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 REGISTRATION FORM
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.
Event Dates:
This is to certify that I, ________________________, NRIC/Passport No.
___________,have read the rules and regulations pertaining to my participation in 25th & 26th of July
the Rockamania XIV organized by the Temasek Polytechnic Adventure Club and
Temasek Polytechnic Sports Climbing. In consideration of the acceptance of my 09
entry, I, for my heirs, executors and administrators, release and forever discharge
the Temasek Polytechnic Adventure Club and Sports Climbing Rockamania XIV 1st & 2nd of
Organizing Committee, for their sponsors, their appointed staff, officials or agents,
of all liabilities, claims, actions, damages, costs or expenses which I may have
August 09
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 Reporting Time:
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
Novice (sec) - 1300,
and attest that I am sufficiently fit physically to complete this event and that I 25 th
July
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 Novice (open)
this form. -0800,26 th July
______________________ _________________ __________________
Name of Participant Signature Open - 26th July 09, 1300hrs
Date
Intermediate - 1st August 09, 0800hrs
----------------------------------------------------------------------------------------------------- Organized By:
----------------------- Speed - 25th July 09, 1630hrs
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 XIV
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.
*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.

________________________ _________________ _________________

Name of Parent/ Guardian Signature Date Incomplete forms will be deemed invalid and will be dealt with as
stated in the Book of Rules & Regulations.
 Personal Particulars
Rules and Regulations
Name Gender M/F
1 General Rules and Regulations
1.1 Registration Closes on 20th July 2009. NRIC
1.2 Fees: Open Categories (Difficulty)- S$12.00 (Speed Individual)- S$6.00
Date of Birth
1.3 On-the-spot registration after the registration window period will only be allowed if there are
Address
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 School Postal Code
schools, universities and any other education institutes in Singapore will be able to participate in
Intermediate, Professional & Speed categories. Contact No. ^Age
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. Email *T-shirt size S / M / L / XL
1.7 Status of national climbers will be according to the list provided by Singapore Mountaineering
Federation (SMF). Categories ( please tick accordingly)
1.8 Each school is limited to 5 participants for each category, Except for novice (secondary school)
category
3 participants.
Difficulty – Novice ( secondary Men
school)
Difficulty – Novice ( open) WomenMen
2 Submission of registration forms
2.1 Registration forms can be directly mailed to the address stated below. Difficulty - Intermediate WomenMen
2.2 Cheques should be crossed and made payable to ‘Temasek Polytechnic– Adventure Club‘. Difficulty - Open WomenMen
(To be mailed along with the registration forms).
Speed (Individual) WomenMen
3 Registration
Women
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. Medical Information – Is there a history of/ have you ever had:
Yes No
3.2 Competitors will receive the event T-shirt and a goodie bag upon registration. 1. Chest Pain, Coronary Problems, High Blood Pressure…………….. ____ ____
3.3 Each school is limited to 5 participants for each category, Except for novice (secondary school) 2. Lung Problems ( Bronchitis, Tuberculosis etc.) …………………____ ____
category …... ____ ____
3 participants. 3. Asthma ……………………………………………………………………
(If yes, when did you last suffer an attack? ) ____ ____
4 Attire/Equipment
4.1 An event shirt will be issued to each participant upon reporting on the day of the event. All
4. Head Injury, Fits, Epilepsy, Fainting Attacks, Migraine … ____ ____
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 5. Back/ Neck Problems …………………………………………………… ____ ____
based shirt. 6. Diabetes …………………………………………………………………..____ ____
4.3 No bare bodied climbing. 7. Eye (Vision)/ Ear (Deafness) Problems ………………………………. ____ ____
4.4 Harnesses and helmets will be provided for all competitors but they may choose to use their own. 8. Nervous Illness …………………………………………………............. ____ ____
9. Arthritis, Bone or Joint Injury …………………………………………… ____ ____
5 Judging
5.1 Difficulty: Competitors will be judged according to the legitimate hold-touch point; height
10. Surgery within the last 3 years ……………………………………….. ____ ____
reached by dynamic means is allowed. 11. Allergies (Drugs, Food etc.) …………………………………………...
12. Routine Medication Needs …………………………………………….
6 Appeals ( If yes to any of the above, please specify:
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. Do you have any other disability or medical information you wish to
highlight?
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. For Women only: Are You Pregnant? No_____ Yes_____
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.
In the event of an emergency
Personthat
I declare to contact: _______________________
all the information Relationship:
provided by me are true and correct to the best of
For enquiries please do not hesitate to contact
my__________
knowledge.
Xue Qian at 96258553 (HP)
Address: _____________________________________ Tel:___________
siokyman@hotmail.com (Email) ______________________ ________________
Temasek Polytechnic – TP Sports Climbing C/O TP Adventure Club, Signature Date
Student & Alumni Department, * Subject to availability of sizes ^ As of 1st January 2009