Wesley College Parents' Association
Four Wheel Drive Touring and Recreation Club

Melbourne, Australia


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INDEMNITY FORM

IN CONSIDERATION of the WESLEY COLLEGE PARENTS' ASSOCIATION FOUR WHEEL DRIVE TOURING AND RECREATION CLUB (“the CLUB”),

I DO HEREBY indemnify the CLUB, its officers, servants or agents, whatsoever from and against any damages, claims or demands arising out of any accident or illness, or loss of any materials or equipment, which may befall or occur to me, my spouse, my children, my guests or my visitors as a consequence of or arising out of the club’s activities or functions.

I FURTHER AUTHORISE any officers, servants or members of the CLUB in the event of any accident or illness befalling me, my spouse, my children, my guests or my visitors whilst I am engaged in any CLUB activity or function to obtain any medical assistance or treatment whatsoever and for this purpose engage any doctors, nursing assistants or hospital accommodation and in this event I agree to pay all such doctors, nurses or hospital fees and expenses directly to the entitled recipient, or to reimburse on demand the CLUB, any officers, servants, agents or members of the CLUB who might have paid such costs on my behalf.

 

DATED THIS                             DAY OF                                   2001

BOTH PARENTAL MEMBERS TO SIGN:

SIGNATURES:___________________________     __________________________

THIS INDEMNITY MUST BE SIGNED AND HANDED TO A CLUB OFFICER PRIOR TO ANY MEMBER ATTENDING ANY CLUB TRIP OR FUNCTION.

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Last modified: 31-Aug-2007.