Consent Terms And Conditions | Dare2DreamBasketball

Please print and sign this Consent Form before starting with Dare2Dream

Consent Form

Participants Name:…………………………………………..D.o.B………………….

• I ……………………………………………. (Legal guardian’s name) give permission for my child/myself

(named above) to participate in the D2DBA program.

• I give permission for D2DBA to call emergency services if they deem it necessary. This

permission also allows for the transportation of my child to the most appropriate facility.

• In the situation where the parent or caregiver/NOK is unable to be contacted, I also give permission to

allow for any medical procedure deemed necessary by a qualified medical practitioner to be undertaken.

This includes the use of anaesthetics or blood transfusion.

• Parents/Participants are advised that while D2DBA have Public Liability Insurance,

Dare2Dream Consultancy Pty Ltd does not have Personal Accident insurance cover for clients. It is a

personal decision for parents as to the type and level of private insurance they arrange to cover their child

for any accidental injury that may occur.

• I give permission for D2DBA to record and take photos for promotional purposes.

• I agree to make payments as agreed to in my letter of offer.

Please strike out and initial any statement above you do not agree with.

Signed: …………………………………………….. (Participant/Legal guardian) Date:……………………..

Legal Guardian Name/Next of Kin:

Address:

Email Address:

Emergency Contact Numbers:

Home/Work: Mobile:

Emergency Contact Name: Relationship to participant:

Emergency Contact Numbers:

Home/Work: Mobile:

Does the participant suffer from asthma? If yes, give details of asthma plan.

Yes/No

Does the participant have any Allergies?

Yes/No

If Yes, please list full details, including medication/dosage

Is the participant currently being treated by a medical practitioner?

Yes/No

Is the participant suffering from an injury or condition which is likely to be aggravated by this activity?

Yes/No

If Yes, please list all details

Date of last Tetanus injection:

Covid vaccination status:

Medicare Card Number: Position number on card:

Cardholder Name:

Private Health Insurance Company Name, Type & Membership Number (if applicable)

Please initial all pages and return before starting with Dare2Dream

Terms And Conditions

1. DEFINITIONS

1.1 “Assessment” means any medical assessments, including mental health

assessments, Dare 2 Dream requires the Client to undertake prior to

providing any of the Services;

1.2 “Background Information” has the meaning given in clause 8.1 of this

Contract;

1.3 “Care Plan” means a care plan developed and prepared by Dare 2

Dream, based on the Dare 2 Dream Mentoring/Basketball Programme;

1.4 “Client” shall mean the Client (or any person acting on behalf of and

with the authority of the Client) as described in the Proposal and includes the

Client’s officers, employees, contractors and agents;

1.5 “Confidential Information” means information that is not already in the

public domain (unless it is in the public domain as a result of a breach of this

Contract), whether or not in written form which relates to or is connected

(either directly or indirectly) with the Services, the Care Plan, the Health

Information Products, the Dare 2 Dream Mentoring Programme, Dare 2

Dream’s intellectual property rights and the terms of this Contract and the

Proposal;

1.6 “Contract” means these Terms and Conditions of Engagement and

includes the Proposal;

1.7 “Dare 2 Dream” means Dare 2 Dream Consultancy Pty Ltd (ACN 610 769

036) and includes its successors and assigns or any person acting on behalf

of and with the express authority of Dare 2 Dream;

1.8 “Dare 2 Dream Mentoring Programme or Dare2Dream Basketball

Academy (D2DBA)” means the mentoring/basketball programme developed

by Dare 2 Dream, as amended from time to time at Dare 2 Dream’s sole

discretion;

1.9 “Deposit” has the meaning given in clause 6.4 of this Contract;

1.10“Fees” means the fees payable for the provision of the Services: (a) as

outlined in the Proposal (as varied in accordance with this Contract); (b)

based on the Rates; or (c) as otherwise expressly and unequivocally agreed

in writing between the parties;

1.11“Guarantor” means the person or persons specified as guarantors in

the Proposal;

1.12“Health Information Products” means any pamphlets, documents or

other communication platform containing information suitable for the Client

in regard to their health and wellbeing, based on the Initial Consultation;

1.13“Initial Consultation” means the initial consultation between Dare 2

Dream and the Client for the purpose of establishing the Services required by

the Client;

1.14 “Loss” means any claim, action, damage, loss, liability, cost, charge or

expense;

1.15“Mentoring Workbook or Dare2Dream Basketball Academy” means a

workbook developed and prepared by Dare 2 Dream, based on the Dare 2

Dream Mentoring Programme;

1.16“Mentoring Workshops or Dare2Dream Basketball Academy” means

3. PERFORMANCE OF SERVICES

3.1 Subject to the terms of the Contract, Dare 2 Dream shall perform the

Services.

3.2 Subject to clause 3.3 and this Contract, the Client agrees and

acknowledges that the Services shall be provided within the time frames and

on the dates stated in the Proposal but if not stated then in a reasonable

timeframe having regard to the nature of the Services to be provided

(Timeframe).

3.3 Dare 2 Dream shall not be liable for any delay to the Timeframe as a

consequence of any delay caused either directly or indirectly by the Client, or

for any other reason out of the direct control of Dare 2 Dream.

3.4 Dare 2 Dream shall not be liable for any direct or indirect Loss incurred by

the Client due to any delays in completing the Services unless caused by the

negligence of Dare 2 Dream and the Client shall indemnify Dare 2 Dream

against any such costs, expenses or other loss associated with any delay.

4. ASSESSMENTS

4.1 Where required by Dare 2 Dream, the Client may be required to undertake

Assessments as deemed necessary by Dare 2 Dream before any Services are

provided, which shall be undertaken by the Client at their own cost.

4.2 The Client agrees to provide (or procure those persons who provide the

Assessments) the results of those Assessments to Dare 2 Dream.

4.3 Dare 2 Dream, upon assessments of the results of any Assessments, shall

be entitled to decline the provision of further Services in its absolute

discretion and may, where appropriate, refer the Client to other health care

professions as may be required.

5. VARIATIONS

5.1 The Services, Care Plan and/or Health Information Products may be varied

by:

(a) a request by Dare 2 Dream to the Client where additional Services are

required due to: (i) circumstances or events that Dare 2 Dream could not

reasonably have foreseen; or (ii) where required by any relevant law,

regulation or by any legal authority; or

(b) request from the Client to Dare 2 Dream,

(Variation Request).

5.2 Where a Variation Request is accepted by Dare 2 Dream or the Client (as

the case requires), the following terms shall apply:

(a) Dare 2 Dream will provide the Client with an estimate of the costs and

expenses required to undertake the Variation;

(b) upon acceptance of the estimated costs, the Client shall be obliged to pay

all additional costs and expenses required to undertake the Variation charged

in accordance with the Rates;

promptly as possible and shall submit such documents to the Client for

D2DB/SCA/NLAE – Terms & Conditions of Engagement

workshops developed and conducted by Dare 2 Dream, based on the Dare 2

Dream Mentoring Programme;

1.17 “Proposal” means a written proposal issued by Dare 2 Dream to the

Client detailing the Services to be provided, based on the Initial

Consultation, and Fees to be charged to the Client;

1.18“Rates” means any rates set out in the Proposal;

1.19 “Services” means:

(a) the development and preparation of a Care Plan and Mentoring

Workbook, and conducting Mentoring Workshops, as set out in the Proposal

(Mentoring Services);

(b) the translation of written documents from English to Samoan, and

Samoan to English (Translation Services);

Cultural Consultation Services);

(d) the Initial Consultation; and

(e) any other services to be provided by Dare 2 Dream to the Client as

described in the Proposal, as varied in accordance with this Contract; and

1.20“Variation” means a variation of the Services in accordance with clause

5.1. 2. ACCEPTANCE

2.1 The terms of this Contract shall be deemed to have been accepted by the

Client on the earlier of: (a) the supply or commencement of provision of the

Services; and (b) the acceptance of a Proposal by the Client.

2.2 Services are supplied by Dare 2 Dream only on the terms and conditions

of this Contract to the exclusion of any other agreement or understanding,

whether subsisting or entered into before or after the date of this Contract

and for the avoidance of doubt shall take precedence to any terms and

conditions notwithstanding any terms stated in any purchase order to the

contrary.

7. SUSPENSION OF SERVICES

7.1 Without prejudice to any other remedies Dare 2 Dream may have, if at any

time the Client is in breach of any obligation (including those relating to

payment) under this Contract, Dare 2 Dream may (in its discretion):

(a) suspend the provision of Services to the Client for any amount of time

until such breach (including payment of any outstanding amount) has been

remedied; or

(b) terminate this Contract by providing not less than 2 business days’ notice

to the Client (provided the Client has not remedied the breach to Dare 2

Dream’s satisfaction within the period of notice).

7.2 Dare 2 Dream will not be liable for any Loss whatsoever suffered, or

alleged to be suffered, by the Client or by any person claiming through the

Client for the suspension of the supply of Services or termination of this

Contract in accordance with clause 7.1.

8. CLIENT’S OBLIGATIONS

acceptance; and

(d) Dare 2 Dream shall not be liable for any Loss suffered or incurred by the

Client with respect to any Variation.

6. FEES AND PAYMENT

6.1 The estimate of Fees set out in the Proposal are estimates only. Subject to

this Contract, any additional costs will be charged to the Client in accordance

with the Rates and Dare 2 Dream will notify the Client in the instance that any

estimate of Fees stated in the Proposal will be exceeded.

6.2 The Client shall pay the Fees for Services as set out in the Proposal.

6.3 The Rates may be varied by way of 30 days written notice being provided

to the Client by Dare 2 Dream.

6.4 Unless otherwise agreed by the parties, a non-refundable deposit

(Deposit) will be required and, where applicable, Dare 2 Dream reserves the

right not to perform any Services until such Deposit has been paid in full.

6.5 Unless otherwise expressly and unequivocally agreed in writing, payment

of the Fees must be paid without set-off or deduction within 30 days from the

date of issue of an invoice to the Client by Dare 2 Dream.

6.6 The Client shall pay interest at the rate of 10% per annum on all

outstanding monies owing to Dare 2 Dream calculated on a daily basis from

the due date for actual payment until the actual date of payment.

6.7 Unless expressly included, the Fees exclude all GST payable in respect of

the supply. If GST is applicable, then the Client shall be liable to pay all GST

payable in respect of a taxable supply.

6.8 If the Client defaults in payment of any Fees when due, the Client shall

indemnify Dare 2 Dream from and against all costs and disbursements

incurred by Dare 2 Dream in pursuing the debt including all legal costs on a

full indemnity basis and collection agency costs.

11 TERMINATION

11.1Without prejudice to any other remedies Dare 2 Dream may have, Dare 2

Dream may terminate this Contract: (a) in accordance with clause 7.1(b) of

16.2 Clause 16.1 shall not apply if the Confidential Information: (a) is already

in the public domain; (b) is required to be disclosed by law.

this Contract;

(b) at any time the Client is in breach of any obligation (including those

relating to payment and the obligations set out in clause 8.1 of this Contract);

proposes or enters into an arrangement with creditors, or makes an

assignment for the benefit of its creditors;

(d) a receiver, manager, liquidator (provisional or otherwise) or similar person

is appointed in respect of the Client or any asset of the Client; or

(e) the Client becomes bankrupt or enters into any agreement or arrangement

under the Bankruptcy Act 1966 (Cth).

11.2 Dare 2 Dream will not be liable to the Client for any Loss whatsoever the

D2DB/SCA/NLAE – Terms & Conditions of Engagement

8.1 The Client shall:

(a) ensure that it attends any consultations and meetings with Dare 2 Dream,

as reasonably requested by Dare 2 Dream from time to time, to enable Dare 2

Dream to undertake the Services; and

(b) undertakes and attends all required Assessments; and

(including, but no limited to, mental health conditions and physical health

conditions) and how they may affect Dare 2 Dream providing the Services

(Background Information).

8.2 Any failure by the Client to comply with its obligations under clause 8.1 of

this Contract will be a breach of this Contract, and Dare 2 Dream shall not be

liable for any Loss suffered or incurred by the Client unless due to the

negligence of Dare 2 Dream.

9. LIMITATION OF LIABILITY

9.1 Except as expressly provided in this Contract, any terms, conditions,

warranties, undertakings, inducements or representations whether express,

implied, statutory or otherwise relating in any way to the subject matter of

this Contract, the Services, or the Dare 2 Dream Mentoring Programme are

excluded to the maximum extent permitted by the law.

9.2 Dare 2 Dream shall not be liable in any way for any Loss incurred by the

Client or any other liability (to the maximum extent permitted by law)

resulting from:

(a) Dare 2 Dream providing the Services to the Client; or

(b) the Client failing to provide full and accurate Background Information.

9.3 Where Dare 2 Dream is not permitted to exclude any liability for any loss

or damage in connection with Dare 2 Dream’s breach of a consumer

guarantee (as defined in the Australian Consumer Law), but are permitted to

limit its liability for such a breach, then, unless the Client is able to establish

that it is not fair and reasonable for Dare 2 Dream to do so, Dare 2 Dream’s

liability to the Client is limited to:

(a) the re-provision of the Services;

(b) payment of the cost of re-providing the Services;

(d) payment of the cost of having the Services independently provided.

9.3 The Client acknowledges that it has not relied on any representation or

warranty made by Dare 2 Dream which has not been stated expressly in the

Contract or upon any descriptions or specifications contained in any

document published or provided by Dare 2 Dream.

9.4 The provisions of this clause 9 survives the expiry or termination of this

Contract.

10 INDEMNITY

The Client shall indemnify (and keep indemnified) Dare 2 Dream from and

against any and all Loss (including all legal costs on a full indemnity basis)

which may be incurred or suffered by Dare 2 Dream, either directly or

Client howsoever suffers because Dare 2 Dream has exercised its rights

under this clause.

11.3The Client may terminate this Contract by providing at least 30 days’

written notice to Dare 2 Dream. For the avoidance of doubt, the Client will be

liable for all costs incurred up to and including the date of termination,

including any accumulated Fees.

12 GUARANTEE

12.1In consideration of the provision of the Services to the

Client, the Guarantor (or where there is more than one Guarantor, each of the

Guarantors):

(a) unconditionally and irrevocably guarantees and continues to guarantee to

Dare 2 Dream that the Client will:

(i) pay the Fees and all other amounts to be paid under this Contract in

accordance with the terms of this Contract; and

(ii) comply with all the other terms of this Contract on its part to be complied

with; and

(b) as separate undertakings:

(i) agrees to indemnify and keep indemnified Dare 2 Dream against any

liability, Loss, Claims, actions, suits, demands, costs, expenses, including all

legal costs and expenses, suffered or incurred by Dare 2 Dream arising from

or in connection with any breach of this Contract; and

(ii) as principal debtor, agrees to pay to Dare 2 Dream on demand an amount

equal to any liability, loss, claims, actions, suits, demands, costs, expenses

referred to in the preceding paragraph (b)(i).

12.2 The guarantee and indemnity specified in clause 12.1 continues in force

until the Client complies with all of its obligations under this Contract.

12.3 The Guarantor agrees to pay to Dare 2 Dream on demand Dare 2 Dream’s

costs and expenses, including legal costs, relating to any action taken under

this guarantee and indemnity.

13 CHARGE

Despite anything to the contrary contained herein or any other rights which

Dare 2 Dream may have, the Client and each of the Guarantors charge their

interest in any property in the name of the Client or the Guarantor with the due

payment of any monies and interest owing to Dare 2 Dream by the Client, and

consents to Dare 2 Dream registering an absolute caveat against the interest

in any such property or properties to further secure the repayment of those

monies and interest payable to Dare 2 Dream pursuant to this Contract.

14 INSURANCE

14.1The Client must, at the Client’s cost, take out and maintain any insurance

required by Dare 2 Dream from time to time.

14.2The Client must provide all certificates of currency for those insurances

set out in clause 14.1 on request by Dare 2 Dream.

15 INTELLECTUAL PROPERTY

D2DB/SCA/NLAE – Terms & Conditions of Engagement

indirectly, arising from or in connection with any one or more of the following:

(a) the breach by the Client of a material term or any of the Client’s

obligations under this Contract;

(b) the termination of this Contract;

Contract;

(d) any claims or demands made by Dare 2 Dream by reason of any loss,

injury or damage which may be suffered by any person from the provision of

the Services.

16 CONFIDENTIALITY

16.1Subject to clause

16.2, the Client must keep Dare 2 Dream’s Confidential Information

confidential and not disclose the Confidential Information without Dare 2

Dream’s express written consent.

17 GENERAL

17.1 If any provision of this Contract shall be invalid, void, illegal or

unenforceable the validity, existence, legality and enforceability of the

remaining provisions shall not be affected, prejudiced or impaired.

17.2 This Contract shall be governed by the laws of Queensland and are

subject to the exclusive jurisdiction of the courts of Queensland.

17.3 The Client agrees that Dare 2 Dream may review these terms and

conditions at any time. If, following any such review, there is to be any change

to these terms and conditions, then that change will take effect from the date

on which Dare 2 Dream notifies the Client of such change.

17.4 The failure by Dare 2 Dream to enforce any provision of these terms and

conditions shall not be treated as a waiver of that provision, nor shall it affect

Dare 2 Dream’s right to subsequently enforce that provision.

17.5 Any special conditions stated in the Proposal shall apply to this

Contract and in the event of any inconsistency with the terms of this

Contract, the special conditions shall prevail.

17.6 This Contract is the entire agreement between the parties in respect of

its subject matter and supersedes all prior and contemporaneous

understandings and agreements relating to its subject matter.

17.7 This Contract may be executed in any number of counterparts and all

those counterparts taken together will constitute one instrument

15.1The Client agrees and acknowledges that:

(a) it does not acquire any rights, including registered and unregistered

intellectual property rights in the Dare 2 Dream Mentoring Programme,

Mentoring Workbook, Mentoring Workshop, Care Plan or Health Information

Products if varied under clause 5.1;

(b) Dare 2 Dream retains copyright in the Dare 2 Dream Mentoring

Programme, Mentoring Workbook, Mentoring Workshop, Care Plan and

Health Information Products.

15.2The Client must not register or apply to register any rights in respect of

the IP. 15.3The Client acknowledges that there may be intellectual property

rights in the Services owned by third parties.