Entry Form
Content
A. T E R M S O F
E N T R Y
I HEREBY AGREE TO PARTICIPATE IN THE JW MOUNTAINBIKE CARNIVAL KUALA LUMPUR 2012 AT MY OWN RISK. I HEREBY WAIVE, RELEASE & DISCHARGE FROM ANY AND ALL LIABILITY FOR DEATH, DISABILITY, PERSONAL INJURY, PROPERTY DAMAGE, PROPERTY THEFT AND ALL OTHER FORESEEABLE RISKS, CLAIMS OR ACTIONS OF ANY KIND (INCLUDING NEGLIGENCE) WHATEVER AND HOWEVER OCCURRED WHICH MAY ARISE, AT ANY TIME FROM OR IN CONNECTION WITH, DIRECTLY OR INDIRECTLY, MY PARTICIPATION IN OR MY TRAVELLING TO AND FROM THIS EVENT, THE FOLLOWING PERSONS OR ENTITIES.
I HEREBY INDEMNIFY AND HOLD HARMLESS THE PERSON OR ENTITIES ,EMOTIONED IN THE PARAGRAPH ABOVE FROM ANY AND ALL LIABILITIES, CLAIMS OR ACTIONS (INCLUDING NEGLIGENCE) WHATEVER AND HOWEVER CAUSED WHICH MAY ARISE AT ANY TIME, AS A RESULT OF OR IN CONNECTION WITH, DIRECTLY OR INDIRECTLY, MY PARTICIPATION IN OR MY TRAVELLING TO AND FROM THIS EVENT I AUTHORISE TO USE MY NAME, VOICE AND PICTURE AND ANY INFORMATION PROVIDED BY ME ON THIS ENTRY FORM TO BE USED WITHOUT PAYMENT IN ANY BROADCAST, TELECAST, PROMOTION AND ADVERTISING AND ON THE EVENT WEBSITE.
ALL PROFESSIONAL RIDERS(SPONSORED RIDERS,STATE RIDER,NATIONAL RIDER,PROFESSIONAL CLUB RIDER,MSN RIDER) ARE AUTOMATICALLY ABSORBED TO THE EXPERT/PRO CATEGORY. THEY ARE STRICTLY PROHIBITED FROM ENTERING THE FUN RIDE CATEGORY. ALL PROFESSIONAL, SPONSORED AND NON MALAYSIAN RIDERS WILL AUTOMATICALLY JOIN THE "EXPERT/PRO" RACE CATEGORY. FULL PAYMENT UPON REGISTRATION (NON REFUNDABLE & TRANSFERABLE)
REGISTRATION IN ON A FIRST-COME-FIRST-SERVED BASIS WITH FULL PAYMENT RECEIVED.
RIDER MUST WEAR SAFETY STANDARD APPROVED HELMET AT ALL TIMES DURING THE RACE / FUN RIDE
PLEASE ENSURE THAT YOUR RIDE NUMBER PLATE IS ATTACHED TO THE FRONT OF YOUR BIKE
NO PRIVATE SUPPORT VEHICLES ARE PERMITTED ON THE RACE TRAIL
q
B. E N T R Y F O R M
A. PARTICULARS
NAME
:
B. REGISTRATION CATEGORY
INDIVIDUAL
TEAM / GROUP ( GENDER
: MALE FEMALE
)
EXPERT / PRO (TRAIL DISTANCE - 40KM) NATIONALITY
:
FUN RIDE (TRAIL - DISTANCE- 30KM) IC NUMBER
: -
ADDRESS
:
C. T-SHIRT SIZE S M L XL
POSTCODE
:
D. EMERGENCY CONTACT
TEL NO
: -
(HANDPHONE)
NAME
:
-
(HOME)
CONTACT NO
:
-
(OFFICE)
RELATIONSHIP
:
EMAIL
:
E. DECLARATION
I HAVE CAREFULLY READ THIS TERM OF ENTRY FORM, I ACKNOWLEDGE AND UNDERSTAND THE ACKNOWLEDGEMENT, RELEASE AND INDEMNITY AND AGREE TO ABIDE BY ALL THE RULES AND DIRECTIONS OF ALL RACE OFFICIALS ON THE DAY.
ENTRANT / PARENTS* / GUARDIAN* SIGNATURE
FULL NAME
IC / PASSPORT NUMBER
RELATIONSHIP*
* IF ENTRANT IS BELOW 18 YEARS OLD
I HEREBY ENCLOSED HEREWITH THE TOTAL SUM OF RM
AS FULL PAYMENT
CASH
BANK IN ( PLEASE ATTACH BANK IN SLIP & EMAIL OR FAX PROOF TO [email protected]
FAX TO 03-4143-7145
E N T R Y
I HEREBY AGREE TO PARTICIPATE IN THE JW MOUNTAINBIKE CARNIVAL KUALA LUMPUR 2012 AT MY OWN RISK. I HEREBY WAIVE, RELEASE & DISCHARGE FROM ANY AND ALL LIABILITY FOR DEATH, DISABILITY, PERSONAL INJURY, PROPERTY DAMAGE, PROPERTY THEFT AND ALL OTHER FORESEEABLE RISKS, CLAIMS OR ACTIONS OF ANY KIND (INCLUDING NEGLIGENCE) WHATEVER AND HOWEVER OCCURRED WHICH MAY ARISE, AT ANY TIME FROM OR IN CONNECTION WITH, DIRECTLY OR INDIRECTLY, MY PARTICIPATION IN OR MY TRAVELLING TO AND FROM THIS EVENT, THE FOLLOWING PERSONS OR ENTITIES.
I HEREBY INDEMNIFY AND HOLD HARMLESS THE PERSON OR ENTITIES ,EMOTIONED IN THE PARAGRAPH ABOVE FROM ANY AND ALL LIABILITIES, CLAIMS OR ACTIONS (INCLUDING NEGLIGENCE) WHATEVER AND HOWEVER CAUSED WHICH MAY ARISE AT ANY TIME, AS A RESULT OF OR IN CONNECTION WITH, DIRECTLY OR INDIRECTLY, MY PARTICIPATION IN OR MY TRAVELLING TO AND FROM THIS EVENT I AUTHORISE TO USE MY NAME, VOICE AND PICTURE AND ANY INFORMATION PROVIDED BY ME ON THIS ENTRY FORM TO BE USED WITHOUT PAYMENT IN ANY BROADCAST, TELECAST, PROMOTION AND ADVERTISING AND ON THE EVENT WEBSITE.
ALL PROFESSIONAL RIDERS(SPONSORED RIDERS,STATE RIDER,NATIONAL RIDER,PROFESSIONAL CLUB RIDER,MSN RIDER) ARE AUTOMATICALLY ABSORBED TO THE EXPERT/PRO CATEGORY. THEY ARE STRICTLY PROHIBITED FROM ENTERING THE FUN RIDE CATEGORY. ALL PROFESSIONAL, SPONSORED AND NON MALAYSIAN RIDERS WILL AUTOMATICALLY JOIN THE "EXPERT/PRO" RACE CATEGORY. FULL PAYMENT UPON REGISTRATION (NON REFUNDABLE & TRANSFERABLE)
REGISTRATION IN ON A FIRST-COME-FIRST-SERVED BASIS WITH FULL PAYMENT RECEIVED.
RIDER MUST WEAR SAFETY STANDARD APPROVED HELMET AT ALL TIMES DURING THE RACE / FUN RIDE
PLEASE ENSURE THAT YOUR RIDE NUMBER PLATE IS ATTACHED TO THE FRONT OF YOUR BIKE
NO PRIVATE SUPPORT VEHICLES ARE PERMITTED ON THE RACE TRAIL
q
B. E N T R Y F O R M
A. PARTICULARS
NAME
:
B. REGISTRATION CATEGORY
INDIVIDUAL
TEAM / GROUP ( GENDER
: MALE FEMALE
)
EXPERT / PRO (TRAIL DISTANCE - 40KM) NATIONALITY
:
FUN RIDE (TRAIL - DISTANCE- 30KM) IC NUMBER
: -
ADDRESS
:
C. T-SHIRT SIZE S M L XL
POSTCODE
:
D. EMERGENCY CONTACT
TEL NO
: -
(HANDPHONE)
NAME
:
-
(HOME)
CONTACT NO
:
-
(OFFICE)
RELATIONSHIP
:
:
E. DECLARATION
I HAVE CAREFULLY READ THIS TERM OF ENTRY FORM, I ACKNOWLEDGE AND UNDERSTAND THE ACKNOWLEDGEMENT, RELEASE AND INDEMNITY AND AGREE TO ABIDE BY ALL THE RULES AND DIRECTIONS OF ALL RACE OFFICIALS ON THE DAY.
ENTRANT / PARENTS* / GUARDIAN* SIGNATURE
FULL NAME
IC / PASSPORT NUMBER
RELATIONSHIP*
* IF ENTRANT IS BELOW 18 YEARS OLD
I HEREBY ENCLOSED HEREWITH THE TOTAL SUM OF RM
AS FULL PAYMENT
CASH
BANK IN ( PLEASE ATTACH BANK IN SLIP & EMAIL OR FAX PROOF TO [email protected]
FAX TO 03-4143-7145
