life skills workshops

Which workshop/s would you like to register for? *

You can select as many as you like.

Totally Mild Superpowers - 24 July

Filling our Self-Care Tank - 31 July

Master of Hats - 7 Aug

Participants Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Gender *

Male

Female

Other

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Would you like transport support?

Logan City Council are offering free transport support to help young people attend these sessions.

Yes

No

Emergency Contact Name *

First Name

Last Name

Media Consent

I give full consent for LCC and Ethni to use my images and/or personal information in any or all promotional and marketing campaigns, e.g., television and cinema advertising, promotional DVDs, and any other printed and or audio-visual or website material relating to Ethni and LCC and the Life Skills Development program or other government agencies at the discretion of LCC.

Yes

No

By signing this document I: *

(a) understand that my child participates in the Life Skill Development program at their own risk and acknowledge and accept the level of risk with the activity/workshop and in accordance with the rules specified by the service provider. (b) hereby agree to indemnify and keep indemnified and hold harmless Logan City Council (“LCC”), its employees and servants, the promoter, partners managers, officers, agents, contractors, any club, organisation and volunteers including medical and paramedical personnel appointed for the workshops, the owners’ licensees and occupiers of land in which the activities or any part of it are conducted, sponsors and workshops organisers (“the parties”), from and against all liability for any damage, loss, costs, expense, liability claims demands, actions, proceedings, injury (including death) or dispute including any negligence by the parties arising out of, directly or indirectly, the actions or omissions (whether wilful, negligent or otherwise) by the parties which may be brough by or on behalf of the above named child, however arising out of or in relation to participation in the Life Skill Development program. To be clear, this waiver includes but is not limited to liability for any negligent or tortuous act or omission, breach of duty, breach of contract or breach of statutory duty on the part of the parties. (c) acknowledge that my child has voluntarily chosen to participate in the Life Skill Development program. (d) acknowledge that there is a risk of COVID-19 transmission while participating in this activity. (e) acknowledge my child is fit, healthy, not suffering from any injuries and if appropriate, have a clearance from my child’s doctor to participate in the Life Skill Development program or if my child has an injury, I have advised the provider of my child’s injuries and my child has been cleared to participate. I HAVE READ, UNDERSTOOD AND PROVIDE THE ABOVE RELEASE, WAIVER AND CONSENT I acknowledge that: (a) I am the legal guardian of the child who is named on this form. I hereby covenant and warrant this information true and correct and hereby agree that we shall both be bound by this document. (b) my signature to this document constitutes a complete and unconditional release of all liability of the LCC to the extent permitted by law in the event of me and/or the children under my care suffering injury, death, or permanent disability.

First Name

Last Name