UCanDance Hanmer Signup
Full Name
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Phone Number
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Email Address
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Emergency Contact Name
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Emergency Contact Number
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Are you able to drive?
Number of seats available including driver?
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Dietary requirements
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Medical conditions
Note that information provided on this form will only be used for the purpose of preparing for the Hanmer trip or in the context of a medical emergency You are not required to provide details of medical conditions if you do not wish to.
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Other personal requirements
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Liabilities
I accept that while UCanDance will monitor the overall safety of its members, my safety is
my responsibility.
I understand and accept the UCanDance is not liable for a) any undue expenses incurred by
attendees of the Hanmer Trip, b) any damage from injuries, illnesses or other medical
emergencies, or c) any expenses incurred as a result of illness, injury or other medical
emergencies, throughout the duration of the Hanmer Trip.
I understand and accept that UCanDance reserves the right to request reimbursement from
members in cases where UCanDance covers the cost of an emergency expense.
Please sign to indicate that you have read and agree to the above conditions.
Please check to indicate that you agree to these conditions.
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