*1.Your details(Required.)

Name

Age

DOB

Phone Number

Email

Address

Postcode

*2.Please tick to confirm you have read and understood the group’s policies
These include but are not limited to the group rules, child protection, data protection and zero tolerance policies. (Available both online or in paper at the meet-ups)(Required.)

Please tick to confirm you have read and understood the group’s policies

*3.Medical Consent Form(Required.)

In case of emergency All About Us – ASD Teens has got my consent to authorise medical care for

In case of emergency All About Us – ASD Teens has not got my consent to authorise medical care for

*4.Continued: Medical (Required.)

My family doctor is

Address

Phone Number

Medication and Allergies (Please list)

5.Emergency contact Details (in order of preference)

First Contacts Name

Phone Number

Second Contacts Name

Phone Number

Third Contacts Name

Phone Number

*6.All About Us – ASD Teens

Accident Form

We would be grateful if you could read this form carefully, sign it and return it to us.

1) I acknowledge that All About Us – ASD Teens provides recreational services ONLY, it does not provide child care services, and activities should not be used for such purposes.

2) I understand that there may be occasion that activities will be off-site and that this Waiver applies to all field trips, excursions, and any and all other off-site activities, regardless of where these programs or activities take place.

3) I agree that participation in any activity affiliated with the group is an acknowledgement that I have inspected the premises, facilities, equipment and that I find them to be safe for my child(ren)s observation, use, and participation.

4) For myself and anyone who claims on my behalf, I forever release and promise not to sue All About Us – ASD Teens, its Trustees, volunteers, and/or any other person or company in any way associated with the group, to the maximum extent allowed by law, from any and all liability, claims, demands, damages, or any other legal responsibilities in any way related to the group or its facilities or participation in any of the programs, events, or activities. This release includes without limitation any and all claims, foreseeable and unforeseeable, relating to physical or other injury, death, or damage to property and any and all claims relating to negligence or negligent instruction, hiring, supervision, inspection, or maintenance.

5) I forever assume full responsibility for any and all risk, known and unknown, of bodily injury, death, or property and other damage to my child(ren) both foreseeable or unforeseeable to the maximum extent allowed by law, while in, about or upon the premises of the group, while using the premises or any group facilities or group equipment, or while participating in any activity affiliated with the group, whether or not the injury occurs on the group's premises. I understand the risks inherent in the activities that the group carries out and assume all such risks, as well as all non-inherent risks.

I intend that this Waiver be as broad and inclusive as permitted by law and that, if any portion of this Waiver should be deemed invalid, the remainder will continue in full legal force and effect. I also intend that this Waiver will remain in full legal force and effect forever, regardless of whether or not my child(rens)s registration has expired.

I have read, understand, and voluntarily sign the All About Us –ASD Teens Disclaimer, Assumption of Risk, and Waiver form. I further agree that no oral representations, statements, or inducements apart from the foregoing Waiver have been made. By signing this Waiver, I have agreed to all of the Waiver's terms and conditions.(Required.)

Signed

*7.Photo/video consent form
We would be grateful if you could fill this form in to give us permission to take pictures and/or videos and to use these in our printed and online publicity, thank you.(Required.)

I do give permission for All About Us – ASD Teens to take photographs and or videos

I do not give permission for All About Us – ASD Teens to take photographs and or videos