I understand that Care Squared will contact me in the event of an accident, injury, trauma, or illness. I agree to collect or make arrangements for the collection of my child/children if they become unwell during the activities program. Should Care Squared be unable to contact me, I authorize the following person to be contacted to collect and care for my child/children (including consent to medical treatment and requesting or permitting administration of medication:

I understand that Care Squared does not have personal accident insurance cover for my child/children. If my child is injured as a result of an accident or incident, all costs associated with the injury, such as medical assistance or treatment (including transportation costs), are the responsibility of myself, the parent/guardian.

I am aware that for my child/children’s safety, I must sign my child in and out each day.

I hereby and forever release, discharge, indemnify and hold harmless Care Squared Pty Ltd and its agents for any accidents, harm, loss, or damage which my child may suffer or sustain in any way connected to the activities as a part of any Intensive Allied Health Program. I am aware that your program, in addition to usual dangers and risks inherent, has certain additional dangers and risks, some of which may include: physical exertion for which my child may not be prepared, weather extremes subject to sudden and unexpected change, remoteness to normal medical services, evacuation difficulties if my child has a disability.

I authorize staff, in the event of an accident or illness, to obtain all necessary medical assistance and treatment for my child and I agree to meet whatever cost may be incurred in respect of the provision of any necessary medical services. In the event of my child requiring medical attention, I understand that Care Squared workers will endeavour to communicate with me concerning the required action. I also agree that Care Squared staff are not responsible for theft of clothing or valuables during my child’s involvement in this program. The information I have provided on this form is correct.

Liability for Damages: For any damage incurred by the participant the quote for repair will be arranged by Care Squared to be paid by the participant within 14 days.

I agree to the following:

I acknowledge that participation in activity programs delivered by Care Squared involve certain risks and could result in some possible personal injury. I accept that, despite precautions being taken by Care Squared Staff, accidents and incidents causing physical injury may occur. I declare my child/ children able to reasonably participate in the chosen activities. All details relating to my child’s medical, physical or management needs that are relevant to the care of my child by Care Squared staff and/or that may affect my child’s participation are listed on Page 2 of this document.