INDEMNITY

Notice: This document is a legally binding agreement. By signing this agreement you are
acknowledging that you have read , understood and accepted the terms and conditions stated on this REGISTRATION FORM
agreement. You further acknowledge and agree that you are waiving your rights to bring court action
to recover compensation or obtain any other remedy for any injury /damage to your self or your
property.
Event Dates:
This is to certify that I, ________________________, NRIC/Passport No. ___________,have read the
rules and regulations pertaining to my participation in the Rockamania XV organized by the Temasek 25th & 26th of July 09
Polytechnic Adventure Club and Temasek Polytechnic Sports Climbing. In consideration of the
acceptance of my entry, I, for my heirs, executors and administrators, release and forever discharge
the Temasek Polytechnic Adventure Club and Sports Climbing Rockamania XV Organizing Committee, 1st & 2nd of August 09
for their sponsors, their appointed staff, officials or agents, of all liabilities, claims, actions, damages,
costs or expenses which I may have against them arising out of or in any way connected with my
participation in this event, including travel to or from this event, including all accidents, injuries or
death that may be suffered by me before, during or after the event, or damage to my equipment
sustained during my participation in this event. I understand that this indemnity includes any claims
based on negligence, action, or inaction of any of the above parties. I acknowledge that there are
significant elements of risk associated with the sports climbing, bouldering and fitness training regime
and equipment. I further acknowledge the nature and extent of the risks inherent in climbing and the
use of its related facilities. I recognize the difficulties of the event and attest that I am sufficiently fit Reporting Time:
physically to complete this event and that I have not been advised otherwise by a qualified medical
professional. I also acknowledge that I have read and will abide to the Rules and Regulations stated in
this form.
Novice (sec) - 1300, 25th July
______________________ _________________ __________________
Name of Participant Signature Date Novice (open) -0800,26th July

---------------------------------------------------------------------------------------------------------------------------- Open - 26th July 09, 1300hrs

TO BE COMPLETED BY PARENT/GUARDIAN OF PARTICIPANT UNDER 21 YEARS OF AGE
Intermediate - 1st August 09, 0800hrs
I, ________________________________, NRIC/Passport No. ______________, hereby allow my
son/daughter/ward to participate in the above mentioned Rockamania XV organized by Temasek Speed – 1st August 09, 1500hrs
Polytechnic Adventure Club and Sports Climbing and would not hold the organizers, sponsors, staff Organized By:
and officials responsible for any accidents, damages, mishaps, injuries or loss of life that may occur in
the course of or as a result of his/her participation in this event.

________________________ _________________ _________________

Name of Parent/ Guardian Signature Date

FOR PARTICIPANTS OF THE OPEN NOVICE CATEGORY
I, _________________________, declare that I have less than one year’s climbing experience and
acknowledge that I will face disqualification if I fail to follow this declaration.
*Note: In the event that bad weather be experienced during the competition, the
events from the closed category will be postponed to the following weekend, subject
to the discretion of the organisers.

Incomplete forms will be deemed invalid and will be dealt with as stated in the Book
_______________________ __________________ __________________ of Rules & Regulations.
Name of Participant Signature Date
 Personal Particulars
Rules and Regulations
Name Gender M/F
1 General Rules and Regulations
1.1 Registration Closes on 20th July 2009. NRIC
1.2 Fees: Open Categories (Difficulty)- S$12.00 (Speed Individual)- S$8.00
Date of Birth
1.3 On-the-spot registration after the registration window period will only be allowed if there are
Address
any vacancies.
1.4 Only full-time students of secondary schools will be able to participate in the Novice(sec) category.
1.5 Only full-time students of secondary schools, polytechnics, junior colleges, ITEs, international School Postal Code
schools, universities and any other education institutes in Singapore will be able to participate in Novice ,Intermediate,
Professional & Speed categories. Contact No. ^Age
1.6 Climbers who have represented Singapore within the span of the last 3 years, or who are part
of the Singapore National Team are eligible to compete in the Difficulty-Pro and Speed events. Email *T-shirt size S / M / L / XL
1.7 Status of national climbers will be according to the list provided by Singapore Mountaineering
Federation (SMF). Categories ( please tick accordingly)
1.8 .1 Open and speed categories has a limit to 5 participants per category for each school.
1.8.2 There is no limit per school for the number of participants for Novice (secondary). Difficulty – Novice ( secondary school) Men Women
1.8.3 Novice and intermediate has a limit of 8 participants per category for each school
Difficulty – Novice ( open) Men Women
2 Submission of registration forms
2.1 Registration forms can be directly mailed to the address stated below. Difficulty - Intermediate Men Women
2.2 Cheques should be crossed and made payable to ‘Temasek Polytechnic– Adventure Club‘. Difficulty - Open Men Women
(To be mailed along with the registration forms).
Speed (Individual) Men Women
3 Registration
3.1 Competitors are required to bring their student pass or student identification card of their
education institution for identification and verification purposes on the day of the competition. Medical Information – Is there a history of/ have you ever had: Yes No
3.2 Competitors will receive the event T-shirt and a goodie bag upon registration. 1. Chest Pain, Coronary Problems, High Blood Pressure…………….. ____ ____
3.3 Each school is limited to 5 participants for each category, Except for novice (secondary school) category 2. Lung Problems ( Bronchitis, Tuberculosis etc.) ……………………... ____ ____
3 participants. 3. Asthma …………………………………………………………………… ____ ____
(If yes, when did you last suffer an attack? )
4 Attire/Equipment 4. Head Injury, Fits, Epilepsy, Fainting Attacks, Migraine ……............ ____ ____
4.1 An event shirt will be issued to each participant upon reporting on the day of the event. All
competitors are required to wear the event shirt throughout the event (isolation and climb).
5. Back/ Neck Problems …………………………………………………… ____ ____
4.2 Note: Event shirt will not be issued to speed participants. Participants to be dressed in school based shirt. 6. Diabetes ………………………………………………………………….. ____ ____
4.3 No bare bodied climbing. 7. Eye (Vision)/ Ear (Deafness) Problems ………………………………. ____ ____
4.4 Harnesses and helmets will be provided for all competitors but they may choose to use their own. 8. Nervous Illness …………………………………………………............. ____ ____
9. Arthritis, Bone or Joint Injury …………………………………………… ____ ____
5 Judging 10. Surgery within the last 3 years ……………………………………….. ____ ____
5.1 Difficulty: Competitors will be judged according to the legitimate hold-touch point; height 11. Allergies (Drugs, Food etc.) …………………………………………... ____ ____
reached by dynamic means is allowed.
12. Routine Medication Needs ……………………………………………. ____ ____
6 Appeals ( If yes to any of the above, please specify: ________________________)
6.1 If a competitor disputes the results of the competition, a written appeal must be made within
30 minutes of the release of the results and must be accompanied by a sum of S$50.00 in Do you have any other disability or medical information you wish to highlight?
cash and will only be refunded if the appeal is successful. _____________________________________________________________________

7 Important note For Women only: Are You Pregnant? No_____ Yes_____
7.1 The Organizing Committee reserves the right to amend any part of the Rules and Regulations
without prior notice. The Book of Rules and Regulations will be available on request. In the event of an emergency
7.2 There is a quota on participants for this competition in order to tally with our planned schedule. Person to contact: _______________________ Relationship: __________
7.3 Event shirts will be given while stocks last.
Address: _____________________________________ Tel:___________
Sent your name, category and IC to deathangel_roxz24@hotmail.com for booking of slots.
For enquiries please do not hesitate to contact
I declare that all the information provided by me are true and correct to the best of
Xue Qian at 96258553 (HP)
my knowledge.
siokyman@hotmail.com (Email)
Temasek Polytechnic – TP Sports Climbing C/O TP Adventure Club,
Student & Alumni Department, ______________________ ________________
Blk 30 #02-01 / 02, 21 Signature Date
Tampines Ave 1 Singapore 529757 * Subject to availability of sizes ^ As of 1st January 2009