SIBS Registration Enquiry

This information is confidential and will be available only to relevant Childhood Cancer Association staff and emergency medical personnel. The legal guardian can complete the medication agreement authorising the taking of medicine whilst attending a group program. All sections of the Authorisation must be completed. Childhood Cancer Association staff are not responsible for the administration of medication, except in the case of an emergency.

The medication instructions must match EXACTLY the pharmacy label on the medication or medication will not be administered.

In signing this form I agree to the terms and conditions and give consent for my child/children to attend the SIBS program. This involves activities at varying locations around Adelaide and which are sometimes conducted by external organisations/professionals. In signing this form, I agree to the following:

• If my son/daughter breaks certain program rules, then he/she may be sent home immediately.
• If I RSVP for my child to attend an event, but my child is unable to attend closer to the time, I will notify the Childhood Cancer Association as early as possible, or else I might be responsible for any costs incurred by the Childhood Cancer Association that have resulted from my child/ren not attending the session. This may include a cancellation fee of $50 per child per session.
• I give the Childhood Cancer Association staff and volunteers consent in the event of any accident or illness to obtain such medical assistance as is required and I agree to meet any costs involved therein (e.g. transport via ambulance to a medical facility). Should this be necessary, I understand that I will be notified as soon as possible.
• I agree to let the Childhood Cancer Association know if my son/daughter(s) have been in contact with or has any contagious illnesses (e.g. measles, chicken pox, shingles) in the two weeks prior to the program.
• I agree that my child won't attend a session if they have been a close COVID-19 contact.
• If my child is unwell on the day of the program, I agree to exclude them from the program.
• I acknowledge and agree that the Childhood Cancer Association is not liable, and excludes all liability, for any damage, loss, harm, injury, cost or any other liability or expense of any kind arising from, or in connection with, any act or omission, whether caused by negligence or otherwise, of the Childhood Cancer Association or any members of its staff or volunteers during the program.
• Some activities may involve an increased risk for participants (e.g. bouncing/climbing apparatus, water sports, cooking). While the Childhood Cancer Association does everything in its power to minimise risk and to keep participants safe, the Childhood Cancer Association is not liable, and excludes all liability, for any damage, loss, harm, injury, cost or any other liability or expense of any kind arising from individual participation in these activities.