TUSA Forms Unique Tassie Experiences Registration Register your interest in attending a Unique Tassie Experiences session by filling in your details below. Name* First Last Email* UTAS Student ID #PhoneWhich campus are you based in? Hobart Launceston Cradle Coast Sydney Which activity are you interested in?* Bushwalking Camping Diving/Snorkelling Fishing & Boating Four Wheel Driving Indoor Rock Climbing Mountain Biking Orienteering/Rogaining Outdoor Rock Climbing Sea/Fresh water Kayaking Skiing/Snow Boarding Slacklining/Highlining Surfing/Boogie Boarding White Water Rafting Emergency ContactPlease provide a contact number for emergenciesDo you have any health issues that could impact your participation in this activity?*Will you need a lift?* Yes No. I have my own car Consent* I agree to the terms & conditions.I confirm that I am 18 years of age or older. In my consideration of the acceptance of participating in activities with the Clubs and Societies running these activities; I hereby waive all claims for myself, my heirs and assigns against the Club/Society’s executive, committee and trip officers (guides) and all other parties including Tasmanian University Student Association Inc. and the University of Tasmania, for death, injury, illness, property damage or loss sustained by me which may result from my participation in any of the Club/Society’s activities. I understand that the members who act as activity officers (guides), organise activities as unpaid volunteers and who like me are only ordinary members of the Club/Society. I agree to pay $5 per activity to the Club/Society running the activity and understand this is only for the Unique Tassie Experiences sessions. I understand that general membership will be an additional cost should I wish to sign up. I agree to contribute to fuel costs if car pooling to an activity. I further state that I am in proper physical condition to participate in the Club/Society’s activities and shall abide by the safety brief provided to me before every Club/Society trip. I also consent to photographs or video footage of myself or taken by myself which have been provided to the Club/Society to be used on their website, in their newsletters and/or their other promotional material as well as those of the Tasmanian University Student Association and University of Tasmania.