Amazing Race Reg Form

SANDSATIONAL RACE 2009 TIONG BAHRU CC YOUTH GROUP OFFICIAL REGISTRATION FORM

CLOSING DATE: 8th May 2009, Friday 1200hours Registration Fee: PAssion Card Holders: $75/= per team Non-PAssion Card Holders: $85 per team ** EARLY-BIRD DISCOUNT: $60 per team (PAssion Card Holders Only) Registration Venue: Tiong Bahru Community Centre, 67A Eu Chin Street Singapore 169715 or fax to 62210034 (Att. Mr. Teo) Registration form without signatures will be rejected without notification. Serial No. of PAssion Card (if applicable): Please tick (√ ) one below: Name of Team: No. of Indemnity Form: ________ Secondary Level JC/Poly/ITE Level

Position

Name (as in NRIC) NRIC No.

Contact Number Name of School/Institution Email Address

Residential Address Blk

Street & Unit No.

Postal Code.

T-Shirt Sizes

Signature

S/M/L/XL

1. Participant (Leader) 2. Participant

3. Participant

4. Participant

5. Participant

TEAM CAPTAIN’S DECLARATION I agree to send a team to SANDSATIONAL RACE 2009. I shall not hold the organizer(s) or the Peoples’ Association responsible for any loss of life or injury sustained arising from the activity. My team shall be responsible for replacement of damaged bicycle equipment that I borrowed from the organizer(s). The team will abide by the Rules and Regulations, maintain good conduct, and play in the spirit of fair play and sportsmanship. ……………………………………………… Name of Team Captain

…………...………………… Signature & Date

Payment Mode: Cash or Cheque Cash payment is to be made at Tiong Bahru CC Cheque Payment payable to “Tiong Bahru CC Youth Group” and mail it to: 67A Eu Chin Street Singapore 169715 Please note that payment must be made within 7 days upon submission of registration form.