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2024 Surfer Indemnity

2024 Surfer Indemnity

We ask all Surfers to update their personal details annually or as they change - this will ensure:

  1. *All personal details are current and correct
  2. *Based on this information we are able to understand the needs of the participant
  3. *Everyone will have access to and agree to the Terms and Conditions which include details on safety, media and the Child and Vulnerable Adult Protection Policy

"*" indicates required fields

Surfer's Name*
Email*
Address*
DD slash MM slash YYYY
Gender*

Race*

This information will help us understand your ability, indicate what equipment may suit you better and determine the make up of your support team.
DD slash MM slash YYYY
Date
Provide details of medication, devices, catheters etc that could impact your experience. Include whether you require mobility aids such as walkers or a wheelchair.
How often you experience pain or discomfort? Will you communicate this to the team? or what are the signs we should look out for?
Can you swim unaided for at least 5 minutes?*
I am older than 18 years*
Adult/Parent/Guardian Contact Name*
Emergency Contact's Name*
Alternative Emergency Contact's Full Name*
In the event the first contact is not available
Preferred Doctor's Full Name*
Would you like to receive our newsletter?
I accept the Terms and Conditions*
Terms and Conditions
If on a mobile device, kindly use your finger to sign. If on a PC or laptop, please use the mouse to sign
This field is for validation purposes and should be left unchanged.

2024 © Roxy Davis Foundation | Registered NPC 2019/167824/08 | NPO 235-936 | PBO 930069168Privacy Policy
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Terms and Conditions

In consideration of your acceptance of my participation, I hereby indemnify, absolve, exempt and release the Roxy Davis Foundation, Surf Emporium and all their members, employees, consultants, sponsors, brand partners and their members, agents or affiliates (here after in these terms and conditions below the company will be referred to as Roxy Davis Foundation) against and from liability for injuries, damages, loss or death arising from or in connection with my participation in, use of any equipment, traveling to or from, or present at the Roxy Davis Foundation.

I waive any and all claims whatsoever which I may have arising from or in connection therewith.

I hereby acknowledge that I have read and understood this indemnity and that I have entered into this indemnity freely, voluntarily and of my own volition. I furthermore acknowledge that all information contained in this indemnity is both true and correct.

  1. I am over 18 years old and possess full legal capacity to sign this indemnity;
     or
     I am not yet 18 years old and as such I have not reached the age of majority
    1. In light thereof, I am assisted by one of my parents / legal guardian who has signed this indemnity on my behalf, therefore providing me with the necessary consent to partake in the various activities, as specified on roxydavisfoundation.org   
    2. Moreover, my parent / legal guardian confirms the accuracy of this form and considers it to be binding on themselves. This indemnity applies also in respect of any injury to such minor children
  2. I hereby confirm that I am not suffering from any disease and / or temporary/ permanent physical impairment or any mental disease that may have an effect on my ability to participate safely in the activities mentioned on roxydavisfoundation.org
    1.  If in the event I do have a disease and / or temporary/ permanent physical impairment or any mental disease I will disclose this information to the Roxy Davis Foundation
  3. I hereby undertake not to consume any alcohol and / or harmful substances prior to and / or during the activities, as specified on roxydavisfoundation.org
  4. I am aware that the activities specified on roxydavisfoundation.org may be both dangerous and hazardous, and that by participating in the said activities, it may result in serious injury or death
    1. I further acknowledge that whilst Roxy Davis Foundation takes every precaution to ensure the reasonable safety of its participants, I must exercise reasonable caution when I participate in any of the activities specified on roxydavisfoundation.org
    2. I furthermore acknowledge that I have made adequate enquiries and I am satisfied with the arrangements, safety precautions and facilities that are available vis-à-vis the activities specified on roxydavisfoundation.org
  5. I hereby acknowledge that Roxy Davis Foundation, their instructors and their crew are exempt from accepting any liability and / or responsibility for any injury and / or damage caused whatsoever and / or loss and / or death arising from any negligence or any other cause suffered by myself, arising out of my participation in any of the activities specified on roxydavisfoundation.org
  6. I hereby absolve, indemnify and hold harmless, Roxy Davis Foundation, from any and all liability and / or damages and / or death arising out of any incident and / or accident which may take place whilst I am participating in any of the activities specified on roxydavisfoundation.org
  7. I hereby acknowledge that I will be held liable for any damage to or loss of any equipment for example but not limited to stand-up paddleboards, paddles, surfboards, and / or wet-suits whilst in my possession and / or use. In light thereof, I acknowledge further that I will be held liable for the repair or replacement of said damaged or lost equipment as stated above and will moreover compensate Roxy Davis Foundation for such damage and / or loss of equipment according to the repair, damage and theft policy schedule
  8. I acknowledge that all floors are slippery when wet, and therefore I hereby absolve, indemnify and hold harmless Roxy Davis Foundation from any and all liability and / or damages and / or loss arising out of any accident or incident arising out of the wet floors
  9. I hereby acknowledge that Roxy Davis Foundation expressly reserves their right of admission
  10. I hereby acknowledge that if I do not complete this form, I will not be able to partake in any activity with Roxy Davis Foundation
  11. I undertake to pay all fees due, owing and payable to Roxy Davis Foundation, Surf Emporium, in advance and without deduction or set-off. In addition to the afore going, I acknowledge that any fees paid to Roxy Davis Foundation, Surf Emporium are not refundable for any reason whatsoever
  12. I agree to abide by all rules and guidelines of Roxy Davis Foundation and accept that in the event that I break any, I will be immediately disqualified and dismissed from any Roxy Davis Foundation events
  13. I acknowledge that on occasion events or surf sessions may be affected by the shark spotters displaying the white flag, indicating the possibility of marine life activity inshore or the presence of a shark in the vicinity of Surfers Corner, Muizenberg Beach. I acknowledge that Roxy Davis Foundation endeavor to do their best to be flexible where possible however water access is beyond their control and in the best interest of safety for water users, I agree to adhere to the Shark Spotter and Roxy Davis Foundation recommendation regarding water access
    1. I agreed to adhere to the shark spotters recommendations and will not enter the surf zone when the white shark flag is flying
  14. I agree to ensure my valuables are locked away in the provided lockers and I understand I must bring a lock to secure my locker
  15. Photography:
    1. I hereby authorise and give full permission to Roxy Davis Foundation, their sponsors and brand partners to utilise and make use of any photographs, moving pictures, visuals and / or internet imagery captured of me whilst partaking in any event and / or surfing lesson, and I furthermore acknowledge that I shall not be entitled to receive any payment and or remuneration thereof
    2. The Roxy Davis Foundation will contact guardians of surfers and vulnerable adults to request permission for use of photos outside of their immediate services and netowork when they are made aware of such requests.
    3. Photographers (Paid and ProBono) to the following:
      1. All photographs taken, will be delivered to Roxy Davis Foundation and will be deemed works made for hire. The Roxy Davis Foundation will be sole owner of the photographs and/or videos and of all rights, including copyrights.
      2. Work may be released to any individual or entity through media such as catalogues, brochures, magazines, newspapers, journals, films, television, slides, negatives, prints or computer communications such as the Internet or other means now known or hereafter developed without obligation in any manner to receive permission from the photographer. The photographer may not sell, assign, sublicense, subcontract, or in any other way transfer any right or obligation without the prior written consent of Roxy Davis Foundation.
      3. The photographer represents and warrants that any Work created or prepared will be original, will not infringe upon the rights of any third party, and will not have been previously, assigned, licensed or otherwise encumbered.
      4. The photographer  represents Roxy Davis Foundation and will not engage with Roxy Davis Foundations “model / surfer / volunteer / participant” outside of the contracted photo shoot time. Nor will the photographer pursue the “model / surfer / volunteer / participant” for personal photography without the consent of Roxy Davis Foundation. The photographer will not share any images / media captured directly with any of  the “models / surfers / volunteers / participants”. 
      5. The photographer agrees to defend, indemnify, and hold Roxy Davis Foundation harmless from and against any and all losses, liabilities, damages, and claims of any person related to or arising from the photographer’s activities under this agreement.
      6. The photographer  agrees to hold Roxy Davis Foundation harmless from any claim by a third person for infringement of copyright, or of a person’s right of privacy, or publicity related to Photographer’s actions or omissions.
  16. This indemnity is the entire agreement between Roxy Davis Foundation, and I concerning the subject matter hereof, and no alteration to the terms or any subsequent agreement shall be of any force and effect unless reduced to writing and signed by both parties

I hereby acknowledge that the Roxy Davis Foundation has taken precautions to keep my personal information secure, and such information will not be disclosed to third parties 

  1. The Roxy Davis Foundation does not, and will not sell its contact lists
  2. The Roxy Davis Foundation has taken steps, including the adoption of physical and electronic security measures, designed to prevent unauthorized access, to maintain data accuracy, and to ensure the appropriate use of personal information collected
  3. The Roxy Davis Foundation we will not share any details about minors without parental consent
  4. The Roxy Davis Foundation provides email updates to keep interested visitors to our website informed of developments and events. In order to receive these updates you must provide the Roxy Davis Foundation with your name and email address. This information will be held in complete confidence, and the Roxy Davis Foundation will NOT sell, rent, trade or otherwise reveal this information to a third party. You will be given the option to remove your name from our email list at the bottom of each email update
  5. Please be aware that the Roxy Davis Foundation may provide links to third party websites from our site and we are not responsible for the content or information collection practices of those sites. The Roxy Davis Foundation is not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of each and every website that collects personal information. This privacy statement applies solely to information collected by this website
  6. The Roxy Davis Foundation reserves the right to change their privacy policy at any time without prior notice. In the event that the Roxy Davis Foundation does change its privacy policy, the Roxy Davis Foundation will post those changes on the Roxy Davis Foundation website. Our goal in providing this privacy policy is to ensure that the Roxy Davis Foundation website users are always aware of how the Roxy Davis Foundation uses and discloses personal information
  7. In the event that the Roxy Davis Foundation wishes to disclose your personal information to third parties in a manner not described within this notice, the Roxy Davis Foundation will not do so without first giving you the opportunity to disapprove of such use via email

I hereby acknowledge that I am familiar with and will uphold the Roxy Davis Foundation Child and Vulnerable Adult Protection Policy.

 

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