LEAD Program and Retreat Registration

Details about you

Please take the time to share your details for registration
Address
City
State/Province
Zip/Postal
Country

Your requirements

Make sure we are aware of your requirements during the retreat and program
We will be providing hoodies to all participants at the retreat to use and take away from the program, so please provide us with your size preference. between extra small (XS) to extra extra large (XXL) You are not guaranteed to receive the exact size but we will do our best.

Emergency Contact Details

Please give us any relevant medical conditions information or two emergency contacts to contact in case medical or other issues arise during the program.

Photos

Please upload a profile photo (e.g. passport style) we can use for our records. A smartphone picture is fine.
Maximum upload size: 516MB

Terms and declaration

I understand that the LEAD retreat and other activities during the program may include some physical exercises. As is the case with any physical activity, I accept that the risk of injury (even serious injury) is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will seek assistance from organisers or facilitators and modify my activity as may be required. I acknowledge and affirm that I am competent to decide whether or not to participate in certain activities and I will make an informed choice before doing so.
I hereby agree to the following:
1. I am fully aware of the risks and hazards involved in attending the LEAD retreat and participating in the program.
2. I represent and warrant that I have no medical condition(s) that might prevent my full participation in group or individual activities, workshops or programs offered by LEAD (including activities like low-rope work or juggling).
4. I will update GSA LEAD organisers as to any changes in my medical condition.
5. I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of my participation. In further consideration, I knowingly, voluntarily and expressly waive any claim I may have against GSA its owners, instructors, workshop and retreat presenters, independent contractors, employees, volunteers, and representatives, for any injury or damages that I may sustain as a result of my participation.
6. I will not engage in any inappropriate conduct that could result in injury to myself or others, including any behavior that breaks the University of Melbourne's Student Conduct Policy - http://policy.unimelb.edu.au/MPF1324.
7. I agree to participate in the program on a challenge by choice basis but will also maintain open and consistent communication with the program organisers in order to make the most of LEAD.
8. I give GSA the express permission to take, use and publish photos and videos of my likeness for the purposes of the program itself or promoting LEAD only and in a manner that is positive and respectful.
9. I agree that this agreement shall be governed by the laws of Victoria and if any conflict arises between me and GSA, I will attempt mediation before submitting my dispute to binding arbitration.