ACTIVITIES ATTENDANCE ROLL CALL
(For use during COVID-19 pandemic)
Leader name
Date
Location
Grading
RISK WARNING and WAIVER of CLAIM. All participants please read carefully before signing below:
In voluntarily participating in this activity of the National Parks Association, I am aware that this may expose me to risks that could
lead to injury, illness, death, or to loss of or damage to my property. These risks include slippery and/or uneven rocks, rocks being
dislodged, swimming, diving, submerged logs, shallow and/or cloudy water, hypothermia, and strong currents. To minimise these
risks, I have endeavored to ensure that: this activity is within my capabilities and; that I am carrying food, water, and
equipment appropriate for the activity. I have advised the activity leader if I am taking any medication or have any physical or
other limitation that might affect my participation in the activity. I will make every effort to remain with the rest of the party during the
activity and accept the instructions of the leader of the activity. I have considered the risks before choosing to sign this Risk Waiver
form. I still wish to join the activity. I agree by signing this form to waive any claim for damages arising from this activity that I may
have against the club, the leader or other participants in tort or contract. My signature below indicates that I have read or heard
and understand these requirements.
Note: For insurance purposes all non-members need to provide a contact number in the box provided.
No
Name
Contact number
Emergency
contact number
Membership
number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Declaration
All participants have been made aware of the conditions of the waive and that by participating they have agreed to comply with and
accept the waiver.
In the event of an emergency, remain calm. Contact 000 using a mobile phone. If the group is not in reception, trigger a personal
locator beacon (PLB).
Please send the form back to Head Office ASAP – NPA, PO Box 528, Pyrmont NSW 2009. or operations@npansw.org.au
If any group member suffers an injury on the walk, they must report the incident to the NPA office by the following morning. Phone:
9299 0000. In addition, trip leaders must submit an incident report (download from Leaders area: bushwalk.npansw.org.au) within
24-48 hours