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CLIENT CONSENT, WAIVER & RELEASE

Pilates at the Pub – Wedgetail Brewery

Business Name: Wedgetail Brewing WA PTY LTD

ABN: 17632227911

Instructor Name(s): Ange Williams. Nazli Gwynn.

Class Location: Wedgetail Brewery

Activity: Mat Pilates (Group Fitness)

Participant Details

Date of Birth
Day
Month
Year

Medical & Health Declaration

Assumption of Risk

Alcohol Acknowledgement

I acknowledge that this activity is conducted at a licensed venue and agree that:

Release, Waiver & Australian Consumer Law Notice

Photography & Media Consent (Optional)
I consent to photographs or video recordings being used for promotional and marketing purposes
I do not consent

Acknowledgement & Signature

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Date
Day
Month
Year
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Address

1/22 Galbraith Loop, Falcon, WA 6210

Phone

0473 623 994

Email

Under the Liquor Control Act 1988, it is an offence: to sell or supply liquor to a person under the age of 18 years on licensed or regulated premises; or for a person under the age of 18 years to purchase, or attempt to purchase, liquor on licensed or regulated premises.

It is a condition of our producer’s license that a meal is purchased ancillary to any beverages not produced by Wedgetail onsite, thank you for understanding.
The Wedgetail Tap Room cannot guarantee there will not be any traces of nuts in the menu produced.
Due to our kitchen production systems, we are unable to give assurance that the food produced are free from any traces of nuts.

Liquor licence number- 6180152372 Licensee – Wedgetail Brewing (W.A) PTY LTD. Producers Licence - Trading as Wedgetail Brewing

© 2023 Wedgetail Brewing. All rights reserved

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