Canteen : Register

Personal Details

First Name *

Last Name *

Alternate display name

Email Address *

Password *

Phone *

Date of birth *

Canteen would like to contact you occasionally to let you know about their cause and assist with your fundraising, please indicate your communication preferences by either selecting 'yes' or 'no.' You can unsubscribe at any time. For more information you can read our privacy policy here: https://www.canteen.org.au/privacy-policy/

Yes No

Postal Address *

Address Line 1 *

Address Line 2 (opt)

Town/Suburb *

Postcode *

State *

Country *

Terms & Conditions

WAIVER

Riders must obey all Western Australian traffic laws, which includes the wearing of approved helmets. Life Cycle For CanTeen (Western Australia) RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT (“AGREEMENT”) IN CONSIDERATION of being permitted to participate in any way in Life Cycle For CanTeen OnRoad (Western Australia) year 2021 Ride Activity, Perth to Busselton Western Australia, 6 - 8 March 2021 inclusive and/or any practice and/or familiarisation rides before the event. I, for myself, my personal representatives, assignees, heirs, and next of kin: 1. ACKNOWLEDGE, agree, and represent that I understand the nature of Bicycling Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further acknowledge that the Activity will be conducted over public roads and facilities open to the public during the Activity and upon which the hazards of travelling are to be expected. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity. 2. FULLY UNDERSTAND that: (a) BICYCLING ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH (“RISKS”); (b) these Risks and dangers may be caused by my own actions, or inactions, the actions or inactions of others participating in Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE “RELEASEES” NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in the Activity. 3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE, Life Cycle For CANTEEN (Western Australia), their respective administrators, agents, members, volunteers and committee members, other participants, any sponsors, advertisers, organisers, and if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the “RELEASEES” herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASEES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, legal fees, loss, liability, damage, or cost which may incur as the result of such claim.

Participants hereby acknowledge that they take part in any bike transfer service entirely at their own risk and hereby agree that they and their dependents waive and shall not have, nor institute any claims whatsoever against, and do hereby indemnify and hold harmless from all liability, Life Cycle for Canteen, the Local Authorities and other involved organizations and all employees, agents, volunteers or contractors of the above (all of which are hereinafter referred to as entities). This waiver and indemnity: Includes death, injury, damage to and loss of property of a participant (including theft of or damage to a bicycle in areas under the control of the above entities); and is effective, whether or not such death, injury, damage or loss may have been caused directly or indirectly or wholly or partly by any act or omission including negligence, of any of the above entities; and will bind the heirs, executors and/or trustees of the estate of a participant. Should liability be found to exist in respect of any one of the said entities for any reason, then that liability shall not exist in respect of the other of such entities, without specific grounds existing for liability on the part of the other of such entities.

Insurance and conditions - in conjunction with waiver

Riders are advised to obtain their own sickness and accident insurance in case of sickness, accident or injury enroute to/from or during the event. School students (who must be 14 years or over at the time of the event and have parental approval to attend) are advised that their school’s insurance may provide 24 hours a day, seven days a week cover at a nominal cost.

Nominees are responsible for their own state of health. The organisers of this event are not medically trained and have no specific ability or skills to professionally assess the health or physical ability of entrants. We recommend that nominees who do not engage in regular and strenuous physical activity seek the advice of their doctor before undertaking this ride.

Before, during and after the event photos of participants may be taken for promotional, media or record purposes. Unless accompanied by a letter specifically stating otherwise (and providing sufficient information to identify the participant) this nomination acts as permission for photos to be taken and used as indicated.

The onus is on each rider to have their bicycle safety checked AND in safe working order for the start of the ride.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILTY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

I UNDERSTAND THAT "LIFE CYCLE FOR CANTEEN" IS A "NO FREE LUNCH" EVENT. THIS MEANS THAT ALL COMMITTEE MEMBERS AND PARTICIPANTS WHO VOLUNTEER THEIR TIME AND EFFORTS GAIN NO BENEFIT.

I UNDERSTAND THAT IT IS MY RESPONSIBILITY TO QUOTE ANY RELEVANT PROMOTIONAL CODE (AVAILABLE ONLY TO CREW / CATERING TEAM) TO OBTAIN A DISCOUNT AND THAT DISCOUNTS OR REFUNDS GRANTED LATER THROUGH NO FAULT OF THE ORGANISERS MAY HAVE TRANSACTION FEES DEDUCTED.

I UNDERSTAND THAT THE EVENT IS ONLY OPEN TO PARTICIPANTS OVER 14 YEARS OF AGE AT MARCH 1, 2021 AND THAT PARTICIPANTS UNDER 18 YEARS OF AGE WILL BE REQUIRED TO PROVIDE PROOF OF PARENTAL PERMISSION.

I UNDERSTAND THAT THE PURPOSE OF LIFE CYCLE FOR CANTEEN IS TO RAISE FUNDS FOR CANTEEN AND THAT OUR AIM IS TO PROVIDE A GREAT VALUE, FUN EVENT WHILE CONTRIBUTING THE MAXIMUM NET AMOUNT TO CANTEEN.

I agree to the above Terms & Conditions *

Doctor Name & Medical Practice *

Doctor's Contact Number *

Emergency Contact and Phone *

Private Health Cover held with *

Private Health Cover member number *

Please enter your Medicare Number *

Ambulance Cover

Please detail any known allergies *

Pre-Existing Medical Conditions *

Please detail any regular medications *

Dietary Requirements *

Which riding group do you anticipate riding in on day 1 *

T-Shirt Size *

Coach return required *

Yes
No
Unsure - please contact Jenny for more details

If you are a return participant, do you give your permission to be a group marshal if required *

I give permission for my photo to be used as deemed appropriate by the committee *

Yes
No

Canteen uses your information to process donations and communicate with you about your support and our work. We will NOT disclose this information with any service providers. Your information will be accessible by the event manager in order to communicate with you regarding the event. For more information you can read our privacy policy here or please make contact if you have any questions about how we will use your information.

Create Account

Already have an Account

Already have an Account with us?

Personal Details

Postal Address *

Terms & Conditions