ENTRY FORM

INDEMNITY

ST. MICHAELS INSTITUTION ALUMNI ASSOCIATION (KLANG VALLEY)

GREEN & WHITE CHARITY TREASURE HUNT.
SUNDAY, 30th JUNE 2013

ST. MICHAELS INSTITUTION ALUMNI ASSOCIATION (KLANG VALLEY)

GREEN & WHITE CHARITYTREASURE HUNT.
SUNDAY, 30thJUNE 2013

OFFICE USE ONLY

Received on: ______________ Paid : ( Yes/No)

COMP. NO: _______________________

CAR REG. NO : ___________

TEAM NAME : ___________________________________________________________
DRIVER
Name : _____________________________I.C. No:________________________________
SMI Alumni (Yes/No ) _______ Alumni Membership No : ___________________________
Mobile No:______________________ E-Mail:____________________________________
NAVIGATOR
Name : _____________________________I.C. No:________________________________

We have read the rules and regulations issued for this event and agree to be bound by them.
In consideration of acceptance of this entry or our being permitted to take part in this event,
we agree to save harmless and keep indemnified the following :
a) The Organiser
b) The Clerk-Of-Course/ Hunt Organisers
c) The Sponsors
d) The Federal and State Governments of Malaysia
e) The Land Owners through whose property this event will run and
f) Their respective officials, servants, representatives and agents
from and against all actions, claims costs, expenses and demands in respect of death or injury
to myself however caused arising out of or in connection with this entry or my taking part in
this event, and notwithstanding that the same way have been contributed to or occasioned by
the negligence of the said bodys officials, servants, representatives or agents.
We declare that the use of the vehicles entered for this event is covered by insurance
as required by the Motor Vehicle (Third Party Risks) Rules (Malaya) 1959 and/or
Road Transport Act 1987 and/or other relevant rules and regulations which is valid for
such part of this event as shall take place on public roads as defined in these rules.
Name

Signature

SMI Alumni(Yes/No ) _______ Alumni Membership No : ____________________________

DRIVER

_____________________________________ _____________________

Mobile No:______________________ E-Mail:___________________________________

NAVIGATOR

_____________________________________ _____________________

PASSENGER I

_____________________________________ _____________________

PASSENGER I
Name : _____________________________I.C. No:________________________________

PASSENGER II
_____________________________________ _____________________
(NB: All participants must sign the Indemnity Form)

SMI Alumni (Yes/No) _______ Alumni Membership No : ____________________________

Mobile No:______________________ E-Mail:___________________________________
PASSENGER II
Name : _____________________________I.C. No:________________________________
SMI Alumni (Yes/No) _______ Alumni Membership No : ____________________________
Mobile No:______________________ E-Mail:____________________________________

Place pay in slip here

RULES AND REGULATIONS

Introduction
This event is a Motorised Treasure Hunt (the Event) and is organised by St. Michaels Institution
Alumni Association Klang Valley (the Organiser) to raise money for the MICHAELIANS GIVE
BACK fund. The fund will be disbursed to needy students to help them continue their studies at St
Michaels Institution, Ipoh including covering costs for books, uniforms, and commuting to school.
Eligibility
Participation is open to the public. A team should consist of min 2 or max 4 persons. To qualify for
Alumni Association category at least 2 team members must be alumni association members.
Prizes
There will be 20 top Prizes.
1st Cash RM2000
2nd Cash RM1500
3rd Cash RM1200
And 17 Other prizes (Total 20)
Top 3 Alumni teams will received additional RM250, RM150 and RM100 respectively.
Official Briefing
Date : 26 June 2013 @ 7.00pm
Venue: La Salle Hall, (opposite SMK LA SALLE PJ) Jalan Chantek, ,PJ
Regular hunters need not attend, briefing note /details will be email out on 27 June 2013.
Treasure Hunt Day:
Sunday, 30th June 2013. Duration: 5hrs (8.00 a.m. to 1.00 pm.)
Route
Navigation will be by described by Route Sheets handed at the start of the event.
The Route Sheets will take the form of TULIP type. All distances will be in kilometres.
Entry Fees
RM 320/car.Payment must be made before the event by direct pay-in to ST. MICHAEL'S
INSTITUTION ALUMNI ASSOCIATION. Maybank A/C No:564801642725
Rights of the Organiser
The Organiser may at their discretion :
a) Refuse any entry of a car which is not road worthy or does not have the necessary road tax
and insurance.
b) Abandon, cancel or postpone the Event in the event of unforeseen circumstances.
Participants are to note that the decision of the Organiser in any matter pertaining to the Event
is final.No protest or claim of any kind and will be entertained under any circumstance.
Entries
a) Entries are to be filled in block letters.
b) Entries are open with immediate effect and will close on 15 June 2013.
c) Entry forms and pay in slip are to be faxed to 03-77295103
Or you may also email to: thomasan2010@unifi.my
d) For further enquiries, please call Thomas Nathan at 012-3338654/ 03 77258654

GREEN & WHITE

CHARITY TREASURE HUNT
SUNDAY 30thJune 2013
STARTS / ENDS: SMK La Salle, PJ.
ORGANISED BY
ST. MICHAELS INSTITUTION ALUMNI ASSOCIATION (KLANG
VALLEY)
FOR
THE MICHAELIANs GIVE BACK fund