2012 HMAS ALBATROSS TOUR the T

Registration Form for use by Defence APS Members and Permanent Support Contractors employed at HMAS ALBATROSS and participants over the age of 18 not employed by the Australian Defence Organisation.

2012 HMAS ALBATROSS ‘TOUR the T’ In support of the GREENACRES Disability Services and Legacy.

8km FUN RUN/4 km FUN WALK 11 October 2012 MANDATORY Verification of Entry/ID for ALL Entrants Between 1530 to 1615 on the day.

Event STARTS at 1630

Full Name:…………………………………… Contact Mobile ……………………….... Email Address:………………………………. Gender M/F

Entries Cost $25 All Money raised will be donated to GREEN ACRES Disability Service and Legacy.

Please Circle (1 Shirt per ENTRY) Unisex T- Shirt (GREY ONLY COLOUR) Sizes XS S M L XL XXL 3XL Half Chest (cm) 49.5 51.5 54 56.5 59 62 66 T-Shirts will be available to pickup during registration on the day ONLY – No Post Outs

To enter deposit amount into: Name: HMAS ALBATROSS FUNDRAISING EVENTS BSB: 642170 Account No: 731835S6 (ADCU Acct to ADCU Acct) BSB: 642170 Account No: 731835 (Other Banks to ADCU Acct) Reference: TTT, surname, initial

Circle which Category is applicable to you:

ALL AGE Male Runner / ALL AGE Female Runner

ALL AGE Male Walker/ ALL AGE Female Walker

Drivers License or suitable ID is required for MANDATORY Entry Verification on the day. Bikes, Rollers Blades etc are NOT allowed on the course.

Prams are permitted but must start at the rear of the field. Participants aged between 10 and 17 may enter using the Minor Registration Form, children under 10 may accompany parents onto the course using the Child Form. Parents/Guardians are responsible for both children and minors at all times. Appropriate footwear is to be worn at all times on course.

Further information can be obtained by contacting CPO Annie Schofield 0418222287

Please complete the entire Entry Form including the Indemnity Section below, and send both to the email address or fax number below. Early replies will assist us in organising the event.

Entries to be emailed to [email protected] or Fax 02 44241471

Confirmation email will be returned to you Registration Form for use by Defence APS Members and Permanent Support Contractors employed at HMAS ALBATROSS and participants over the age of 18 not employed by the Australian Defence Organisation.

Indemnity Form.

COMMONWEALTH OF AUSTRALIA DEPARTMENT OF DEFENCE

FOR AND IN CONSIDERATION of the Commonwealth of Australia granting ……………………………...... (name) permission to participate in the HMAS ALBATROSS Tour the T for Charity run/walk event, held in New South Wales,

I…………………………..……………………………………………………(name) Of……………………………………………………………………….(address) and all my heirs, successors, executives, administrators, agents and assigns HEREBY AGREE:

TO WAIVE all and any claim, right or cause of action which I or my heirs, successors, executives, administrators, agents and assigns might otherwise have for or arising out of loss of my life, injury, damage or loss of description whatsoever which I may suffer or sustain in the course of participation of the HMAS ALBATROSS Tour the T for Charity Run/Walk event.

TO RELEASE AND FOREVER DISCHARGE the Commonwealth of Australia, its officer, employees and agents from all liability to, my personal representatives, heirs and next of kin for loss of my life, injury, damage or loss of any description, whatsoever arising out of or in any way connected with or incidental to my access or use of the sporting and recreational facilities located at HMAS ALBATROSS whether anticipated or not and whether caused by the negligence, default or misconduct of the Releasees or otherwise.

TO INDEMNIFY AND AGREE TO KEEP INDEMNIFIED the Commonwealth of Australia, its officers, employees and agents from and against all actions, proceedings, suits, costs, claims, damages, loss, expense and demands or liability of any kind, including all legal costs however suffered or incurred, and the costs reasonably incurred in defending or resisting the same, that may be made or brought by any person or persons in respect of personal injury to or the death of any person whomsoever or loss of or damage to any property whatsoever arising out of or as a consequence of or in any way connected with my acts or omissions, by reason of my access and use of HMAS ALBATROSS facilities.

I FULLY UNDERSTAND that my access and use of HMAS ALBATROSS facilities may involve the risk of serious injury, including permanent disability, death and social and economic loss arising not only from my own intentional or negligent acts or omissions, but also from the intentional or negligent acts or omissions of others, from the rules of play and their application, from the conditions of the premises and/or equipment, as well as from other sources both known and unknown. Notwithstanding this knowledge I freely and voluntarily assume all risks both known and unknown associated with my access and use of HMAS ALBATROSS facilities.

I ACKNOWLEDGE AND UNDERSTAND that I have read and Understood the matters set out in this document above and that I am legally competent to give this waver, release and indemnity. I acknowledge that the conditions set out in this document are contractual in nature, are intended to have legal effect and are not merely a warning or recital. I have signed this document on my own freewill and without any representation or inducement by the Commonwealth of Australia, its officers, employees and agents. Registration Form for use by Defence APS Members and Permanent Support Contractors employed at HMAS ALBATROSS and participants over the age of 18 not employed by the Australian Defence Organisation.

Do I have an illness, injury, medical concern, restriction, limitation or condition that may prevent me from safely participating in the HMAS ALBATROSS Tour the T for Charity Run/Walk event?

(Please circle) Yes or No

(Details if Yes)………………………………………………………………………….

…………………………………………………………………………………………..

RELEASEE TO COMPLETE

Signature……………………………………………………………………………….

Name……………………………………………………………………………………

Date…………………………………………………………………………………….

WITNESS

Witnessed by……………………………………………………………………………

(Signature of Witness) Name…………………………………………………………………………………… (Printed name of Witness)

Date……………………………………………………………………………………..