REGISTRATION FORM


                    TREE GROWING FESTIVAL

June 29, 2012
             QUEZON MOUNTAIN RANGE, CITY OF KORONADAL


REGISTRATION FORM FOR INDIVIDUAL

Name_____________________________________________________________________
                First Name                              Middle Name          Surname

City Address: _______________________________________________________________
School/Company: ___________________________________________________________
Age: _________      Gender: __________                 Contact No.:______________________

Person to notify in case of emergency:

Name: __________________________  Relationship: ______________________________
Address: _________________________Contact No.: ______________________________


DECLARATION OF FITNESS AND WAIVER

I, ____________________________ clearly understand the nature and risks of the activity I will be participating on, will abide by its rule and regulations and that the above details are true and correct. I am aware and accept that participants join this activity at their own risk. Accordingly on behalf of myself, my heirs, and executors, I hereby waive and release all rights or claims for damages I may have against death, damage or loss I may sustain during or as a consequence of the activity.

           I hereby declare that I have read and understand this declaration of fitness and waiver and that I execute this document willingly and voluntarily.

           IN WITNESS WHEREOF, I have hereunto set my hand this_________________, 2012 at the City of Koronadal.




                                                                                             ________________________
                                                                                               Printed Name and Signature




 Note:Submit registration form on or before June 1, 2012  at the City ENRO, 2ND Floor City Hall
or any registration outlet located at, ACE CENTERPOINT, KCC MALL, GRAND GAISANO MALL.
For more details please call 2281732.

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