Llanidloes Events

Booking Form

Wye Trail

Events Saturday 27th July 2019
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Cost: adults £40.00, under 18s £15.00

SECTION 1: Main Registrant

Payment Method:

Surname:

First name:

Age (the main entrant must be 18yrs +):

Mobile Tel No (the number of the phone you will have on your person on the event):

Email address:

Medical Conditions that could affect you on the walk including any medications you may take:

Name of Next of Kin for Emergency Contact:

Next of Kin Contact Telephone Number:

[] Do you declare that you are free of any health impediments and remain physically able to undertake all activities in the Event without compromising your Personal Safety, the safety of Other Participants, the safety of Directing Staff and the General Public

SECTION 2: Adding Additional Persons to this booking

How many ADDITIONAL persons would you like to add to this booking:

SECTION 3: Entrants Agreement to event terms, conditions and rules

Please tick the boxes to confirm your acceptance/agreement and sign the declaration in Section 4

[] Agreement that you are willing to be bound by the terms, conditions, rules, and requisites of the event; and that in all circumstances the event Directing Staff's decisions will be accepted final.

[] Agreement to follow the Directing staff instruction and carry out activities without compromising your personal safety, that of other participants, Directing Staff or the General Public.

[] You confirm that you are suitably experienced, competent and in good health to partake in the event. The participant confirms that they have experience in partaking in such hi-endurance events, acknowledge that they fully understand and accept responsibility for risks associated with partaking in such hi-endurance events, and remain in good physical and mental condition to undertake and successfully complete the event without compromising their safety or safety of others involved or associated with the event.

[] Agreement that you will attend the event adequately equipped to partake in such an activity, in the organized terrain, and to accommodate prevailing weather conditions at the time.

[] Agreement to observe the Country Code at all times and Leave No Trace (LNT) of your activity on completion of the event.

[] Agreement that you (and persons you are responsible for) participate at your own risk, and accept that no liability is accepted by the Event Organisers or Directing Staff for any injury, damage or loss sustained by you during the event.

[] Agreement that the Event Organisers and Directing Staff may take photographs of activities that include yourselves and persons you are responsible for, for purposes of marketing and promoting future events.

[] Agreement to be respectful and courteous all other persons who may use Public all Right-of-way sections on the Route, and not cause any hindrance or disruption to any such persons activities

[] The route is in the Cambrian Mountains; and is routed through a combination of Mountain, Forest and Lowland Terrain. Please ensure you fully adhere to Mountain Safety Guidance & Advice that is provided by Mountain Rescue England & Wales and the British Mountaineering Council alike. If in doubt please refer to: https://www.mountain.rescue.org.uk/stay-safe-out-there You acknowledge that you fully understand this and will abide by the respective guidance and advice.

[] There are sections of main Roads you will need to cross or walk along on-route. Please cross or walk along these roads safely, give way to vehicles using the road and do not cause a hazard or obstruction to traffic on the road. Please adhere to the Highway Code Rules for Pedestrians (1-35). If in doubt refer to: https://www.gov.uk/guidance/the-highway-code/rules-for-pedestrians-1-to-35 You acknowledge that you fully understand this and will abide by the respective guidance and advice.

[] Sections of the Route maybe routed through Private Land with expressive permission granted by the Landowners, and on permissive footpaths through working farmland. In this respect no dogs are permitted on the event. You acknowledge that you fully understand this and will abide by associated requirements.

[] A majority of the Route is on permissive footpaths in the countryside and through working farmland. Please respect and adhere to the Country Code at all times. If in doubt please refer to: https://www.gov.uk/government/publications/the-countryside-code/the-countryside-code You acknowledge that you fully understand this and will abide by the respective guidance and advice.

[] You agree that under no circumstance will you leave the event without advising an Event Marshal or Safety Marshal.

[] You will be issued a Wristband at Registration. You agree to wear this at all times and give the last 3 digits of your Wristband Number to the Event Marshalls at Rendezvous Stations and Check Point Stations you pass through on route.

[] Agreement that your details may be held in a secure electronic retrieval system for sole purposes of administering the event and advising you about future events. Information will be shared with funding partners purely for the purposes of evaluating the event Post event you may unsubscribe at any time by contacting event-admin@llanileisure.co.uk

SECTION 4: The main entrant's declaration

That the information provided above is true and accurate

Signature (type your name in full):

Date:

The Main Entrant confirms that all Additional Entrants will fully comply to all the event terms, conditions and requisites highlighted in section 3 by signing this declaration. The Parent/Guardian must be the Main Entrant, and must take full responsibility to ensure that the Junior Entrant/s fully comply to Terms, Conditions, Rules and Requisites of the Event; and confirms so by signing this declaration.

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