The Rotary Club of Harlow Tye
DISTRICT 1240 No. 1361
Abseil co-ordinator - Bill Colton
Telephone 01279 423879
www.harlowtyerotary.org.uk
e-mail :
The 2016 Abseil for Charity
at Church Langley Water Tower, Harlow on Saturday 30th April and Sunday 1st May 2016
REGISTRATION FORM
Your Full Name
Age on event day (only required if you will be UNDER 19)N.B. You must be 16 years of age or over on the day to participate.
Postal Address
Post Code
Telephone / (day) / (evening)
Our Charity / Rotary Club of Harlow Tye Trust Fund
A registered charity supporting the local community and giving aid to local and national charities
Or Name the Charity of your choice /
1st Preferred
Day & Time / Day Time
2nd Preferred
Day & Time / Day Time
In registering to take part in the 2016 Abseil, I have read and will abide by all the Terms and Conditions, and enclose my registration fee of £35 If you register before the 31st December 2015 your registration fee will be £30
Please tick this box if you agree that your name and address (only) may be
passed to your nominated charity by us (to comply with Data Protection Act 1998).
Signature DateSend completed form with a cheque or postal order made payable to:
Rotary Club of Harlow Tye and post items to: -
Bill Colton, Event co-ordinator
85 Copse Hill
Harlow CM19 4PP
PTO
HARLOW TYE ROTARY CLUB - ABSEIL FOR CHARITY 2016
NOTES FOR PARTICIPANTS AND TERMS & CONDITIONS OF ENTRY
Harlow Tye Rotary Club wishes you to be aware that mobile telephony masts are present and will be operating on the tower during the event. We have been assured that there is no risk to the health or safety of participants by the presence or proximity of this equipment.
Conditions and event instructions: By entering the event you agree to abide by ALL the Terms and Conditions of Entry, and will follow any instructions given to you either by the organisers and officials of the Harlow Tye Rotary Club Abseil for Charity, or by the officials of the Dukes Barn Outdoor Adventure Organisation.
Registration fee: Whether you decide to raise funds for the Rotary Club of Harlow Tye Trust fund, or an organisation of your own choice, the individual registration fee of £35 is payable by cheque in advance, and this payment must accompany your registration form. If you register before 31st December 2015 the fee is £30. Payment can be made on line, please contact Bill Colton for further details.
Once your entry has been accepted, your registration fee is non-refundable.
Age: You must be 16 years of age or over on the day that you take part in the event.
There is no maximum age. (See also Medical Condition and Wheelchair entrants, below).
Beneficiaries: Your chosen registered or unregistered charity, or voluntary organisation, must be preapproved by the Rotary Club of Harlow Tye. Acceptance of your registration is dependent on the acceptability to us of your nominated beneficiary group. If you do not know, please contact us first.
In taking part, you agree to send your collected sponsorship monies direct to Harlow Tye Rotary Club as soon as possible after the event. No deduction will be made by the club from any monies sent to us before these are passed on to your nominated beneficiary.
This process is essential to allow us to provide an accurate audit of the event.
Collection and transfer of your sponsorship via ‘online giving sites’ will only be allowed subject to specific criteria. If you want to do this, tell us and we will ask you for the details we must have in order to give approval.
Disclaimer: You will be required to sign a general disclaimer on the day in order to take part in the event. This will not preclude your right to take action in the event of proven negligence on the part of our officers, contractors or agents, nor restrict liability for actions by them, that are not lawfully permitted.
Participants under 19 years old must get a parent, guardian or carer to sign a waiver regarding photos.
Medical condition: You are strongly advised to consult your doctor prior to taking part, if you have any medical condition which may put you at risk e.g. heart problems.
Wheelchair or other disabled entrants: If you cannot climb the central stairs and ladder inside the Water Tower due to a disability, your entry may still be accepted if you are willing to be winched up the outside of the Tower. Due to time constraints, the number of such entries available is extremely limited.
You must advise us of the nature of any disability when sending your registration form, as we may need to confer with our professional contractor before accepting the entry.
Data protection: Officials of Harlow Tye Rotary Club will process and hold your personal data solely for the purposes of managing your entry and participation in the Abseil, and will do so in accordance with the Data Protection Act 1998.
Use of data and image: By entering the event you give permission for the free use of your name, voice and/or picture in any broadcast, telecast, advertising, promotion or other account of the event, organised by the Rotary Club of Harlow Tye.
Event cancellation: If the event is delayed or cancelled due to any situation beyond our control,
e.g. adverse weather conditions, we will try to arrange for the event to take place at a later date.
No registration fees are refundable, under any circumstances.