NCP WAIVER

Warning: You cannot come onto the property, walking or driving in, or to play polo unless you sign this waiver.

Provider details

Niall F Coburn, Noosa Country Polo Inc No. 1A4490621 and Noosa Country Polo Events Pty Ltd ACN 650480676 (Noosa Country Polo)
83 Tunba Court, Cooroy Mountain QLD 4563

Our Emergency Contacts

Eileen (illy) Coburn: 0400 196 550
Niall Coburn: 0488 488 649

Our Preferred Veterinarian

Ben Poole
COOROORA Qld 4563
Phone: 0418 762 007

Warning and Waiver of Liability for attending or participating in polo activities

Noosa Country Polo Inc No. 1A4490621, Noosa Country Polo Events Pty Ltd, and their licensees (collectively “Noosa Country Polo”) operate and host events on the property located at 83 Tunba Court, Cooroy Mountain QLD 4563 (“the Property”) owned by Niall Coburn. For the purposes of this document, the Polo Activities means participation or attendance in polo, polo lessons, riding, riding lessons, agistment and handling of agistee’s horses, spectating, walking, bike riding on the property, driving a car or truck on the property or attending a polo event and use of facilities at Noosa Country Polo.

"*" indicates required fields

Participant or Attendee Details

The following effects your legal rights and obligations. Please read this document carefully and only sign it if you fully understand the contents. For Participants and Attendees under 18 years of age, these documents must be completed by a parent or legal guardian. The participation or attendance in the Polo Activities at Noosa Country Polo contains elements of risk, both obvious and inherent. The risks involved may result in property damage and/or personal injury including death.
DOB*
Date of birth
Address*
Emergency Contact(s)*
Emergency Contact(s)
Full Name
Relationship
Best Phone
 

Declaration & Signature

I have read carefully and understand this risk warning and waiver of liability and sign it freely and voluntarily without inducement of any kind.
Name of person signing this form (where participant is under the age of 18)