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C4C Registration – K’gari 2024
I am registering to be a
Address Line 1
Address Line 2
State / Province / Region
Antigua and Barbuda
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Cocos (Keeling) Islands
Congo (Democratic Republic of the)
Eswatini (Kingdom of)
Falkland Islands (Malvinas)
French Southern Territories
Heard Island and McDonald Islands
Iran (Islamic Republic of)
Ireland (Republic of)
Isle of Man
Korea (Democratic People's Republic of)
Korea (Republic of)
Lao People's Democratic Republic
Micronesia (Federated States of)
Moldova (Republic of)
North Macedonia (Republic of)
Northern Mariana Islands
Palestine (State of)
Papua New Guinea
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
Sint Maarten (Dutch part)
South Georgia and the South Sandwich Islands
Svalbard and Jan Mayen
Syrian Arab Republic
Taiwan, Republic of China
Tanzania (United Republic of)
Trinidad and Tobago
Turks and Caicos Islands
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Vatican City State
Venezuela (Bolivarian Republic of)
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Date of birth
Emergency Contact Phone
Please list any current health conditions/concerns
Details of current medications
Year of last tetanus injection
Do you object to blood transfusions
Details of private health insurance
Name and phone number of your GP
I agree to the terms of the medical release
If emergency medical care is required for myself and if I, or an accompanying spouse or relative, am not able to convey permission in a timely manner, then I authorise appropriate emergency medical care as deemed necessary by emergency medical personnel, a physician or the medical facility providing treatment.
Terms and Conditions
I agree to the terms and conditions
CHALLENGE FOR CHANGE 2024 EVENT TERMS AND CONDITIONS
The following are the terms and conditions of entry of Challenge for Change events (ABN: 17 133 069 002) held during 2024. These terms are not negotiable and by paying the entry fees for any Challenge for Change event, you are acknowledging that you accept the terms and conditions. For participants under the age of 18, a parent or guardian must accept. I agree to participate in this event on the following basis:
1. I release and indemnify all persons or corporations associated directly or indirectly with the conduct of the event from all liability, claims and costs whether in negligence or otherwise in connection with my participation in this event. This release shall extend to and include the organisers and project partners (event sponsors, event funding bodies, beneficiaries and their respective committee members, directors, employees, contractors, volunteers and representatives, the owners, licensees and occupiers of land and property upon which the event/s or any part of it is conducted including statutory bodies and local authorities). The indemnity includes an indemnity against any claims made for or on behalf of the participant who is a minor.
2. I understand that this event may involve walking on public roads used by other traffic in close proximity and I am aware of and accept the hazards involved. I understand that events may be held on public roads which will not be closed to traffic.
3. I agree (or have counselled the minor) to abide by the road rules of each state through which the event may pass and to follow directions given by the organisers and police.
4. I accept that the event involves the real risk of serious injury or even death from causes including but not limited to; overexertion, equipment failure, dehydration, accidents with other event participants, spectators or road users, weather and other conditions.
5. I am over 18 years of age and of sufficient competence and fitness to take part in the event. (If the participant is a minor, then the parent/guardian signing this Deed consents to the minor’s participation and certifies that the minor is fit and capable of participating in the event.
6. I am (or the minor is) in good health and physically and mentally capable of completing the event. I acknowledge that if I am aware of an existing medical condition and uncertain of my state of fitness then a medical practitioner should verify my physical condition. I agree to advise the event organisers if I have a specific medical condition that may affect my own safety or the safety of others.
7. Safety precautions undertaken by the organisers (such as course supervision, safety briefings and equipment checks) are a service to me and other participants but are not a guarantee of safety.
8. I agree to (or shall direct the minor to) wear event identification and sponsorship materials as provided.
9. I acknowledge that private (the participant’s) support vehicles are not permitted along the route during the event/s.
10. I acknowledge that in registering for participation in the event, I may receive event information from Challenge 4 Change. I will read all the information pertaining to the event sent by the organisers including by hardcopy and email. As a parent/guardian, I agree to convey the information to the minor participant.
11. I acknowledge that film/video footage and still images may be taken by other participants, the organisers and official photographers and that these images may be used by the organisers and project partners for promotional and publicity purposes, operational assessments and related activities. I consent to the use of such images for these purposes. I acknowledge and consent to the event organisers providing my personal details (limited to participant number, full name and email address) to official photographers for the purpose of promoting photographs from the event.
12. I acknowledge that I am fully responsible for the security of my personal belongings, including any valuable items within the area that the event is conducted. The organisers and project partners will not be liable for replacement of any personal possessions.
13. If I wish to withdraw from the event, the following cancellation policy will apply:
• Entry fees may be refunded up to four weeks prior to the commencement of the event minus administration costs only.
• No refunds will be offered within four weeks prior of commencement of the event.
14. Conduct, which in the opinion of the organisers has, may be or will result in a breach of these conditions, harm or damage to any participant or their property, illegal activity, bad language, or other unsocial behaviour, may result in removal from the event.
15. The organisers have the right to veto, edit or delete personal blog entries of participants that are deemed to have content that is defamatory, slanderous or otherwise offensive and which may bring the event, event organisers, project partners and/or other participants into disrepute.
16. The organisers reserve the right to refuse admission to the event to any person without providing a reason, even though that person may have been previously accepted as a participant in the event.
17. The organisers and project partners are not liable to the participant for any loss, damage, cost or expense of any kind if the participant is denied access to, or removed from the event for any reason.
18. The organisers reserve the right to change the accommodation, venues, the route, any information published about the event or items provided on the event without notice, and are not liable for any extra costs incurred by the participant as a result of these changes.
19. The organisers are not liable to the participant for any loss, damage, cost or expense of any kind due to program changes, poor weather before or during the event or postponement or cancellation of all or part of the event due to circumstances beyond the control of the organisers including, but not limited to; weather, safety, theft, disaster, accident, strike or direction by any government authority.
20. The participant is responsible for any damage and/or costs incurred to the organiser’s equipment that has been loaned and/or any spare parts given to the participant during the event.
21. If the participant is under 18 years of age (the minor) these terms and conditions must be signed by the legal guardian or parent of the minor who, by signing these terms and conditions, warrants that he or she holds that position and the indemnity and that terms and conditions contained in this Deed apply to any claim made by or on behalf of the minor.
22. By entering the event, the participant agrees to be bound by these conditions.
I am paying the following amount today:
Deposit (balance due 16 June 2024) – $250.00
Walker Registration (full) – $895.00
Support Crew Registration (full) – $765.00
The registration fee covers accommodation, meals, transport during the event and other costs associated with running the event. We can provide transport from Brisbane or you can meet us at Rainbow Beach. Challenge for Change shirts or hoodies will be extra.
Stripe Credit Card