CONTENT PAGE. 1. Pre-event 1.1 Cycle Pack Collection 1.2 Pre-event Briefing 1.3 Bike Tune-Ups

Transcription

1 E-Briefing Notes

2 CONTENT PAGE 1. Pre-event 1.1 Cycle Pack Collection 1.2 Pre-event Briefing 1.3 Bike Tune-Ups 2. Overview of TTSH Community Charity Fund Charity Ride Program Overview 2.2 Ferry Services 2.3 Accommodation: Nirwana Gardens, Bintan 2.4 Checklist: Things to Bring 2.5 Serial I.D Number Stickers 2.6 Bike Transport 2.7 Protecting your Bike 2.8 Luggage 3. Route 3.1 Fun30km 3.2 Explore60km 3.3 Challenge145km 3.4 Official Support Vehicles 3.5 Bike Mechanic 3.6 Wet Weather Advisory 4. Others 4.1 Safe Cycling Tips 4.2 Insurance coverage 4.3 Hotline

3 1. PRE-EVENT 1.1 Cycle Pack Collection You may collect your Cycle Pack on the following dates: Date Time Location 8 June, Sat 11am to 3pm Tan Tock Seng Hospital Atrium Level 1 (opposite Kopitiam) 15 June, Sat 11am to 3pm Tan Tock Seng Hospital Atrium Level 1 (opposite Kopitiam) All cycle packs must be collected prior to the event. Please bring along your NRIC/ Passport along with your Cycle Pack Collection Notification for identification. 1.2 Pre-event Briefing (Attendance is strongly encouraged) Participants are encouraged to attend the pre-event briefing on the traveling details, program schedule, routes, safety plans and other essential information. You may choose to attend the briefing on either of the following dates: Date Time Location 8 June, Sat 1pm to 2pm Tan Tock Seng Hospital Annex Block, Level 5 Meeting Room L5-N-M002 (Pavilion) 15 June, Sat 2pm to 3pm Tan Tock Seng Hospital Annex Block, Level 5 Meeting Room L5-N-M002 (Pavilion) Kindly confirm your attendance for the Pre-event Briefing with Xin_Yi_NG@ttsh.com.sg 1.3 Bike Needs Visit our Official Bike Mechanic, Fat Cat Cycles, for your bike servicing needs. You are encouraged to send your bike for professional servicing before the event. You may also discuss your bike needs with Fat Cat Cycles, in anticipation for any possible requirements for the event. Address: 33 Ubi Ave 3 #01-09 Vertex Singapore Telephone: info@fatcatcycles.sg Website: All participants will receive a 15% discount voucher in their cycle pack for purchases of Storck branded bikes, parts and accessories. The discount voucher is valid till 31 December 2013.

4 2. OVERVIEW OF TTSH COMMUNITY CHARITY FUND CHARITY RIDE Program Overview Due to the ferry s limited capacity, cyclists will be split into 2 departing groups. Group 1 cyclists will depart on the 2pm Ferry to Bintan. Group 2 cyclists will depart on the 5pm Ferry to Bintan. Program for Fun30km and Explore60km Date Time Programme 21 June, Friday Group 1 cyclists 11.30am to 1.00pm 2.00pm (SG Time) 2.00pm (Bintan Time*) 3.30pm Group 2 cyclists 2.30pm to 4.00pm 5.00pm (SG Time) 5.00pm (Bintan Time) 6.00pm 7pm to 9.30pm 9.30pm Registration at Tanah Merah Ferry Terminal Ferry DEP for Bintan Ferry ARR at Bandar Bentan Telani Ferry Terminal Safety Resort Center (1hr) Registration at Tanah Merah Ferry Terminal Ferry DEP for Bintan Ferry ARR at Bandar Bentan Telani Ferry Terminal Safety Resort Center (1hr) Bike tuning Lock-up 22 June, Sat 5.00am 7.30am 9.00am onwards 10.30am onwards 11.30am to 1.00pm 12.00pm 2.15pm 2.30pm 3.35pm Breakfast Flag-off Expected completion of Fun 30km ride Expected completion of Explore 60km ride Quick Lunch before departure Check-out time Get ready to leave for Ferry Terminal Coach depart for Bandar Bentan Telani Ferry Terminal Ferry DEP for Singapore *Bintan is 1 hour behind Singapore. Please note that the above schedules are subject to changes. The Organizers reserve the right to amend the schedules or any other information deemed necessary without prior notice.

5 Program for Challenge145km Date Time Programme 21 June, Friday Group 1 cyclists 11.30am (SG Time) Registration at Tanah Merah Ferry Terminal 2.00pm 2.00pm (Bintan Time) 3.30pm Ferry DEP for Bintan Ferry ARR at Bandar Bentan Telani Ferry Terminal Safety Resort Center (1hr) Group 2 cyclists 2.30pm (SG Time) 5.00pm (SG Time) 5.00pm (Bintan Time) 6.00pm 7pm to 9.30pm 9.30pm Registration at Tanah Merah Ferry Terminal Ferry DEP for Bintan Ferry ARR at Bandar Bentan Telani Ferry Terminal Safety Resort Center (1hr) Bike tuning Lock-up 22 June, Saturday 5.00am 7.30am 3.30pm onwards 6.00pm Breakfast Flag-off Completion of Challenge 145km ride Dinner for Challenge 145km cyclists 23 June, Sunday 10.15am 10.30am 11.35am 1.35pm (SG Time) Get ready to leave for Ferry Terminal Coach depart for Bandar Bentan Telani Ferry Terminal Ferry DEP to Singapore Ferry ARR Tanah Merah Ferry Terminal *Bintan is 1 hour behind Singapore. Please note that the above schedules are subject to changes. The Organizers reserve the right to amend the schedules or any other information deemed necessary without prior notice.

6 2.2 Ferry Services Ferry Operator: Ferry Terminal: Bintan Resort Ferry Tanah Merah Ferry Terminal 50 Tanah Merah Ferry Road (S) Parking is available at the ferry terminal: $1.07/hr or part thereof (capped at $20.00 per 24 hours block). Group DEPARTURE Fun30km Explore60km Challenge145km Date & Time: Singapore to Bintan 21 June, Friday 2.00pm Group 1 (90 seats only) 5.00pm Group 2 Note: Ferry timings are assigned on a 1 st -come-1 st -served basis. When seats on the first ferry are filled, cyclists will spill over and go on the second ferry. Important: Boarding passes will be arranged for all participants. Participants must report and register at the Ria Bintan Counter at Tanah Merah ferry terminal at 12pm latest to collect their boarding passes. Bikes will be checked-in. All participants are advised to protect their bikes with bubble wrap, or a bike bag to prevent damages. The ferry terminal requires all passengers to check-in at least 90 mins before departure time. Please ensure that your passport is of at least 6 months validity as of the event date. Visa on Arrival (VOA) Cyclists who require Visa may proceed to the VISA counter at Bandar Bentan Telani Ferry Terminal to purchase the VOA sticker at S$18nett or USD$10, before joining the immigration queue. Please bring exact amount as no change will be provided.

7 Ferry Schedule Fun30km Explore60km Challenge145km Date & Time: 22 June, Saturday 23 June, Sunday Bintan to Singapore 3.35pm 11.35am Important: Boarding passes will be arranged for all participants. Fun30km & Explore 60km Participants must collect their boarding passes at the Customer Service Counter at Nirwana Resort Hotel by 22 June, Saturday at 2pm. Challenge145km Participants must collect their boarding passes at the Customer Service Counter at Nirwana Resort Hotel by 23 June, Sunday at 10am. Bikes will be checked-in. All participants are advised to protect their bikes with bubble wrap, or a bike bag to prevent damages. 2.3 Accommodation: Nirwana Resort Hotel Hotel: Nirwana Resort Hotel Nirwana Gardens Bintan Jalan Panglima Pantar, Lagoi 29155, Bintan Resorts, Indonesia Tel : (62) Fax: (62) Website: Check-in Date & Time: 21 June 2013, 3.00pm Check-out Date & Time: Fun30km & Explore60km 22 June 2013, by 1pm Challenge145km 23 June 2013, by 10am Room Type: Nirwana Resort Hotel (Garden View) Twin-sharing* inclusive of breakfast Complimentary Wi-fi *Room-mates will be assigned unless otherwise requested Other information: Any incidental charges, upgrades to single occupancy and extension of stay will be charged to participants accordingly upon check-out where applicable. Credit Card information is required upon check-in for guarantee purposes only.

8 2.4 Checklist Things to bring TTSH Charity Ride 2013 cycling Jersey Serial ID Number stickers Bike Front & rear blinkers Helmet Spare inner tubes Tyre Levers & Hand Pump Cycling Shoes Travel Passport Water bottle Cash Credit Card Mobile Phone Sunblock Power Gels Nutrition Bars GPS distance tracker 2.5 Serial I.D Number Stickers You will be given 5 pieces of stickers with your participation I.D number. Usage Qty Purpose On wrapped bike 2 For identification of bike during the travel period to & fro Bintan Front of Helmet 1 For identification during ride Side of Helmet 1 For identification during ride On seat-tube of the bike 1 For identification during ride 2.6 Bike Transport Upon registration at Tanah Merah Ferry Terminal, you will be given 2 Ferry Bike Tags for bike identification and claim purposes (akin to the usage of luggage tags). Orange Tag: to be used on 21 June (Ferry transfer to Bintan) White Tag: to be used on 22/ 23June (Ferry transfer back to Singapore) Please ensure that your bikes are correctly tagged before check-in and do not lose the corresponding stub. The corresponding stub must be presented to claim your bike in Bintan and upon return, at Tanah Merah Ferry Terminal. Replacement for loss of Ferry Bike Tags will be charged at S$15 per piece. 2.7 Protecting your bike To protect your bike during check-in and ferry transportation, you are encouraged to secure it with bubble wrap or other protective measures. The Organizers will assist you in ensuring that your bike is secured from damage but the onus lies with the owner. The Organizers will not be held responsible for damages whilst on transit. You are to prepare for the necessary bubble wrap, tape or other protective measures for your return journey back to Singapore too. 2.8 Luggage Please pack light. The onus is on you to ensure that your personal property is kept safe and secure.

9 2.9 Nirwana Gardens Site Map Location What s happening here? Nirwana Resort Centre Group Check-in Area Bike Depot Safety Briefing Flag-off Lunch on 22 June Nirwana Resort Hotel Accommodation Breakfast Pick-up for Transfers to Ferry Terminal Nirwana Beach Club Dinner on 22 June Buggy Transfers to the Beach Club will be provided at 5.45pm at Nirwana Resort Hotel Lobby.

10 3. ROUTES 3.1 FUN 30KM ROUTE Km Type of Road Junctions Directions Description Ref. to Video 0.0 Flag-off Arch Start Resort Centre 2.1 Roundabout Straight on Garden One Security Post 1:33 Exit Nirwana Gardens 2.3 T junction Straight on Jln Teluk Berembang 1: Sharp Bend Right Jln Panglima Pantar 2: T junction Left Jln Raja Ali Haji 3: T junction Straight on Jln Teluk Lancang 6.7 T junction Straight on Jln Raja Ali Haji / Jln Teluk Sebung 9.6 T junction Straight on Fire Safety 10.5 Crossing Straight on Reservoir 6: T junction Left Ria Bintan Security Post 7:31 Entrance to Ria Bintan Resort & Golf Club 13.7 T junction Straight on Ria Bintan Internal road 8: Roundabout U turn Ria Bintan Internal road 9: T junction Right Ria Bintan Security Post Exit Ria Bintan Resort & Golf Club 18.7 Crossing Straight on Reservoir Drinks Station 22.4 T junction Straight on Jln Raja Ali Haji / Jln Teluk Sebung 23.8 T junction Straight on Jln Teluk Lancang 24.2 T junction Right Jln Panglima Pantar Split Point for 30km, 60km & 145km cyclists 27.1 Run About Straight on Garden One Security Post Entrance to Nirwana Gardens 29.2 Flag-off Arch Finish Resort Centre

11 FUN30KM ROUTE (MAP) CLOSE-UP VIEW

12 3.2 EXPLORE60KM ROUTE Km Type of Road Junctions Directions Description Ref. to Map 0.0 Flag-off Arch Start Resort Centre 2.1 Roundabout Straight on Garden One Security Post Exit Nirwana Gardens 2.3 T junction Straight on Jln Teluk Berembang 3.6 Sharp Bend Right Jln Panglima Pantar 5.0 T junction Left Jln Raja Ali Haji 5.2 T junction Straight on Jln Teluk Lancang 6.7 T junction Straight on Jln Raja Ali Haji / Jln Teluk Sebung 9.6 T junction Straight on Fire Safety 10.5 Crossing Straight on Reservoir 13.0 T junction Left Ria Bintan Security Post Entrance to Ria Bintan Resort & Golf Club 13.7 T junction Straight on Ria Bintan Internal road 14.6 Roundabout U turn Ria Bintan Internal road 16.1 T junction Right Ria Bintan Security Post Exit Ria Bintan Resort & Golf Club 18.7 Crossing Straight on Reservoir Drinks Station 22.4 T junction Straight on Jln Raja Ali Haji / Jln Teluk Sebung 10 Split Point for 30km, 60km & 145km cyclists 24.0 Crossing Straight on King of Mountains (KOM) Caution! Watch speed 30.1 Cross Junction Right Simpang Lagoi Check Point 13 Drinks Station 34.3 Cross Junction Straight on Simpang Sei Kecil 37.8 T junction Right Simpang Telecom Tower 16 Split Point for 60km & 145km cyclists 38.4 Crossing Straight on Internal road Caution! 38.6 T junction Right Internal road Sandy Roads 39.0 Crossing Straight on Internal road Damaged Roads 39.6 T junction Right Simpang Sebung T junction Right Sei Kecil 18 Caution! Sharp Bend Populated Area 43.8 Cross Junction Left Simpang Sei Kecil Cross Junction Left Simpang Lagoi / Check Point 13 Drinks Station 55.7 T junction Left Jln Raja Ali Haji / Jln Teluk Sebung 57.0 T junction Straight on Jln Teluk Lancang 57.4 T junction Right Jln Panglima Pantar 60.3 Roundabout Straight on Garden One Security Post Entrance to Nirwana Gardens 62.5 Flag-off Arch Finish Resort Centre

13 EXPLORE60KM ROUTE (MAP) CLOSE-UP VIEW

14 3.3 CHALLENGE145KM ROUTE Km Type of Road Junctions Directions Description 0.0 Flag-off Arch Start Resort Centre 2.1 Roundabout Straight on Garden One Security Post Exit Nirwana Gardens 2.3 T junction Straight on Jln Teluk Berembang 3.6 Sharp Bend Right Jln Panglima Pantar 5.0 T junction Left Jln Raja Ali Haji 5.2 T junction Straight on Jln Teluk Lancang Jln Raja Ali Haji / Jln 6.7 T junction Straight on Teluk Sebung 9.6 T junction Straight on Fire Safety 10.5 Crossing Straight on Reservoir 13.0 T junction Left Ria Bintan Security Post 13.7 T junction Straight on Ria Bintan Internal road 14.6 Roundabout U turn Ria Bintan Internal road T junction Right Ria Bintan Security Post Ref to Map Entrance to Ria Bintan Resort & Golf Club Exit Ria Bintan Resort & Golf Club 18.7 Crossing Straight on Reservoir Drinks Station 22.4 T junction Straight on Jln Raja Ali Haji / Jln Teluk Sebung 10 Split Point for 30km, 60km & 145km cyclists 24.0 Crossing Straight on King of Mountains (KOM) Caution! Watch speed Cross Junction Right Simpang Lagoi Check Point 14 Drinks Station Cross Junction Straight on Simpang Sei Kecil 37.8 T junction Straight on Simpang Telecom Tower 16* Split Point for 60km & 145km cyclists 40.0 Crossing Straight on Jln Sei Tongkang Drinks Station 42.1 Crossing Straight on Bukit Senyum 43.8 T junction Left Sei Jeram 47.7 T junction Straight on Jln Suka Damai Police Office 48.6 T junction Left Simpang Jago 49.0 T junction Straight on Internal road Caution! Very steep slope down 50.0 Crossing Straight on Internal road 19 Damaged Roads 50.5 T junction Right Jln Berdikari 51.0 T junction Left Jln Indunsuri Melayu Bedendang Swimming pool 52.9 T junction Straight on Simpang Lobam 20 Busung Hospital 60.0 Crossing Straight on Village Office Drinks Station 60.8 Crossing Straight on Lintas barat Caution! Sandy road 66.0 Crossing Straight on Busung Bridge

15 71.9 T junction Left Simpang Pelita baru 72.9 T junction Right Simpang Penaga Narrow road 74.5 T junction Straight on Simpang Ekang 78.9 Crossing Straight on Village Office Cross Simpang Lagoi / Check 80.9 Junction Left Point 26* Drinks Station 85.1 Cross Junction Right Simpang Sei Kecil 28 Caution! Populated Area Road 86.8 Sharp Bend Left Sei Kecil Damaged Roads 91.3 Crossing Straight on Sanggar Budaya / Cultural 91.6 Crossing Straight on Sebung 95.0 Crossing Straight on Puskesmas 95.8 Crossing Straight on Senior High School 98.2 Sharp Bend Left Sakera Crossing Straight on Sakera Caution! Sandy road Caution! Narrow road T junction Left Jln M Tahir Latif Populated Area T junction Left Jln Taman Sari / Dahope 33 Drinks Station Sharp Bend Left Jln Taman Sari / Dahope Caution! Sandy road T junction Straight on Jln Mekar sari T junction Straight on Simpang Telecom Tower T junction Straight on Simpang Sei Kecil Cross Junction Left Simpang Lagoi / Check Point Crossing Straight on King of Mountain (KOM) Jln Raja Ali Haji / Jln T junction Right Teluk Sebung 41* T junction Left Ria Bintan Security Post Ria Bintan Internal Road Roundabout U turn Ria Bintan Security Post Drinks Station Caution! Watch slopes and speed Crossing Straight on Reservoir Drinks Station Jln Raja Ali Haji / Jln T junction Straight on Teluk Sebung T junction Straight on Jln Teluk Lancang T junction Right Jln Panglima Pantar Run About Straight on Garden One Security Post Flag-off Arch Finish Resort Centre * Deciding point to change route Entrance to Nirwana Gardens

16 CHALLENGE145KM ROUTE (MAP) 3.4 Official Support Vehicles Cyclists will be escorted by the following: Local police in 1 car and 6 motorcycles 2 Ambulance with medic 9 Marshals 2 Mobile hydration vehicles 1 Mechanic There will be 7 static water stations throughout the route, at approximately 20km apart.

17 3.5 Bike Mechanic You are encouraged to bring along your own spare tubes and handle minor repairs for your bike whenever possible. Should you need further assistance from the mechanic, you may call the hotline at or alert any official support vehicle or road marshals who are present. There will be 1 Bike Mechanic travelling with the cyclists and will be able to assist you with minor repairs. However, major parts & services will be charged accordingly. Payment arrangements should be made with Fat Cat Cycle after the event. 3.6 Wet Weather Advisory In the event of inclement weather, the Organizers reserve the right to delay, stop or cancel the ride at any point. Cyclists are to use their own discretion by seeking the nearest shelter and resume cycling when the weather permits. The traffic marshals will also advise on safety accordingly. In the event of heavy rain before flag-off, the flag-off may be postponed and the following route revisions will apply: If Flag-off happens Fun 30km Explore 60km Challenge 145km between: (Completion in approx.< 2hrs) (Completion in approx.< 4hrs) (Completion in approx.< 7hrs) Keep to original route Keep to original route Keep to original route 7.30 to 8.30am 8.30am to 9.30am Keep to original route Keep to original route * Lagging cyclists may be swept in view of 1pm checkout time. Reduced by 15km Avoid 2nd Ria Bintan Loop Refer to Map: Skip route from point 42 to am to 10.00am Keep to original route Take 30km Route *Lagging cyclists may be swept in view of 1pm checkout time. * Lagging cyclists may be swept in view of 1pm checkout time. Reduced by 50km Avoid Coastal Loop Refer to Map: Skip route from point 27 to 38 Last official flag-off Last official flag-off is time is 10.00am 10.00am 10.00am to 11.00am Cancelled Cancelled Take 60km Route Last official flag-off is 11.00am IMPORTANT: Last official flag-off for Fun30km & Explore 60km is 10.00am. Last official flag-off for Challenge145km is 11.00am. Official logistics and medical support will be kept only to the official revised routes as per the respective flag-off times shown above. Event is deemed as CANCELLED if flag-off is not done by 10.00am for Fun30km & Explore60km and 11.00am for Challenge145km.

18 Should the event be cancelled, the donations collected will still be directed towards the TTSH Community Charity Fund. Tax exempt receipts will be issued where applicable 4. OTHERS 4.1 Safe Cycling Tips You are encouraged to have your bike inspected by a professional bicycle mechanic before the event. Cycling bare torso is not permitted. Helmets are compulsory, and must be worn at all times. Please keep to the left side of the road unless overtaking and observe traffic rules at all times. When overtaking, please proceed by the right of the cyclist. Ensure a safety distance of about 7m between yourself and the bike in front of you. Be conscious of fellow riders and always indicate your intention early. Please adhere to the instructions of the marshals. 4.2 Insurance Coverage Accident insurance coverage of up to S$10,000 for death/permanent disablement and S$500 for accidental medical expenses has been arranged for cyclists. You may wish to purchase the following insurance for your own additional coverage. The application form is appended at the end of this document. 4.3 Hotline Live only on 22 June, 5am to 5pm Please save this number on your mobile phone. You may call this hotline for emergency purposes such as for medical assistance, mechanic assistance, report of accident, if you are lost, etc. Thank you for your enthusiasm and participation in the TTSH Charity Ride 2013! Your generosity will go a long way to help our needy patients. For further enquiries: Janice Liu DID: Janice_SL_Liu@ttsh.com.sg

19 ANNEX Tan Tock Seng Hospital Charity Ride 2013 Insurance matters Existing Coverage under TTSH Charity Ride 2013 Accident insurance coverage of up to S$10,000 for death/permanent disablement and S$500 for accidental medical expenses (excluding ferry and evacuation expenses) has been arranged for cyclists. Additional Insurance Coverage for TTSH Charity Ride 2013 (Optional) Participants of TTSH Charity Ride 2013 may choose to purchase the following insurance for additional coverage. Policy 1 Personal Accident Worldwide coverage Effective from 21 June 2013 to 20 June 2014 Premium S$ (annual) Coverage Accident medical reimbursement Traditional Chinese Medicine (TCM) Mobility & ambulance services Accidental Death & Permanent Disablement Sum Assured S$4,000/- S$750/- S$2,000/- S$100,000/- 2 Travel Insurance For coverage to Bintan, Indonesia Effective 21 June 2013 to 23 June 2013 ( 1-3 days) S$22.00 Coverage (for Adults under 70 years old) Medical expenses incurred overseas Medical expenses incurred in Singapore Loss or damage of baggage and personal belongings Note: Does not include sports equipment such as bicycle, golf sets Emergency evacuation Sum Assured (S$) S$250,000/- S$12,500/- Up to S$3,000/- (Max S$500 per article) Up to S$500,000/- To apply: Please complete the Application Form in the next page Notes: 1. The above policies are offered to participants of the TTSH Charity Ride 2013 only. 2. The above does not form any insurance contract /agreement. 3. Premium rates are subjected to changes by the insurers. 4. A group discount of 10% would be offered if 4 or more people signed up for the travel insurance. 5. Annual travel insurance can be applied. Please contact Victor for details. For enquiry, please contact Kairos Planners at or Victor at

20 Application Form IMPORTANT NOTES 1. Under Section 25(5) of the Insurance Act Cap 142 or any subsequent amendment thereof, you are to disclose in this Application form, fully and faithfully, all the facts which you know or ought to know, otherwise the policy issued may be void. 2. Please complete all sections on this form (IN BLOCK LETTERS), in order to avoid unnecessary delay in the processing of this application. PART 1: PARTICULARS OF APPLICANT Surname Mr / Ms / Mrs / Mdm / Dr Given Name NRIC/ FIN/ Passport No. Nationality Sex: Male / Female Date of birth Age Marital Status Hse/Blk No. Unit No. Street & Postal Code Tel (H) (O) (Mobile) Occupation/Profession PART 2: PLANS & MODE OF PAYMENT (Please tick one of the following.) Personal Accident (cost $123p.a) Travel insurance (cost $22 this trip) Both Personal Accident & Travel Insurance (cost $145) Mode of Payment Cheque Cash Credit Card Details: Credit Card Visa MasterCar Amex *Please tick accordingly Cardholder s Name: Credit Card No: CVV: Expiry Date: (MM/YYYY) Address: (if differ from above) I /We agree to pay the premiums according to the plan chosen and I /we herby authorise the respective insurers to charge the premiums to the above credit card. Where there is a third party credit card is used, I/We declare that the cardholder has authorised and consented to its use. Note: The insurance policy will be effective on the official date of travel to Bintan for the TTSH Charity Ride 2013 only upon receipt of payment or approval by the credit card company, and approval of the application by the insurers involved. PART 3: DECLARATION & AUTHORISATION 1. I/We declare that the above answers are full, complete and true and agree that they shall form part of my/our application which shall be the basis of the contract of insurance. 2. I /We understand that the Personal Accident Plan and its benefits shall be payable upon occurrence of an accident, subject to applicable terms and conditions. 3. For Personal Accident Plan, I /We are aware that any pre-existing conditions are not covered. 4. I /we authorise Kairos Planners to use the information provided to facilitate the application of the PA or Travel insurance with the respective insurers on my /our behalf. 5. I /We hereby declare and agree on behalf of myself /ourselves that any information collected or held by the insurers and Karios Planners may be used and disclosed to third party for issuance of policy and / or to provide advice for policies and services that Kairos Planners or the insurers believe may be of interest to me /us, and to communicate with me /us for any purposes. Signature of Applicant Date (DD/MM/YYYY) To apply, please complete this application form and send it back to Kairo Planners via: kairosplan@gmail.com; victor.chan@axaplanner.com.sg Or Fax: Kairos Planners Killney Road P.O. Box 2032 Singapore O: F: M: E: kairosplan@gmail.com W: Co.Reg No C