Paragolfer/Paramotion Indemnity Form

Through Empower Golf, the impossible becomes possible

Empower is a full service disability recreation not-for-profit organisation whose mission is to facilitate and promote the world’s most inclusive sport for people living with disabilities.

This agreement between the Customer and Empower Golf Australia Ltd (“EGA”) must be completed prior to use of the device.

Todays Date

First Name

Last Name

Mobile Number

Address

Address 2

City

State

Postcode

What is the location (s) you wish to use the device

The Customer wishes to use the ParaGolfer/Paramotion for golfing activities at the above location (s).

The Customer acknowledges and agrees that using the ParaGolfer/Paramotion may involve various hazards and risks and possibly dangerous activities. The Customer agrees that all activities and events undertaken by the Customer with EGA will be at own risk and the Customer accepts full responsibility and risk in connection with those activities.

In consideration of EGA agreeing to the Customer using the ParaGolfer/Paramotion for certain risky and dangerous activities at all locations the Customer releases and indemnifies EGA against all liabilities, claims, demands, costs, expenses, losses or damages suffered or incurred by EGA and any other person arising out of or in any way in connection with the events and activities where the ParaGolfer is used by the Customer.

By signing this document the Customer acknowledges that EGA have alerted the Customer to the risks and provided guidance and training which will be implemented and adhered in a responsible manner.

Finally, by signing below the Customer agrees to all of the above and that they will be responsible for paying for any damage to the device.

Signature