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, 2^ND Floor City Hall

or any registration outlet located at, ACE CENTERPOINT, KCC MALL, GRAND GAISANO MALL.

For more details please call 2281732.