Participant Registration Emac (2)

TEAM BUILDING, CORPORATE RETREATS AND EXPEDITIONS CAVING, PARAGLIDING, HANG GLIDING, EXPLORING, ROCK CLIMBING, RAPPELLING RAP JUMPING, CLIFF DIVING, NIGHT CAVING DAY TRIPS, WEEKEND CAMPINGS, MULTI-DAY EXPEDITIONS AND SAFARIS Participant ID:______________________ Date:______________________ Event ID:______________________ Instructor/Guide:______________________

REGISTRATION FORM

FIRST NAME AGE

SUR NAME OCCUPATION

ADDRESS

EMAIL

HOME PHONE__________________WORK PHONE_____________________MOBILE_____________________

DIETARY REQUIRMENTS

NO

YES

MEDICAL CONDITIONS

NO

YES

PAST EXPERIENCE

(Paragliding)

(Caving)

(Rock Climbing)

(Swimming)

(Hiking)

IN CASE OF EMERGENCY, PLEASE CONTACT (NAME & TELEPHONE NUMBER)

- - PERSONAL DECLARATION - I CONFIRM THAT : I am 18 years of age or over on the day of this event – if under 18 this form must be signed by Parent/Guardian • • • • • •

I am medically fit and will inform the Organizers in advance of the day of any medical condition which may affect my participation. I am taking part in this event entirely at my own risk and that the Organizers, Club staff, Sponsors, and Suppliers will not be liable for any injury or loss in consequence of my participation in this event. EMAC will not accept responsibility for claims in respect of death or bodily injury or damage to property arising as a result of dare-devil acts, negligence and not following instructions. That I will be liable for any loss or damage to the club property including equipment owned (or leased from a third party supplier) in consequence to my use of the said equipment in this event. That I will respect the culture, people and natural habitat of the area and refrain from unnecessary pollution.

Participants Signature and Date

1

Disclaimer: There are significant elements of risk and hazards to participants in any adventure sports. Each participant is responsible for making choices involving certain risks while accomplishing the tasks presented. The EMAC Club staff will provide as safe an environment as possible, but cannot eliminate all of the elements of risk and danger given the nature of the activities. Risks: The risks involved are not limited to but include the following: o Injury from falling from high elevations. o Cuts, bruises, abrasions, muscle and tendon strain, insect stings, rope burns, paralysis and death. o Injury from falling equipment or rocks and the presence, actions or falls of other participants and staff. o Getting dirt or other materials in the eyes. o Injuries from choosing not to wear a personal harness or helmet o Failure to follow the safety policies and instructions. o Misuse of equipment or facilities, failure of ropes, harness, climbing hardware, anchor points or any part of the equipment. o Fatigue, dehydration, chill and/or dizziness which may diminish reaction time and increase the risk of accidents. o Slips, trips or crashes during hiking/trekking or activity. Assumption of Risk and Release: I hereby certify that I have full knowledge of the risks involved in adventure and extreme sport activities and that not all risks can be eliminated given the nature of these activities. Further, I expressly agree and assume/accept all of the related risks. My participation in this activity is purely voluntary. I hereby voluntarily release, forever discharge, agree to indemnify and hold harmless and covenant not to sue Extreme Maneuvers Adventure Club, its employees, and suppliers for any and all claims, demands, causes of action, damage, personal injury, costs and expenses which are in any way connected with my participation in this event, equipment or facilities whether caused by the negligence, omissions or carelessness of the club staff. This release shall be binding on my family, heirs, estate, administrators, personal representatives and assigns. My signature below indicates that I have been made aware of the risks involved and/or given a copy of the Disclaimer and Risks that I have read and understand.

__________________________________________ Participant Signature __________________________________________ Participant Printed Name __________________________ Date Extreme Maneuvers Adventure Club Suite # 6, Block III, PHA G-7/2 Islamabad Pakistan +92.321.8562477 +92.300.2440066 www.emac1.webs.com

2

Useful Information This expedition is organized to be held in Khanpur Lake area, near Taxila. It is about 1 hour drive from Islamabad and close to all emergency services. It is advisable to tell someone about your trip and expected return time. Also leave our contact details at home or your work place. Mobile phone signal might fluctuate in some areas. Expected return time to Islamabad is 9.00 pm. Traffic congestion at Tarnol area, on GT Road may cause slight delay during our return journey. Trip Instructors: Mohammad Rashid Saeed Alam

0321 8562477 0300 2440066

Ideal clothing to wear: Jeans & T Shirt Hiking boots Cap Sunglasses Highly Recommended and useful ‘bring • • • • •

along items’:

Sandals Extra T Shirt Sun block Swimming costume Towel

It is important to also note that expensive personal items like jewelry, mobiles, IPods, cameras etc be left at home, whenever possible. Branded or expensive clothing is also not advisable as they WILL get soiled or damaged. The safety of your personal property is solely your own personal responsibility. EMAC, or its staff and suppliers will not be held responsible for any such items that are lost, dropped, damaged or left behind. If you have any questions, please feel free to ask your instructor or booking agent,. You can call us now or visit our website for more details.

What to expect: Safe, Professional Guides/Instructors • Personalized Experiences • Chilled refreshments throughout & BBQ Lunch • Amazing Natural Beauty • New skills • Lots of laughter • Exploration and Discovery at a comfortable pace •

HAVE FUN! 3