Welsh Three Peaks Challenge 2016 Full Name Address Postcode Telephone Mobile Email Date of Birth M/ F T shirt size S M L XL Emergency Contact details of someone not taking part in the event Full Name Relationship to you Telephone Terms and Conditions I agree to adhere to the following Welsh Three Peaks Challenge Terms and Conditions: 1. Participants confirm that their photographs and any video footage taken during the challenge may be used to publicise future events and will be the sole property of Rhondda Cynon Taf CBC 2. Participants are expected to conduct themselves in an appropriate and courteous manner for the duration of the challenge 3. Rhondda Cynon Taf CBC cannot accept any liability in respect of loss or damage to personal property whilst taking part in the challenge 4. Participants confirm that they are in good health and have no medical condition that may cause undue concern or inconvenience to others. If there is any doubt about your fitness you should consult a doctor before signing up for the challenge 5. Participants are responsible and assume liability for any medical expenses occurred as a result of training and participating in the challenge. 6. Participants must not be under the influence of drugs or alcohol. 7. Participants confirm that they participate in the challenge entirely at their own risk and that Rhondda Cynon Taf CBC cannot accept any liability in respect of personal injury whilst taking part in the challenge. 8. It is recommended that you take out your own insurance to cover accident or loss occurring during the course of the challenge 9. In the case of inclement weather the challenge will be cancelled, the guide’s decision will be final. 10. Participants confirm that they are aware of the above terms and conditions and that they accept them in their entirety before the start of the challenge I enclose a non-refundable deposit of £50 and am committed to raising the minimum amount of £50 (£100 in total) to cover the cost of my taking part in the Three Peaks Challenge. Print name Signature Date Please return to: Events Team, Pavilion C, Cambrian Park, Clydach Vale, Tonypandy, CF40 2XX .