I give full permission to participate, or for my dependant to participate in all activities at Autism West.
• I consent to being taken out on excursions with Autism West, using both private and public transport as arranged when necessary.
• I have supplied full behavioural, health and dietary information and provided details of emergency contacts.
• I acknowledge that in the event of an emergency, it is Autism West’s intention to make every effort to contact me or the people listed as emergency contacts. If contact cannot be made, I give permission to receiving ambulance, or any emergency medical care necessary, and I accept full responsibility for all expenses incurred.
|I have read, understood and agree with all the conditions outlined in this form. ★|
|Thank you for taking the
to complete this form.