Form of Indemnity

Arkaroola Mars Robot Challenge Arkaroola Mars RobotChallenge

Form of Indemnity

Mars Society Australia, Inc.

In consideration of Mars Society Australia accepting my membership of the Arkaroola Mars Robot Challenge,

I, ……………………………………………, agree to and do hereby indemnify Mars Society Australia, its officers, members, servants and agents from and against all action s, suits, damages claims and demands arising out of any accidents or illness which may befall or occur to myself during or as a result of my participation in any activity or function connected with Mars Society Australia or when travelling to or from such activity or function or arising out of the death of myself during or as a result of my participation in any activity or function connected with Mars Society Australia or when travelling to or from such activity or function.

I further authorise any officer, member or servant of Mars Society Australia in the event of such accident or illness to obtain such medical assistance or treatment for myself as he or she may consider necessary and for this purpose to engage any doctors, nursing assistance or hospital accommodation and in this event agree to pay Mars Society Australia on demand all such doctors’, nurses’, hospital and medical fees and expenses.

I specifically agree to assume full responsibility for, and hereby acknowledges the risk of, any bodily injury, death or property damage that may arise from riding any type of vehicle anywhere while a participant on Arkaroola Mars Robot Challenge.

I also specifically hereby acknowledge and confirm my understanding that use of an EVA suit constricts and limits my ability to safely conduct activities that I may undertake while participating in Arkaroola Mars Robot Challenge, including but not limited to hiking, riding vehicles, climbing, sample taking, and other such activities (EVA activities). Such restricted abilities in the Outback desert environment may be dangerous and can lead to serious injury or death. I specifically agree to assume full responsibility for, and hereby acknowledge the risk of, any bodily injury, death or property damage that may arise from riding any type of EVA activities anywhere while a participant on Arkaroola Mars Robot Challenge.

I attest that no oral representations, statements, or inducements apart from the foregoing written agreement have been made.

I hereby acknowledge and grant Mars Society Australia, its officers, members, servants and agents, the right to photograph me and use my picture and any other reproduction of my physical likeness (as the same may appear in any still camera photograph and motion picture) in, and in connection with, exhibition, theatrically, on television or otherwise, or any motion picture(s) in which the same may be used or incorporated, and also in the advertising, exploiting, and/or publicizing of any such motion picture(s), but not limited to television or theatrical motion picture(s).

I hereby certify and represent that I have received valuable consideration in return for said release, and hereby waive any and all rights to compensation in connection with the utilization of my picture and any other reproduction of my physical likeness with reference to the project known as Arkaroola Mars Robot Challenge..

To procure this waiver and release, I hereby declare: that I am more than 18 years of age or have a guardian’s signature; that I am in good physical health; that I recognise that Arkaroola Mars Robot Challenge is a potentially dangerous activity, and that no representation regarding the nature and extent of legal liability or financial responsibility of any party hereby released, have induced me to make this waiver.

Date: …………………………… Signed: ………………………………..

This Form of Indemnity should be completed and returned to the President, Mars

Society Australia Incorporated, PO BOX 151, Clifton Hill, Victoria 3068, Australia, or delivered by hand at the start of the expedition.