- Date of Birth / Age:
- Email Address:
- Hotel name and room no.:
- How did you hear about Rip Curl School of Surf?
In consideration of the acceptance of my offer to participate in lessons at the Rip Curl School of Surf, I have read, understood, approved and agree to the following terms and conditions:
None of the following Medical conditions apply to me
- HEART CONDITIONS
- A PREVIOUS INJURY THAT MAY REOCCUR
- I accept that the sport of surfing carries with it some degree of risk both to the person and property. Knowing the risk involved, I still wish to register for lessons with the Rip Curl School of Surf and so expressly agree to assume the risk of injury or damage while participating in this activity.
- I release, waive and hold harmless Rip Curl School of Surf, its officers, agents and/or employees from all claims, losses, damages or expenses during or in conjunction with my participation in Rip Curl School of Surf, including any claims for damage caused by the negligence of Rip Curl School of Surf, its officers, agents and/or employees, together with any cost including legal fees that may be incurred as a result of any such claims, losses, damages or expenses whether valid or not.
- I also indemnify the Rip Curl School of Surf, its officers, agents and/or its employees against all claims losses damages, expenses or claim that any one or more of their executors, administrators, heirs, next of kin, successors or assignees may have and against any costs including legal fees that may be incurred as a result of any such claims, losses damages or expenses whether valid or not.
- If I am not a resident of Indonesia, I declare that I will not avoid Conditions (B) or (C) by commencing any legal action in another country.
- I declare and confirm that I am physically fit and have no conditions or injury that could be affected by this activity (as previously stated).
- I hereby consent to receive medical treatment which may be deemed necessary by Rip Curl School of Surf in the case of injury, accident or illness during the course of undertaking a surfing lesson and also agree to indemnify Rip Curl School of Surf in the respect of such medical treatment.
- I accept responsibility for the equipment, including surfboard, helmet and rash shirt in which the Rip Curl School of Surf has allocated to my name. I hereby agree to pay for all repairs or replacement in such case of negligence.
- I agree to waiver all responsibility and medical insurance coverage from the Rip Curl School of Surf when refusing to wear the supplied helmet.
- I agree that any films, sound or other recording of my surfing lessons will not be used in any promotion or advertising without the prior consent of Rip Curl School of Surf. I also agree the company itself may use such recordings as it deems fit without any prior consent.
- I agree that this agreement shall be governed in all respect by and in accordance with the laws of Indonesia.
Full Name ___________________________________________________________________
Signature ________________________________ (Parent’s or Guardian’s Signature if under 18)
This Day ____________________________________________________________________
In the presence of __________________________________________________ (Receptionist)