Reporting Time:: Event Dates

INDEMNITY Notice: This document is a legally binding agreement. By signing this agreement you are acknowledging that you have read , understood and accepted the terms and conditions stated on this agreement. You further acknowledge and agree that you are waiving your rights to bring court action to recover compensation or obtain any other remedy for any injury /damage to your self or your property. This is to certify that I, ________________________, NRIC/Passport No. ___________,have read the rules and regulations pertaining to my participation in the Rockamania XV organized by the Temasek Polytechnic Adventure Club and Temasek Polytechnic Sports Climbing. In consideration of the acceptance of my entry, I, for my heirs, executors and administrators, release and forever discharge the Temasek Polytechnic Adventure Club and Sports Climbing Rockamania XV Organizing Committee, for their sponsors, their appointed staff, officials or agents, of all liabilities, claims, actions, damages, costs or expenses which I may have against them arising out of or in any way connected with my participation in this event, including travel to or from this event, including all accidents, injuries or death that may be suffered by me before, during or after the event, or damage to my equipment sustained during my participation in this event. I understand that this indemnity includes any claims based on negligence, action, or inaction of any of the above parties. I acknowledge that there are significant elements of risk associated with the sports climbing, bouldering and fitness training regime and equipment. I further acknowledge the nature and extent of the risks inherent in climbing and the use of its related facilities. I recognize the difficulties of the event and attest that I am sufficiently fit physically to complete this event and that I have not been advised otherwise by a qualified medical professional. I also acknowledge that I have read and will abide to the Rules and Regulations stated in this form. ______________________ _________________ __________________ Name of Participant Signature Date --------------------------------------------------------------------------------------------------------------------------TO BE COMPLETED BY PARENT/GUARDIAN OF PARTICIPANT UNDER 21 YEARS OF AGE I, ________________________________, NRIC/Passport No. ______________, hereby allow my son/daughter/ward to participate in the above mentioned Rockamania XV organized by Temasek Polytechnic Adventure Club and Sports Climbing and would not hold the organizers, sponsors, staff and officials responsible for any accidents, damages, mishaps, injuries or loss of life that may occur in the course of or as a result of his/her participation in this event. ________________________ Name of Parent/ Guardian

_________________ Signature

REGISTRATION FORM Event Dates: 25th & 26th of July 09 1st & 2nd of August 09

Reporting Time: Novice (sec) - 1300, 25th

July Novice (open)

-0800,26 th

July

Open - 26th July 09, 1300hrs Intermediate - 1st August 09, 0800hrs

Organized By:

*Note: In the event that bad weather be experienced during the competition, the events from the closed category will be postponed to the following weekend, subject to the discretion of the organisers.

_________________ Date

FOR PARTICIPANTS OF THE OPEN NOVICE CATEGORY

Incomplete forms will be deemed invalid and will be dealt with as stated in the Book of Rules & Regulations.

Rules and Regulations 1 1.1 1.2 1.3

General Rules and Regulations Registration Closes on 20th July 2009. Fees: Open Categories (Difficulty)- S$12.00 (Speed Individual)- S$6.00 On-the-spot registration after the registration window period will only be allowed if there are any vacancies. An additional fee of S$4.00 will be collected for on-the-spot registration. 1.4 Only full-time students of secondary schools will be able to participate in the Novice category. 1.5 Only full-time students of secondary schools, polytechnics, junior colleges, ITEs, international schools, universities and any other education institutes in Singapore will be able to participate in Intermediate, Professional & Speed categories. 1.6 Climbers who have represented Singapore within the span of the last 3 years, or who are part of the Singapore National Team are eligible to compete in the Difficulty-Pro and Speed events. 1.7 Status of national climbers will be according to the list provided by Singapore Mountaineering Federation (SMF). 1.8 Each school is limited to 5 participants for each category, Except for novice (secondary school) category 3 participants.

Personal Particulars Name

Gende r N RIC

Date of Birth Addres s Schoo l Contact No. Emai l

Categories

M/ F

Postal Code ^ Age *T-shirt size

S/M/L/ XL

( please tick

accordingly)

2 Submission of registration forms 2.1 Registration forms can be directly mailed to the address stated below. 2.2 Cheques should be crossed and made payable to ‘Temasek Polytechnic– Adventure Club‘. (To be mailed along with the registration forms). 3 Registration 3.1 Competitors are required to bring their student pass or student identification card of their education institution for identification and verification purposes on the day of the competition. 3.2 Competitors will receive the event T-shirt and a goodie bag upon registration. 3.3 Each school is limited to 5 participants for each category, Except for novice (secondary school) category 3 participants. 4 Attire/Equipment 4.1 An event shirt will be issued to each participant upon reporting on the day of the event. All competitors are required to wear the event shirt throughout their event (isolation and climb). 4.2 Note: Event shirt will not be issued to speed participants. Participants to be dressed in school based shirt. 4.3 No bare bodied climbing. 4.4 Harnesses and helmets will be provided for all competitors but they may choose to use their own. 5 Judging 5.1 Difficulty: Competitors will be judged according to the legitimate hold-touch point; height reached by dynamic means is allowed. 6 Appeals 6.1 If a competitor disputes the results of the competition, a written appeal must be made within 30 minutes of the release of the results and must be accompanied by a sum of S$50.00 in cash and will only be refunded if the appeal is successful. 7 Important note 7.1 The Organizing Committee reserves the right to amend any part of the Rules and Regulations without prior notice. The Book of Rules and Regulations will be available on request. 7.2 There is a quota on participants for this competition in order to tally with our planned schedule. 7.3 Event shirts will be given while stocks last.

Sent your name, category and IC to [email protected] for booking of slots. For enquiries please do not hesitate to contact Xue Qian at 96258553 (HP) [email protected] (Email) Temasek Polytechnic – TP Sports Climbing C/O TP Adventure Club, Student & Alumni Department,

Medical Information– Is there a history of/ have you ever had: Yes 1. Chest Pain, Coronary Problems, High Blood Pressure…………….. ____ 2. Lung Problems ( Bronchitis, Tuberculosis etc.) ……………………... ____ ____ 3. Asthma …………………………………………………………………… (If yes, when did you last suffer an attack? ) ____ 4. Head Injury, Fits, Epilepsy, Fainting Attacks, Migraine … ____ …............ ____ 5. Back/ Neck Problems …………………………………………………… ____ 6. Diabetes …………………………………………………………………..____ 7. Eye (Vision)/ Ear (Deafness) Problems ………………………………. ____ 8. Nervous Illness …………………………………………………............. ____ 9. Arthritis, Bone or Joint Injury …………………………………………… ____ 10. Surgery within the last 3 years ……………………………………….. ____ 11. Allergies (Drugs, Food etc.) …………………………………………... 12. Routine Medication Needs ……………………………………………. ( If yes to any of the above, please specify: ________________________)

No ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____

Do you have any other disability or medical information you wish to highlight? _____________________________________________________________________

For Women only: Are You Pregnant? No_____ Yes_____

I declare that all the information provided by me are true and correct to the best of my knowledge. ______________________ Signature

________________ Date

* Subject to availability of sizes

^ As of 1st