REGISTRATION FORM NAME NRIC No (MALAYSIAN) GENDER ADDRESS CITY TELEPHONE EMAIL EMERGENCY CONTACT RELATIONSHIP
NATIONALITY PASSPORT AGE POST CODE COUNTRY MOBILE 1. 2. 1. 2.
RULES & REGULATIONS 1. Participants are required to have bicycles in good riding condition to register and pay the registration fee for the event. 2. Participants are required to wear helmets. 3. Participants shall obey all traffic laws and practice safety in bicycling. 4. The organisers or any organisations referred with the organising of the Event will not be responsible for any death, injury, damages or loss of belongings of the participants. 5. Transportation will be provided for bicycles from Menumbok to Kota Kinabalu on 21 April 2013. If participants wish to transport their bicycles on their own, they are to inform the Organiser one week in advance. 6. During transportation of bicycles, the Organiser should not be held responsible for any unforeseen damage of the bicycles. 7. Participants should assume responsibility to ensure that they are physically fit to participate in a strenuous long-distance cycling event. 8. The Organiser reserved the right to amend all matters pertaining to the ride, postpone or even cancel the event without notice in the event of unsafe conditions or unforeseen circumstances. Registration fees are not refundable under any circumstances. REGISTRATION FEE RM150 per person (start and return to Kota Kinabalu) Fee is inclusive of: 1. One night accommodation in Labuan 2. Welcome Dinner in Labuan on 20 April 3. Event t-shirt 4. Meals from lunch on 20 April 2013 to breakfast on 21 April 2013 (3 meals) 5. Refreshment at Peace Park on 21 April 2013 6. Water, isotonic drinks, and fruits at fill-up stations during cycling 7. One way transportation for participant and bicycle from Menumbok to Kota Kinabalu on 21 April 2013
RM100 per person (in Labuan only) Fee is inclusive of:
1. 2. 3. 4.
Welcome Dinner in Labuan on 20 April Event t-shirt Refreshment at Peace Park on 21 April 2013 Water, isotonic drinks, and fruits at fill-up stations during cycling
________________________________________________________________________________________ Please make all registration fee payment to the Organiser: Bank: OCBC BANK Account Name: Borneoâ€™s Hidden Treasures Current Account Number: 765113377-4 Email, MMS or WhatsApp for prove of payment to: Patrick Wong Tel: +6016 8339343 E-mail: email@example.com Registration Forms can be obtained and payment made at the Cycling Association of Kota Kinabalu premises on behalf of the Organiser: Block D, Ground Floor, Lot 7, D-G-7 Lorong Pusat Komersial 88/2 88 Market Place, Ph. 10A 88200 Kota Kinabalu Registration fee for the said event must be paid before 20th March 2013 and is non-refundable.
DECLARATION I hereby declare that the above information is truthful and valid and by submitting this entry, I am fully aware of the below conditions and I release the organiser from all legal consequences upon signing of this registration form. I, the undersign, certify that the information on this form is correct and have signed here to signify that I am in agreement with this entry, and will participate in accordance with the rules and regulations of the PEDAL FOR PEACE event. I understand that the PEDAL FOR PEACE ride will be a strenuous event requiring special bicycle handling skills, which requires bicycle helmets to be worn by all participants while operating bicycle and there is no exception to this requirement. I hereby agree to participate in this event and voluntarily assume such risks. In consideration of being permitted to participate in this event, I release for myself, my heirs and personal representatives, Pedal for Peace and their respective co-organisers, volunteers, sponsors and staff from any claim, liability, demand, action and cause of action whatsoever arising out of this event.
Confirmed & Agreed
This scenic expedition will start in Kota Kinabalu where all of us will journey down the west coast to Menumbok and board a ferry to Labuan...