Mar 19, 2016 - Email: Emergency Contact Person: Relationship: Contact No: [ ] I hereby agree to Queensbay Mall processin
Registration at RM10 only!
Earth Hour Charity Ride 19 March 2016, Saturday | 7.30pm Queensbay Mall Outdoor Driveway
FREE t-shirt Programme 7.30pm Arrival of cyclist 7.45pm Live Band Performance Set 1 8.10pm Cyclists Assembly & Safety Briefing (North Zone, Outdoor) 8.15pm Lucky Draw Presentation 8.30pm Earth Hour Charity Ride Flag Off & Live Band Performance Set 2
Cyclist helmets and proper lightings (headlights & tail lights) are compulsory.
Participant’s Name:
Authorised By:
Contact Number: T-Shirt Size:
Date: S
M
L
XL CUSTOMER’S COPY
*Please bring along this slip for T-Shirt Collection.
Earth Hour Charity Ride 19 March 2016, Saturday | 7.30pm Queensbay Mall Outdoor Driveway Name:
Gender:
Male
Female
Age:
Address: NRIC:
Contact (H/P):
Emergency Contact Person: [
Email: Relationship:
Contact No:
] I hereby agree to Queensbay Mall processing my personal data for the above and contacting me in accordance with its Personal Data Protection Notice. (Kindly read our Privacy Policy at our Information Counter or visit www.queensbaymallmalaysia.com)
Acknowledgement & Indemnity Clause I, the undersigned, acknowledge the receipt of the abovementioned terms and conditions. I have fully read, understood and accepted the terms and conditions of the event. I further understand that The Management is merely a facilitator of Earth Hour Charity Ride and I shall take part in the activities at my own risk and expense. The responsibility lies solely on myself to ensure my own personal health, safety and security at all times during any events or activities carried out by The Management. I hereby release the Management from any liabilities in the event that I incur or suffer any types of loss, damage, injury and fatality howsoever incurred during or after the said events or activities including but not limited to any of loss, damage, injury and fatality incurred or suffered from the usage and/or possession of the prizes received by virtue of my participation in the event. I shall further indemnify The Management for any losses, damages, claims, demands, actions, proceedings, prosecutions, fines, penalties, costs, expenses and/or liabilities, personal injury or loss of life howsoever incurred and suffered by any third parties if caused by the actions of my participation during or after the event whether negligently or otherwise.
Signature:
Date:
Terms & Conditions 1. Earth Hour Charity Ride is opened to the public aged 16 years
old and above. 2. Registration opens until 6.00pm on 15 March 2016 at Info
Counter, Queensbay Mall. 3. All participants MUST wear cyclist helmets and ensure proper
lightings (headlights and tail lights) on their bicycles. 4. The Organiser will provide Isotonic Drinks, Mineral Water and
Light Snacks. 5. Lucky Draw prizes are not exchangeable, transferable or
redeemable for cash or other goods or services. 6. Absentees and/or participants who are not punctual shall be
disqualified from the event without notice and the Management shall not entertain any appeal from the participants. 7. The Management shall not be held responsible/liable for any damages, losses, claims, demands, actions proceedings, prosecutions, fines, penalties, costs, expenses and liabilities whatsoever if the event is cancelled or postponed for any reason whatsoever.
The Management reserves the right to amend any terms, conditions, rules and regulations and any other details without prior notice to any of the participants. 9. The Management reserves the right to use the participant’s name and email, likeness, image, voice, appearance and performance whether recorded on or transferred to videotape, film, slides, photographs, audio tapes, or other media, now known or late developed (herein referred to as the “Advertising Materials”). This right of use the Advertising Materials shall include but not limited to the right to edit, mix or duplicate and to use or re-use the Advertising Materials in whole or part as The Management may elect for the purpose of advertising and promotion. The Management or its designee shall have complete ownership of the Advertising Materials in which the participant appears, including copyright interest, and the participating acknowledges that he/she has no interest or ownership of its copyright. 10. For more information, call Information Counter at 04-619 8989. 8.
Registration at RM10 only!
Earth Hour Charity Ride 19 March 2016, Saturday | 7.30pm Queensbay Mall Outdoor Driveway
FREE t-shirt Programme 7.30pm Arrival of cyclist 7.45pm Live Band Performance Set 1 8.10pm Cyclists Assembly & Safety Briefing (North Zone, Outdoor) 8.15pm Lucky Draw Presentation 8.30pm Earth Hour Charity Ride Flag Off & Live Band Performance Set 2
Cyclist helmets and proper lightings (headlights & tail lights) are compulsory.
Participant’s Name:
Authorised By:
Contact Number: T-Shirt Size:
Date: S
M
L
XL CUSTOMER’S COPY
*Please bring along this slip for T-Shirt Collection.
Earth Hour Charity Ride 19 March 2016, Saturday | 7.30pm Queensbay Mall Outdoor Driveway Name:
Gender:
Male
Female
Age:
Address: NRIC:
Contact (H/P):
Emergency Contact Person: [
Email: Relationship:
Contact No:
] I hereby agree to Queensbay Mall processing my personal data for the above and contacting me in accordance with its Personal Data Protection Notice. (Kindly read our Privacy Policy at our Information Counter or visit www.queensbaymallmalaysia.com)
Acknowledgement & Indemnity Clause I, the undersigned, acknowledge the receipt of the abovementioned terms and conditions. I have fully read, understood and accepted the terms and conditions of the event. I further understand that The Management is merely a facilitator of Earth Hour Charity Ride and I shall take part in the activities at my own risk and expense. The responsibility lies solely on myself to ensure my own personal health, safety and security at all times during any events or activities carried out by The Management. I hereby release the Management from any liabilities in the event that I incur or suffer any types of loss, damage, injury and fatality howsoever incurred during or after the said events or activities including but not limited to any of loss, damage, injury and fatality incurred or suffered from the usage and/or possession of the prizes received by virtue of my participation in the event. I shall further indemnify The Management for any losses, damages, claims, demands, actions, proceedings, prosecutions, fines, penalties, costs, expenses and/or liabilities, personal injury or loss of life howsoever incurred and suffered by any third parties if caused by the actions of my participation during or after the event whether negligently or otherwise.
Signature:
Date:
Terms & Conditions 1. 2. 3. 4. 5. 6.
7.
Earth Hour Charity Ride is opened to the public aged 16 years old and above. Registration opens until 6.00pm on 15 March 2016 at Info Counter, Queensbay Mall. All participants MUST wear cyclist helmets and ensure proper lightings (headlights and tail lights) on their bicycles. The Organiser will provide Isotonic Drinks, Mineral Water and Light Snacks. Lucky Draw prizes are not exchangeable, transferable or redeemable for cash or other goods or services. Absentees and/or participants who are not punctual shall be disqualified from the event without notice and the Management shall not entertain any appeal from the participants. The Management shall not be held responsible/liable for any damages, losses, claims, demands, actions proceedings, prosecutions, fines, penalties, costs, expenses and liabilities whatsoever if the event is cancelled or postponed for any reason whatsoever.
The Management reserves the right to amend any terms, conditions, rules and regulations and any other details without prior notice to any of the participants. 9. The Management reserves the right to use the participant’s name and email, likeness, image, voice, appearance and performance whether recorded on or transferred to videotape, film, slides, photographs, audio tapes, or other media, now known or late developed (herein referred to as the “Advertising Materials”). This right of use the Advertising Materials shall include but not limited to the right to edit, mix or duplicate and to use or re-use the Advertising Materials in whole or part as The Management may elect for the purpose of advertising and promotion. The Management or its designee shall have complete ownership of the Advertising Materials in which the participant appears, including copyright interest, and the participating acknowledges that he/she has no interest or ownership of its copyright. 10. For more information, call Information Counter at 04-619 8989. 8.
