Entry Form - Green Valley

Transcription

Entry Form - Green Valley
ENTRY FEE
Attached is cash/cheque No: ________________ payable to “PERSATUAN ANANDA MARGA YOGA KUALA
LUMPUR” being payment for as follows:
a) 4 adults (2 rooms twin share) (Driver, Navigator and 2 Passengers) @ RM740
RM _______
b) 2 adults (1 room twin share) (Driver and Navigator only) @ RM440
RM _______
c) 3 adults (1 room triple share) @ RM630
RM _______
d) 1 additional adult team member (1 single room) @RM360
RM _______
e) Child sharing room without extra bed @ RM90 per child x _______ child/children
RM _______
f)
Child sharing room with extra bed @ RM120 per child x _______ child/children
RM _______
g) Non Staying (incl. prize presentation dinner only) @ RM150 per person x ______ person/s
Total Payable:
RM _______
RM
Entry Fee above includes participation fees, accommodation at Pulai Spring Resort, Prize Presentation buffet
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buka puasa dinner on 11 July 2015, as well as buffet breakfast or sahur on 12 July 2015 with an exception for
(g) which excludes accommodation and breakfast. Child rates apply only to those aged between 5 to 12. Anyone
above 12 years will pay normal adult fee as above. No charges for children aged below 5 who share bed with
adult team member.
Please submit this entry form together with cash/cheque to:
PERSATUAN ANANDA MARGA YOGA KUALA LUMPUR
The Secretariat,
Green Valley Treasure Hunt 2015
No 3. Jalan Sepakat 9, Off Jalan Sepadu, Taman Bukit Indah,
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5 Miles Old Klang Road, 58200 Kuala Lumpur.
Or bank in the payment to Public Bank A/C No: 3178330430 for “PERSATUAN ANANDA MARGA YOGA
KUALA LUMPUR” and email the bank-in slip together with this entry form to:
E-Mail: [email protected]
For assistance, please call our Hotline @ 012-278 9935
DECLARATION
In consideration of the acceptance of our entry, we, the undersigned, hereby agree to abide by the Rules and
Regulations of the GREEN VALLEY TREASURE HUNT 2015 (“The Hunt”) and to indemnify and save harmless
PERSATUAN ANANDA MARGA YOGA KUALA LUMPUR, the Sponsors of the Hunt, the Federal and State
Governments of Malaysia and all other person or persons howsoever connected to or involved with the
organisation or conduct of the Hunt and their respective servants or agents from all actions’ claims, costs and
damages in respect of death or injury to any of us or damage to our property howsoever caused arising out of our
taking part in the Hunt notwithstanding that such death, injury or damage may have been contributed to or caused
by the negligence of the aforesaid bodies, their servants or agents. We further declare that all the information
given in this Entry Form is true and complete.
Driver
:
Signature :
Navigator
:
Signature :
Passenger 1
:
Signature :
Passenger 2
:
Signature :
For office use only:
Competition No:
___________________
Official Receipt:
No:______________ Date: ________
Authorised by:
________________________
GREEN VALLEY TREASURE HUNT 2015
Rules and Regulations
1. Participating vehicles must be motorised (excluding lorries, buses and motorcycles) with valid road tax and
insurance as at the day of the Hunt.
2. Each team shall consist of a driver and a navigator, with an option of no more than 2 additional passengers, but
the Organiser may allow additional young children to travel with the team. The Declaration duly signed by all the
team members must be submitted together with the Entry Form. The Declaration must be signed by
parents/guardians on behalf of all team members who are minors and the Organiser shall be required to enquire if
such consent has been obtained or not.
3. The Driver and Navigator in each team must possess valid driving licences as at the day of the Hunt.
4. Entry fees must be submitted together with the completed Entry Form.
5. To be eligible to win the prizes for the Treasure Hunt, at least one member of the team should be present during
the prize presentation dinner.
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6. At least 1 team member from each team must attend the Registration and Briefing on Thursday, 9 July 2015, at
a venue to be advised later. He/She/They shall be responsible for disseminating all information provided at the
briefing to all other team members.
7. Competition numbers and various car stickers provided by the Organiser shall be placed on the participating
vehicle as directed by the Organiser and must remain on the vehicle throughout the Hunt. No other form of
advertising other than those provided by the Organiser shall be permitted.
8. Participants are required to comply with the dress code for the Event as determined by the Organiser.
9. Any change(s) to entries after submission must be made on or before the Briefing Date subject to acceptance by
the Organising Committee, otherwise teams will be deemed to comprise of the members stated in the Entry form
as at the Briefing date.
10. Starting order for the Hunt shall be as determined by the Organiser.
11. All treasures submitted shall belong to the Organiser and no team or members thereof shall have any claim
thereto.
12. The team that scores the highest number of points in the Hunt less penalty points incurred will be declared the
winner and all subsequent positions will be determined on the same basis. In the event of a tie, tie-breakers shall
be announced to the participants at the Briefing.
13. The Organiser reserves the right without assigning any reason therefore to:
a. Make any changes, abandon, cancel or postpone the Event as deemed necessary
b. Reject any Entry whether before or after he acceptance thereof;
c. Bar or exclude any one or more members from any team.
d. Disqualify and or impose penalty points on any team found to have been guilty of
i. Any breach of these Rules and Regulations or road traffic rules
ii. Collaboration or cheating in any manner
iii. Providing false Declaration and
iv. Failing to complete the Hunt within the stipulated time
14. All materials of whatsoever nature in relation to the Hunt shall belong to the Organiser who shall be entitled to use
such materials to publicise the Hunt in any form or any purpose that the Organiser deems fit.
15. These Rules and Regulations may be added to or amended at the discretion of the Organiser. These Rules and
all additions and amendments thereto, the interpretation thereof and the decision of the Organiser in all matters
concerning the Event shall be final and binding on all participants.
ENTRY FORM
Please fill in:
Vehicle Registration No:
Road Tax Expiry Date:
No. Of team members observing Ramadan:
(for Sahur Food Pack)
____________________
_________________
_________________________________
Driver
Mr/Ms/Mdm
:
Birth Date
:
Address
:
Tel No
:
Email
:
HP :
(O)
H
(Fax) :
:
:
Navigator
Mr/Ms/Mdm
:
Birth Date
:
Address
:
Tel No
:
Email
NRIC (new) :
HP :
(O)
H
(Fax) :
:
:
:
Passenger 1
Mr/Ms/Mdm
:
Birth Date
:
Address
:
Tel No
:
Yes, I would like to support ANANDA MARGA in its future activities.
Email
:
Enclosed please find a cheque payable to “PERSATUAN ANANDA MARGA YOGA KUALA
LUMPUR” amounting RM ______________ (Cheque No: ____________________)
Passenger 2
Name (in full)
:
Birth Date
:
Address
:
Address
:
Tel No
:
Email
:
ANANDA MARGA DONATION FORM
NRIC (new) :
Mr/Ms/Mdm
NRIC (new) :
HP :
(O)
H
(Fax) :
:
:
:
NRIC (new) :
:
Contact No
:
E-Mail
:
All donations received will be issued with official receipts.
HP :
(O)
H
(Fax) :
:
: