Welcome to WithNature's Registration Form. We keep your personal details to ourselves.

start
 
What's your first name? *

 
Hey {{answer_11692556}}, nice to meet you.

What is your last name?

 
What suburb do you live in? (this helps me locate events so they're convenient for you)

 
And your best contact number?

 
I take all possible care to host WithNature programs with care and consideration and am covered by Public Liability Insurance. However, as the experience takes place outdoors I do have to ask that you agree to take responsibility for your own health and well-being by accepting the terms below.

I warrant and acknowledge: 

That my general health is good and there is nothing which renders me unfit to undertake this event.       

That I understand and appreciate fully that there may well be risks, hazards and dangers involved to which I might be subjected, and I acknowledge my responsibility for participating in these activities.  

More particularly: 

o   that there will not always be protection in the form of fences, buildings and vehicles in which to take cover; 

o   there is the possible exposure to poisonous snakes, spiders, insects and plants and other natural hazards may occur during the course of the event and that trees, ponds, rivers, dams, streams and oceans are part of the natural environment; and, 

o   that I am aware of the potential dangers of exposure to the sun, directly or indirectly, and that serious sunburn may result from unprotected exposure.  

I accept and I voluntarily assume the risk inherent in taking part in this event.    

I acknowledge that while WithNature and its colleagues will make every reasonable effort to minimise exposure to known risks, all hazards and dangers associated with this event cannot be foreseen or may be beyond the control of WithNature and its colleagues. 

I authorise WithNature and its colleagues to render first aid to the level of their competence and to obtain any medical assistance they deem necessary in the event of any accident or illness suffered by me. 

I also authorise qualified practitioners to administer anesthetic, blood and blood products, anti-venom or any medication such practitioners deem necessary.
     
 
Would you like to be added to the WithNature mailing list? You'll receive articles that explore connection with nature and invitations to future events and offerings.

(You can unsubscribe any time)

     
 
I'm committed to offering you outstanding customer service and experience. May I email you after the event for feedback on your experience to help improve WithNature's offerings?

     
 
Thank you for registering for this WithNature event. I look forward to spending some quality time with you in the wild soon! You'll receive any further information you require for your event by email shortly.

Thanks for completing this typeform
Now create your own — it's free, easy, & beautiful
Create a <strong>typeform</strong>
Powered by Typeform