Loading...

Coonawarra Discovery Ebike Waiver and Release Form

 This document sets out a waiver and release form (Waiver and Release form) that applies to your use of any of our equipment, including e-bikes, helmets and any other equipment or accompanying accessories or personal protective equipment (equipment).

Please read this form carefully and be aware that in signing up and participating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity (including transportation services and vehicle operations, when provided).

When you make a booking to hire our equipment, (whether online or inperson) and you click ‘I accept’ (or similar), you agree to comply with and be bound by this Waiver and Release form. This Waiver and Release form is in addition to the hire terms that you must also click to accept when you make a booking (Hire Terms).

1. General

a. You acknowledge that we are providing you a benefit by allowing you to use the equipment.
b. You are at least 18 years old.

2. Dangerous recreational activity

a. You acknowledge and agree that:

a. use of the equipment is a dangerous recreational activity;
b. your use of the equipment may involve a significant risk of serious bodily injury and physical harm, including the risk of serious and permanent injury; and
c. you use the equipment in this dangerous recreational activity at your own risk.

3. Medical conditions and other

a. You confirm that:

a. you are in good health and a proper physical condition to use the equipment;
b. you do not present an abnormal, unusual or unreasonable risk of, and are not susceptible to, physical and psychological injury, including (without limitation) high blood pressure, heart attack, asthma, or other ear, respiratory and circulatory disorders which affects your ability to use the equipment;
c. you are not currently taking any medications that would preclude you from using the equipment;
d. you have not been advised by a qualified medical professional not to use the equipment;
e. in the event you believe the conditions are unsafe or you feel unwell you will immediately discontinue use of the equipment;
f. you are a proficient cyclist and are confident you can use the equipment in a safe manner, including in variable traffic and weather conditions;
g. you will wear a helmet at all times whilst using the equipment (unless you hold a valid exemption under local law) that complies with Australian standard AS/NZS 2063:2008 (or as updated from time to time);
h. you will ensure, on each occasion before commencing a ride that the equipment is roadworthy (including front and back lights if you intend on riding after sunset);
i. you will not operate the equipment in a negligent manager, or in violation of any laws;
j. we have given you instructions on how to use the equipment; and
k. you have read and understood all applicable health and safety policies and procedures and/or instructional or use guidelines provided by us to you and agree to comply with all applicable obligations contained within those documents, including as set out in the Hire Terms (and its schedules).

4. Waiver and release, payment for damage

a. Without limiting any rights you may have under any applicable law (including Australian consumer law) and to the fullest extent permitted by law, you:

a. release us and our related bodies corporate and each of their officers, directors, employees and agents (those released), and exclude those released from any and all liability, loss (including consequential loss), damages, claims, costs, expenses, death, disability or personal injury suffered or incurred arising out of, or in connection with, the equipment, and/or your use of the equipment, including without limitation as a result of any negligent acts or omissions of those released; and
b. indemnify those released in respect of all loss (including consequential loss), legal fees on a full indemnity basis, damage, claims, costs, expenses, death, disability or personal injury suffered or incurred arising out of, or in connection with:

a. breach of the Hire Terms;
b. any negligent, wrongful or unlawful act or omission by you;

c. agree to pay for any damage to any person or the property of any person which is:

a. caused or contributed to by you or any other person using the equipment; or
b. which arises from your use of the equipment or any other person using the equipment;

d. agree to pay for any loss of (including theft) and/or damage to, equipment caused by any act or omission by you.

          5. Standard Fees for damaged items

              a) Bike collection fee (bike is not returned to place of hire for any reason) $100 for up to 2 eBikes;
              b) Scratches $30 (from tipping bike over etc)
              c) Dents $50 (from collisions etc)
              d) Loss/damage of flags $10
              e) Loss/damage of rear vision mirror $10
              f) Loss/damage to helmet $30
              g) Loss/damage to safety vest $30
              h) Loss/damage to battery $300
              i) Blown tyres - no charge - call 0455 146 647 and we can repair in situ.

I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against Coonawarra Bush Holiday Park or Coonawarra Discovery Holding P/L, including its officials, agents, volunteers and employees. Liability for damage to eBikes – I accept that I am personally responsible for any damage to the eBike howsoever caused.

I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims.

Today's date: May 2, 2024

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!