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1. Parties: Identification of the party providing the risk acknowledgement (participant/customer) and the party receiving it (company/service provider)
2. Background: Brief context of the activity or service for which risks are being acknowledged
3. Definitions: Clear definitions of key terms used in the document, including technical terms and risk-related terminology
4. Risk Acknowledgement Statement: Clear statement that the participant has been informed of and understands the risks involved
5. Specific Risks: Detailed listing and description of all potential risks being acknowledged
6. Voluntary Participation Declaration: Statement confirming that participation is voluntary and participant is choosing to proceed despite known risks
7. Health and Physical Condition: Participant's confirmation of suitable health/physical condition for the activity
8. Compliance Agreement: Participant's agreement to comply with all safety rules and instructions
9. Emergency Contact Information: Space for participant to provide emergency contact details
10. Execution: Signature blocks, date, and witness provisions
1. Parental Consent: Required when participant is under legal age (typically 18 in Indonesia)
2. Medical Disclosure: Detailed medical information section for high-risk physical activities
3. Insurance Declaration: Acknowledgement of insurance coverage or lack thereof, when relevant to the activity
4. Photo/Video Release: Permission to use participant's image in activities where photography/videography is common
5. Equipment Usage: Specific acknowledgements related to use of specialized equipment
6. Language Declaration: Confirmation that the participant understands the language of the form, particularly relevant for international participants
1. Schedule A - Detailed Risk Description: Comprehensive list and explanation of all potential risks associated with the activity
2. Schedule B - Safety Procedures: Detailed safety procedures and protocols that must be followed
3. Schedule C - Medical Questionnaire: Detailed health questionnaire for activities requiring medical clearance
4. Appendix 1 - Emergency Protocols: Emergency procedures and contact information
5. Appendix 2 - Equipment Checklist: List of required equipment and safety gear for the activity
Adventure Tourism
Sports and Recreation
Healthcare
Manufacturing
Construction
Education and Training
Fitness and Wellness
Research and Development
Chemical Industry
Transportation
Mining
Event Management
Clinical Trials
Extreme Sports
Legal
Risk Management
Operations
Health & Safety
Compliance
Customer Service
Quality Assurance
Training & Development
Medical Services
Insurance
Event Operations
Facility Management
Legal Counsel
Risk Manager
Safety Officer
Operations Manager
Compliance Officer
Insurance Coordinator
Activity Director
Training Manager
Health and Safety Manager
Customer Service Manager
Facility Manager
Program Coordinator
Event Manager
Medical Director
Quality Assurance Manager
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