Program Participation Agreement
1. The program activity participant (participant) has agreed to voluntarily assist Interplast Australia & New Zealand (Interplast) in delivering or observing program activities.
2. The participant agrees that he/she is a volunteer or observer and is not an employee, servant, agent or contractor of Interplast and that this agreement and any other matter concerning the relationship between the participant and Interplast cannot be construed so as to create an employment or any relationship of that description (with the exception of Interplast employees).
3. The participant agrees to indemnify Interplast in respect of all loss and damage arising from claims threatened or brought against Interplast by any person, where such claims are based on any property damage or personal injury (including death) caused by a negligent or deliberate act or omission of the volunteer that is related or incidental to his/her volunteering to assist Interplast (including travel).
4. The participant agrees to forego all claims against Interplast arising from any property damage, personal injury or any other matter (weather caused by negligence or otherwise) related or incidental to his/her volunteering to assist Interplast (including travel). This release may be pleaded by Interplast in bar to any claim, indemnity or other proceedings commenced by the volunteer or his/her representation, successors or assignees.
5. In this agreement:
Claims includes actions, suits, demands, damages, charges, costs and expenses of any nature whatsoever.
Participant includes volunteer surgeons, anaesthetists, nurses and allied health professionals, medical and non-medical observers and other individuals who are formally included as part of an Interplast program activity.
Interplast Program Activity incudes all activities undertaken by Interplast in Australia and overseas forming part of its annual program plans and includes surgical activities, training courses, planning and evaluation projects and assessment visits.
Interplast Australia & New Zealand includes its Chairman, Secretary, Directors, Committees and Members and any person who is their agent, employee, volunteer or acting on their behalf other than the participant.
Personal injury includes sickness and death.
6. The participant must obtain and maintain insurance in respect to any property damage, personal injury or any other matter.
7. The participant acknowledges that Interplast provides basic insurance cover for the duration of the program. A copy of the travel insurance policy schedule is provided to all participants. The participant agrees to review the travel insurance policy schedule, and if deemed necessary, takes the responsibility to obtain additional individual travel insurance coverage. This is described in the Program Activity Participant Protocol, a copy of which has been provided to the participant.
8. This deed is governed by the laws of the State of Victoria and the parties exclusively and irrevocably submit to the Courts of the State of Victoria.
9. Medical volunteer program participants agree that it is his/her responsibility to notify his/her medical defence organisation that he/she intends to undertake a volunteer placement overseas with Interplast. Proof of his/her medical indemnity coverage during the Interplast program overseas must be provided to Interplast. Nurse and allied health professionals are covered under Interplast’s own policy.
10. The participant acknowledges that he/she has tread the Pre-departure Briefing Pack and the Interplast policies as outlined therein. The participant acknowledges that he/she is aware that he/she is required to comply with these policies.
Child Protection Code of Conduct
• Recognize that risk to the safety of children is inherent in the delivery of Interplast programs overseas, due to the nature of programs (delivery of health services) and the vulnerability of the beneficiary population due to poverty, disability and power-inequity. As such, I will ensure to be mindful of this risk in all that I do, during the course of my involvement with the Interplast program.
• Treat children with respect regardless of race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status
• Be aware of behaviour and avoid actions or behaviours that could be perceived by others as child exploitation and abuse,
• Not use language or behaviour towards children that is inappropriate, harassing, abusive, sexually provocative, demeaning or culturally inappropriate,
• Not engage children in any form of sexual activity or acts, including paying for sexual services or acts, where under the law(s) applicable to the child (and the child is below the age of consent or the act(s) are an offence under relevant laws,
• Wherever possible, ensure another adult is present when working in the proximity of children,
• Not invite unaccompanied children into my home, hotel or a remote or isolated area unless they are at immediate risk of injury or in physical danger,
• Not sleep close to unsupervised children (noting that this does not apply to an individuals’ own children)
• Not give or provide children with alcohol or illegal drugs;
• Not show favouritism through the provision of gifts or inappropriate attention (this does not apply to small token gifts to children receiving clinical treatment, such as Interplast teddy bears, balloons etc);
• Not use any computers, mobile phones or video and digital cameras inappropriately and never to exploit or harass children or to access child pornography through any medium,
• Refrain from physical punishment or discipline of children,
• Refrain from hiring children for domestic or other labour which is inappropriate given their age or developmental stage, which interferes with their time available for education and recreational activities, or which places them at significant risk of injury,
• Comply with all relevant Australian and local legislation, including labour laws in relation to child labour
• Immediately disclose all charges, convictions and other outcomes of an offence that relates to child exploitation and abuse, including those under traditional law, which occurred before or occurs during association with Interplast• Ensure that I immediately report concerns or allegations of child abuse or exploitation in accordance with Interplast’s reporting requirements.
I further agree that, while working with Interplast or engaged in Interplast activities, and when photographing or filming a child or using children’s images for work-related purposes, I must:
• before photographing or filming a child, assess and endeavour to comply with local traditions or restrictions for reproducing personal images;
• before photographing or filming a child, obtain informed verbal consent from the child and a parent or guardian of the child;
• ensure photographs, films, videos and DVDs present children in a dignified and respectful manner and not in a vulnerable or submissive manner. Children should be adequately clothed and not in poses that could be seen as sexually suggestive;
• ensure images are honest representations of the context and the facts; and
• ensure the file labels, meta data or text descriptions do not reveal identifying information about a child when sending images electronically or publishing images in any form.
By ticking the below declaration, I confirm and accept:
• I shall abide by all the standards and guidelines of the Interplast Child Protection Policy, and associated key documents as listed in section 7 of the Child Protection Policy
• My failure to comply with the standards of the Child Protection Policy and Code of Conduct may result in disciplinary action.