OXFAM TRAILWALKER 2018 PARTICIPANT DETAIL REGISTRATION FORM

Transcription

1 OXFAM TRAILWALKER 2018 PARTICIPANT DETAIL REGISTRATION FORM Each team member must complete this form and present it to the computer desk to collect your bibs. Also one copy of the support crew registration form must be presented. Please only print pages 1-3 of this form. Team name: Event distance: Fundraising commitment: Start time: Bib number: (To be completed by registration staff) Yes, we would like to upgrade! New target $ Enter your personal details Name: Gender: D.O.B: Address: Suburb: City: Postcode: Country: Home phone: Mobile: I will have a different mobile number during the event Event mobile: THIS IS A CHANGE TO MY PREVIOUS CONTACT DETAILS I AM A NEW OR REPLACEMENT TEAM MEMBER

2 Emergency contact details: Team member emergency contact (preferably someone not at the event with you): Name of contact: Mobile: Relationship: Yes, my emergency contact is also part of my support crew This information will be used only in case of emergency and will be securely destroyed after the event. Medical declaration: Please disclose any medical issues or conditions (including medications and allergies) that we should be aware of during your participating in this event and in cases of emergency: All records will be securely destroyed following the completion of the Oxfam Trailwalker. Team member declaration: I have disclosed any medical issues or conditions above that may affect me during my participation in this event. I have read and understood the Event Rules and Terms & Conditions (see appendix 1 below and available at registration) and agree to abide by them. This includes having all appropriate safety and emergency equipment, clothing, food, hydration and gear required to support me and my team with health, safety and wellbeing to complete the 50km or 100km event. I will attend a compulsory Health and Safety and Event briefing on March 9 th at: (please circle) 4pm 6pm 8pm Medical disclaimer: I give permission for St John Ambulance to provide Oxfam with my name, contact details and nature of any injury/ illness, should I need to receive treatment from them during the event. Signature: Date:

3 Green Survey Will you be carpooling to Oxfam Trailwalker 2018? Did you bring a reusable water bottle to the event? Did you bring supplies in reusable containers? Do you pledge not to use plastic bags on the trail? Thanks helping us look after our environment and being part of the solution with Oxfam Trailwalker 2018.

4 Appendix 1 Please do not print this page EVENT RULES AND TERMS AND CONDITIONS By submitting an Entry Form to take part in Oxfam Trailwalker New Zealand 2018 ("the event") you: 1. On the day of the event, all 100km event participants must be aged 18 years or more. For the 50km event, participants must be aged 16 years or more with a minimum of two persons in the team aged 18 years or more. Participants aged under 18 years must have written parental consent. 2. At the start of the event, each team must have four members. 3. Teams entered must raise a minimum $2500 in addition to the non-tax deductible reservation and entry fees. The final fundraising deadline is April Teams can substitute team members using their online administration pages before Monday February 19, After this date teams must notify the organisers of any change of team members before registration on Friday, March 9, 2018 and this will incur a $20 fee. No substitutions may be made once a team has completed registration. 5. Acknowledge that the event is organised and promoted by Oxfam New Zealand ("Oxfam") which is a charitable trust (Registered No.: CC24641) and that the purpose of the event is to raise funds in aid of Oxfam's work with others to help overcome poverty and injustice exclusively. 6. Agree that you undertake the event, and any associated training walk(s) organised by Oxfam, entirely at your own risk and will not hold Oxfam, Whakatāne District Council, or any land owner responsible for any accident, injury, damage to, or loss of personal property during the event or in preparation for it. 7. Understand that the event involves sustained physical exercise in a remote area, and may involve walking and/or running at night over rugged terrain, and that you are responsible for your own fitness and health to take part in the event, and have consulted a doctor about your participation if you have a medical condition likely to be affected by the above. 8. Understand that the trail will include several road crossings and short sections along roads and that all normal road rules apply. Road crossings times have been calculated based on teams completing the event between hours for 100km teams and between 8-18 hours for 50km teams. If teams are faster than this then they may come across road crossings without marshals and need to take extreme care. 9. Agree to adhere to the rules of the event. 10. Agree that Oxfam reserves the right to close or alter stages and/or checkpoint closure times for safety or any other reasons. Checkpoint times have been calculated based on teams completing the event between hours for 100km teams and between 8-18 hours for 50km teams. If teams are faster, there may be reduced resources available and checkpoints may manually record their check in and out time.

5 11. Understand that the route shown on promotional material may be subject to change and that Oxfam may need to cancel, postpone, halt, delay, abridge, re-route or otherwise alter the event in response to hazards including but not limited to natural disaster, fire, flood, path instability, livestock disease or land access permits. In such instances, you will be given as much notice as possible and any necessary alterations will attempt to preserve the nature of the event as much as possible. 12. Agree that at any time before or during the event Oxfam reserves the right to withdraw a team or individual from the event. By entering Oxfam Trailwalker New Zealand 2018 you: 13. Agree to pay a reservation fee of $80 (incl. GST) and the entry fee appropriate to the date on which you pay (incl. GST), or a reduced entry fee should you have a valid promotional code. Entry fees for Oxfam Trailwalker 2018 are: Deadline 50km 100km Early bird End August 2017 $430 $590 Standard End November 2017 $480 $680 Late entry End January 2018 $520 $ Understand that the reservation fee only reserves your place for 28 days and that if you take more than 28 days to complete your entry then you could miss out if there is high demand for the 300 team spots. 15. Understand that the amount of funds raised by your team does not include the sums paid as the reservation fee and entry fee, nor any other previous donations or pre-existing agreements to support Oxfam. 16. Reservation and confirmation fees are strictly non-refundable. Confirmation fees can be transferred to the following year. 17. Understand that should your confirmation fees be paid for by time payment option, which these will be paid for within the price deadline. Direct debit from your bank account or credit card will be authorized and set up by Oxfam New Zealand with prior approval from team leader. 18. Acknowledge that by raising funds for Oxfam, you are placing yourself in a position of substantial trust and that you have a moral and legal obligation to acquit the funds you raise and temporarily hold in trust for the charity accurately, honestly, responsibly and in a timely manner. 19. Agree to ensure that all your sponsors/donors understand that their sponsorship donation is

6 in support of your team's attempt at, rather than completion of, the Oxfam Trailwalker challenge. 20. Agree that images, video and interview material taken at the event or uploaded to teams' online fundraising pages may be used by Oxfam in future promotions. 21. In the unlikely event that Oxfam Trailwalker is cancelled, you will be given the option to have your entry fee; a) donated to Oxfam's life-saving work; b) carried over to the next year's event in full; or c) 50% refunded. 22. If your team withdraws from the event or the event is cancelled Oxfam will cancel your team's fundraising commitment. 23. Donations to teams are non-refundable. 24. While Oxfam NZ has taken all reasonably practicable steps to ensure that hazards and risks have been identified, minimized and isolated and communicated to you both pre, during and post event, you understand that you undertake the event entirely at your own risk.