X Funduro – 1 May 2020

X Funduro - 1 May 2020

Registration & Indemnity Form

Please Note :
This page needs to be completed by each rider / lift.
Copy needs to be shown at the entry gate


Personal Details Riding Details : Mark With "X"
Name & Surname CLASSIFICATION
Age: 1 KIDS UP TO 12 YEARS X
2 INTERMEDIATE X
Cellphone NR: 3 COMPETITIVE JUNKIES X
Email Address: 1st May X Funduro 5 KM track
Emergancy Contact Name : 1 Kids entry - R150 X
Emergancy Contact NR: 2 Main Entry - R200 X
Banking details on request. All above entry fee incl
entry to the Winter Festival
Event Organisers:
Denzil : 082 922 0858
Hendrick Grobler : 0727133376
(Full name & surname) (Parent / guardian name & surname if rider is a minor)



Will willingly be participating in the Winter Festival X Funduro
I acknowledge that in participating in these activities I shall be subjecting myself, family, passengers and my quad bike / 2 wheeler to danger and the possibility of personal injury, loss of support and or the loss of my life or family or passengers lives and / or the loss or damage to personal possessions during this event.


Therefore, I do hereby acknowledge that I have freely and voluntarily and fully accepted the risk to myself and my minor dependents and do hereby on behalf of myself absolve the organisers of the X FUNDURO / Winter Festival, their committee, landowners and any other person involved in the organisation of this event even where such activities constitute a negligent act or omission on the part of the X FUNDURO/Winter Festival from any claim or claims whatever the nature prior to and including the day of the event and particularly as a result of any activity which the X FUNDURO/Winter Festival is in any way party to.


I acknowledge the X FUNDURO/Winter festival event and I do further indemnify the X FUNDURO/Winter festival against any claim or claims, which may be brought against them by any other person arising out of my actions aforementioned, and in particular against claims made against the X FUNDURO/Winter festival for any claim or claims preferred against them by my dependents.


Yes Yes
(Full name & surname) (Parent / guardian name & surname if rider is a minor)