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  • Activity Participation Agreement & Medical History Form

    Please carefully read & complete this form to confirm your attendance.
  • Completing this Form, reading and agreeing to the Terms of this Agreement is a pre-condition of your attendance into the event nominated below.   

    Please note, to complete this document you will be required to provide details such as your Doctors phone number, your Medicare Number and Health Insurance Policy details.  We suggest you have this information on hand at the time of completing this Form, as an incomplete form may result in de-enrolment into the event nominated below, and you may not be eligable for any refund of monies paid.

    In the event changes to this Activity Participation Agreement & Medical History Form need to be made after submitting, please ensure you email Real Education at customerservice@realeducation.com.au and provide a full detailed list of all relevant information relating to your health and wellbeing to ensure you still remain eligable to attend the Workshop/Seminar/Program.

    • Specific Workshop/Seminar Information  
    • We thank you for your willingness to contribute, and appreciate the time taken away from family and other commitments to support in this great cause.

    • We confirm you are no longer available to Crew on this event, and thank you for your notification.   

      To submit this form, after completing Question 1 below, please go to the very bottom of this document, after the Full Standard Terms & Conditions, in order to select the submit button

    • 1. General Information

    • To assist Crew and Participants in reducing administration time submission of one full Activity Agreement and Medical History Form once a year - only on the basis that you confirm every other event for that year that the details on the first Activity Agreement and Medical History Form submitted for that year are unchanged.

      It will be your responsibility to advise Real Education of any and all changes immediatly.  If you choose to submit only one full Activity Agreement & Medical History Form once a year then you confirm when completing any subsequent Medical History & Activity Agreements that the information provided in the first document is still current, true and correct and that agree, if you omit to notify Real Education of any and all changes to the information contained in your first document, Real Education will not be held responsible for any detrimental impact or effect this may have or create as a result. 

      If this is your subsequent Activity Agreement and Medical History Form for the current year, please read over your first/initial Activity Agreement and Medical History Form before answering the following questions, and to ensure those answers are still current, true and correct.

    • You have selected "NO I do not confirm".  You will be required to complete the full Activity Agreement and Medical History Form.

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    • If you answer NO, or if you arrive and are
      1. unwell or have Covid19 symptoms
      2. have been tested positive to Covid19
      3. have been in a Covid19 hotspot within 14 days prior to the event commencing

      you will be unable to attend the event and Participants will be transferred to the next event. 

      If you answer YES you agree to complete a Covid19 Wellbeing Screening no sooner than the day before the event commences. And you further consent to having your temperature taken at registration on your arrival to the event.

    • 2. Emergency Contact

      "ICE" In Case of an Emergency
    • I confirm that my Emergency Contact details remain unchanged from my previous Activity & Medical History Agreement Form previously submitted earlier this year.

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    • 3. Psychosocial History

    • I confirm that my Psychosocial History details remain unchanged from my previous Activity & Medical History Agreement Form previously submitted earlier this year.



    • 4. Medical History

    • I confirm that my Medical History details remain unchanged from my previous Activity & Medical History Agreement Form previously submitted earlier this year.

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    • Do you have, or have you had, any of the following conditions or symptoms?

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    • NOTE: Further to your terms and conditions of your attendance, if you are legally blind or have a physical disability, we will have to assess your participation in this Workshop.   We will require further information and or possibly medical clearance, given the nature of the Workshop and the facilities at our chosen venue.  We hold the right to cancel enrolments and give full refunds if the venue and facilities are not suitable for your specific needs.

    • If you answered YES to the above 2 questions, please explain further in section 5. below, titled ‘Medical History Detailed Responses’.

    • 5. Medical History Detailed Responses

    • If you answered YES to any of the Medical History questions above, please explain below.  Include the following:         

               *   What specific symptoms are occurring     *   How you care for symptoms/conditions

               *   How often symptoms/conditions occur     *   How symptoms/conditions restrict your activity

               *   How long symptoms/conditions last         *   Date of last occurrence

    • 6. Medications, Allergies & Diet

    • I confirm that my Medical details regarding Medication & Dietary requirments remain unchanged from my previous Activity & Medical History Agreement Form previously submitted earlier this year.

    • Due to legal constraints Real Education crew are not permitted to administer analgesics (Panadol, Asprin etc).  A letter from the participant’s doctor stating that there is no allergy may assist in the case of an emergency.

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    • 7. Declaration

    • Please read below for full Standard Terms & Conditions *In order to SUBMIT this FORM you must Agree to the T&C's, electronically Sign.  
    • This Agreement covers all events that you as an individual participating in any capacity or role before, during or after the Activity.

      1.  Term of this Agreement

      This Agreement remains in place and applies in every instance where the Mentor Coach / Participant / Crew Member / Reviewer / Guest participates in the Activities.

      2.  Rights of a Consumer

      This Agreement does not purport to or have the effect of excluding, restricting or modifying the application of any of the provisions of the Fair Trading Act or the Trade Practices Act 1974 (Cth) or the exercise of a right of conferred by any such provision or any liability for a breach of condition or warranty implied by such provision.


      3.  Governing Law and Jurisdiction

      This Agreement is governed by the laws of Queensland.  In relation to it and related non-contractual matters each party irrevocably submits to the non-exclusive jurisdiction of courts with jurisdiction there, and waives any right to object to the venue on any ground. 

      4. Agree that this Release, Waiver of Liability and Indemnity is intended to be as broad and inclusive as is permitted by the laws of Queensland and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.I also acknowledge that I have read this Release, Waiver of Liability, and Indemnity, fully understand its terms, understand that I am assuming full risk of participating in the Activities and using the facilities and has signed this Agreement freely and voluntarily without any inducement, assurance or guarantee being made and intends their signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

      5.  Entire Agreement

      This Agreement constitutes the entire agreement between the parties and shall supersede all other negotiations, representations, proposals and agreement whether oral or written with respect to the subject matter of this Agreement.

      6.  Privacy Statement

      6.1 This Privacy Statement sets out the Providers obtains, uses and discloses information about you. We are bound by the National Privacy Principles set out in Schedule 3 of the Privacy Amendment (Private Sector) Act 2000 ("the Act"). We are committed to providing a high level of privacy in relation to all Personal Information that is collected by us.  You consent to the privacy statement by signing this Agreement.

      Personal Information is information about your health, your contact details, and your bank account details.  The types of Personal Information generally collected by us include your name, address, mobile and telephone numbers, facsimile number and e-mail address, payment details, whether you are on any medication and other health related information that is necessary to properly advise you about fitness training. Personal Information is also collected when you provide business cards or other documentation to us containing such Personal Information. Personal Information also includes information we collect in the course of providing services to you and communications between you and us.

      6.2 Any Personal Information that we collect about you will be used and disclosed by us so that we can provide you with the best training program to suit your needs. For example, we must make all of our instructors aware of information about your health, so that they can safely advise about training programs. If we were to sell our business, we may disclose your Personal Information to the purchaser of the business.

      6.3 We will add your name, address, mobile and telephone numbers, facsimile number and e-mail address to our database which may be used for marketing purposes such as providing to you new offers in relation to Activities. If we retain your Personal Information, you have our commitment to your privacy.

      6.4 We do not and will not rent, sell or otherwise disclose your Personal Information to any other company or organization, without your prior consent where that consent is required by law.

      6.5 Subject to what is permitted by law, the types of third parties we may disclose your personal information to include, where relevant:

      credit reporting agencies;
      our agents, contractors and external advisers whom we engage from time to time to carry out, or advise on, our functions and activities;
      your agents and contractors, including your finance broker, builder and settlement agent and your legal or financial adviser;
      your executor, administrator, trustee, guardian or attorney;
      our referees;
      regulatory bodies, government agencies, law enforcement bodies and courts;
      any person or organisation who introduces you to us;
      other organisations with whom we have alliances or arrangements for the purpose of promoting our respective products and services;
      any agents used by us and our business partners in administering such an arrangement or alliance;
      debt collecting agencies;
      other financial institutions;
      external payment systems operators;
      your and our insurers or prospective insurers and their underwriters;
      any person to the extent necessary, in our view in order to carry out any instruction you give to them by us;
      other organisations (including our related bodies corporate) and their agents for the marketing of specific products and services (unless you tell us not to.)
      16.6 We use all reasonable endeavours to secure your Personal Information and to keep this information accurate and up-to-date. 

      7.  Statement of Understanding

      I represent that I am participating in the Activities voluntarily and not as a result of coercion, pressure, and or condition of employment or to satisfy anyone other than myself.

      I warrant that all relevant health information has been disclosed to the Provider.

      I understand the Activities are not therapy, nor is it meant to be a substitute for psychotherapy, counselling or any other form of health care.

      I have read, or have had read to me the above terms and conditions and having understood the same, I consent and agree to undertake Real Education Activities on the above terms and conditions of this Agreement.

      OR

      I warrant that I am the legal parent or guardian of the Mentor Coach / Participant / Crew Member / Reviewer / Guest and that I give him/her permission to participate in the Activities.  I have read and understood these terms and conditions and warrant that all of the information that has been provided the Mentor Coach / Participant / Crew Member / Reviewer / Guest is true and correct, and that all relevant health information about the Mentor Coach / Participant / Crew Member / Reviewer / Guest has been disclosed to the Providers.  I understand that I am fully responsible for the Mentor Coach / Participant / Crew Member / Reviewer / Guest  actions whilst undertaking the Activities and that these terms and conditions apply to me as if I was the Mentor Coach / Participant / Crew Member / Reviewer / Guest myself. 


      8.   All Real Education current and future events

      6.1 Act of God Disclaimer In the event of a natural disaster or “act of god” such as but not limited to, Earthquake, Explosions, Fire, Thunderbolts, Storm and Flood, Real Education Accelerated Learning is not liable for including but not limited to injury, damage or loss of property, Workshop/Seminar/Program fees, all travel cost such as airfares and transfers and all accommodation costs.

      At the sole discretion of Real Education Accelerated Learning we may elect to reschedule the event, but  are under no obligation to do so.

       

    • Parental/Guardian permission is given for the Participant under the Age of 18 years of age to attend the nominated Workshop/Seminar/Program by the Parent/Guardian signing below

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