agreeing that your rights to sue the supplier under the Australian Consumer Law and Fair Trading Act 2012 if you are killed or injured because the services provided were not in accordance with these guarantees, are excluded, restricted or modified in the way set out in this form.

NOTE: The change to your rights, as set out in this form, does not apply if your death or injury is due to gross negligence on the supplier's part.  Gross negligence, in relation to an act or omission, means doing the act or omitting to do an act with reckless disregard, with or without consciousness, for the consequences of the act or omission.  See regulation 5 of the Australian Consumer Law and Fair Trading Regulations 2012 and section 22(3)(b) of the Australian Consumer Law and Fair Trading Act 2012.

Agreement to exclude, restrict or modify your rights:

I agree that the liability of the Provider for any personal injury that may result from the supply of the recreational services that may be suffered by me (or a person for whom or on whose behalf I am acquiring the services) is excluded.

Declaration and Signature

I have read carefully and understand this risk warning and waiver of liability and sign it feely and voluntarily without inducement of any kind.

For Participants under age 18

This is to certify that I, as a parent/guardian with legal responsibility for the Participant, acknowledge, understand and accept all of the above and consent to his/her release as provided above.  I release and agree to indemnify and hold harmless the Provider from any and all liabilities arising from my minor child’s involvement or participation in the Activities and/or recreational services, even if arising from the negligence of the Provider.

I give, Act Believe Achieve as well as people acting for and with Act Believe Achieve, permission to interview, photograph, video and or audio record to use and to edit, without compensation to me, the items listed below in any medium, including print and electronic (web-based) material for education, promotional and marketing purposes:

• Photographs for video footage of I/We

• Spoken (written or recorded) interviews of I/We and quotes from I/We;

• Full name in connection with the photograph(s), video footage, interviews or quotes; and

• Location in connection with the photograph(s), video footage, interviews or quotes.

Any points above to which are not agreeable have been crossed out.

I will make no monetary or other claim in connection with the authorised use of my name or photograph(s), videos(s), interviews and/or quotes.  I now release Act Believe Achieve and partner organisations and their employees and/or partners in education, promotion, publicity and marketing interviews from any claims, demands, and/or liabilities in connection with the use authorised and agreed to here, by I/We