Staff Waiver Form

Purpose for this form is to make all participants be accountable for their own actions in regards to what they say and how they practice any of the escapes with a partner. To maintain safety for all participants concerned.

1. Participants Details

Last Name: …………………………….………….Given Names: ……………………………….
Address: ……………………………………………………………………………………………………….
Suburb: ………………………….………………………………..Postcode: ……………………..…
Ph (h)……………………………………………………Ph (w)……………………………………………
Fax (w)…….………………………………………….Mobile:……….………………………………
Email: ………………………….……………………………………………………………………….. Organisation ………………………………………………………………………………………..

2. Waiver and Indemnity

In all other cases and except where inconsistent with the above, the Applicant for him/herself, his/her executors, administrators, dependents and other personal representatives, hereby absolves and indemnifies the providers and all their servants, agents, employees and other persons under the providers control (the “indemnified”) from all liability howsoever arising for injury or damage (including but not limited to the Applicants’ person, whether fatal or otherwise, property and personal belongings) however caused including by the negligence of the indemnified, arising out of or participating in the training or in connection with the training or in anyway caused by, or arising out of, any activity carried on by the indemnified.
I, the Applicant, have been advised and understand that the practice of these techniques is potentially dangerous. I, the Applicant, agree to occupy and use the premises provided at risk to myself and release to full extent permitted by law (Rod Catterall & Associates), The All Star Group of company’s, and its agents, servants, contractors and employees from all claims and demands of every kind in of or resulting from any accident or damage to property or injury or death to myself while undertaking training with the All Stars Group.

3. Training is done at Applicant’s own Risk

Any person training, or in activities connected with or participating in any activity carried on by this Company are only allowed to do so on the distinct understanding that they do so entirely at their own risk.

4. Training not to be taught by Applicant

The Applicant agrees that he/she is in no way qualified or authorized to teach activities carried on by All Stars publically or privately in any way whatsoever for personal, monetary or any form of gain whatsoever unless with the written authorization of Rod Catterall.

5. Training not to be Recorded, Copy Directly or Shared to any Third Party in any way or in Part by Applicant or Organisation in Part by Applicant or Organisation

The Applicant agrees that he/she will not record, copy or duplicate or share any of the information received without the written authorization of Rod Catterall.

6. Agreement to abide by the Rules of Participation

I, the Applicant, agree that I will abide by the Rules of Participation and agree and acknowledge that any failure to abide by Rules of Participation may result in my exclusion from the training.

7. Statement of Understanding

I, the Applicant have read, or have had read to me the above conditions and having understood the same, I consent to the activities proposed.

Signed (Applicant’s) ……………………………………………………………………………………………………………


This (date) …………….day of (month)……………………(Year) 20…………………
in the presence of (signature of witness/ trainer in attendance) ……………………………………………………………………………………………………………