Loopy Kids Registration Form

Required fields are marked with an asterisk (*).
Participant Details
Date of Birth *
Gender *
Ride selection *
T-shirt size *
Guardian Information
Medication Does the child require any prescribed medication in relation to a specific medical condition that the event organisers should be aware of?
Terms and Conditions
Consent * By agreeing to these terms and conditions, you indemnify City of Prospect, its employees and/or agents against all actions, costs, claims and expenses whatsoever which may be brought or made against any of them arising out of or in relation to any (Loopy Kids) activities.
Indemnity * In the event of any accident or illness sustained by my child, I agree to pay all medical expenses including ambulance/call out fee or any administration, anaesthetic by a registered medical practitioner which is considered necessary. City of Prospect and its supporting partners take no responsibility for any death, injury or damage to any person or property involved in the event. I give permission for photographs and video footage of my child to be used by City of Prospect and its partners in promotional materials including print, electronic publications and online. Photographs and electronic media will remain the property of the event organisers.