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REGISTRATION FORM NAME: Kristoffer G. Montalban AGE: 37 ADDRESS: Block 16 Lot 14 Terraverde Residence, Bancal
REGISTRATION FORM NAME: Kristoffer G. Montalban AGE: 37 ADDRESS: Block 16 Lot 14 Terraverde Residence, Bancal
REGISTRATION FORM NAME: Kristoffer G. Montalban AGE: 37 ADDRESS: Block 16 Lot 14 Terraverde Residence, Bancal
REGISTRATION FORM NAME: Kristoffer G. Montalban AGE: 37 ADDRESS: Block 16 Lot 14 Terraverde Residence, Bancal
REGISTRATION FORM NAME: Kristoffer G. Montalban AGE: 37 ADDRESS: Block 16 Lot 14 Terraverde Residence, Bancal

REGISTRATION FORM

NAME: Kristoffer G. Montalban AGE: 37 ADDRESS: Block 16 Lot 14 Terraverde Residence, Bancal Carmona CP NO.:09561528703

T-SHIRT SIZE: (Pls. Check) SMALL

REGISTRATION FORM NAME: Kristoffer G. Montalban AGE: 37 ADDRESS: Block 16 Lot 14 Terraverde Residence, Bancal
REGISTRATION FORM NAME: Kristoffer G. Montalban AGE: 37 ADDRESS: Block 16 Lot 14 Terraverde Residence, Bancal

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REGISTRATION FORM NAME: Kristoffer G. Montalban AGE: 37 ADDRESS: Block 16 Lot 14 Terraverde Residence, Bancal

*FOR AGES 17 AND BELOW PLEASE SECURE PARENTAL CONSENT

WWAAIIVVEERR

PARENTAL CONSENT FOR MINORS

PARENT’S NAME & SIGNATURE

voluntarily allow my child to join in this Tour De Mountain Province, and hereby certify that

I

 

my child

is physically and mentally fit to

participate.

 

CERTIFICATION & WAIVER

NAME & SIGNATURE OF PARTICIPANT

I

hereby certify that all above information are

 

true and correct. I release the organizers of this Tour De Mountain Province from any liability whatsoever, arising from any injury or damage which may be sustained during the race and waive any right of course of action relative thereto.