Mount Rinjani 2023
Event Timing: 22 - 27 September, 2023.
Event Address: Lombok, Indonesia
Cost : S$700 SAC member, $830 Non SAC member
Contact us at (65) 84214558 or patrickhonn@gmail.com
Sign in to Google to save your progress. Learn more
Name (as in Passport) *
Membership Number (if any)
Date of Birth
*
MM
/
DD
/
YYYY
Citizenship
*
Gender
*
Special Diet
*
Passport Number
*
Passport Expiry Date
*
MM
/
DD
/
YYYY
Mobile Contact
*
Email *
Name of Next of Kin *
Next of Kin/Relationship
*
Next of Kin Contact Number
*
Are you currently on medication or having any existing ailments? *
Do you have any camping experience in the forest for at least two nights? *
Kindly rate your level of experience:
*
Have you hiked any mountain of above 3000m before?
*
Statement of Indemnity
*
I understand that participation in the activities of the Singapore Adventurers’ Club is completely voluntary and entirely at my own risk. In consideration of the Club agreeing to my participation in the above activity, I hereby undertake that I will make no claims against the Club in respect of and will at all times hereafter indemnify and keep the Club fully indemnified from and against all claims for damages, costs, injuries, death, and other demands, howsoever arising which may be made or claimed against the Club or which the Club may incur by reason of or in connection with my participation. I also understand that the Club or which The Club may incur by reason of or in connection with my participations.  I also understand that the organizers, leaders and co-leaders of the above activity are volunteers and act only as representative for the Club and I hereby undertake to similarly indemnify and keep them fully indemnified from and against all claims which may arise or which may be incurred by reason of or in connection with my participation. I agree that the Club reserves the right to turn down or terminate my participation in or to abort or terminate the above activity at any time without assigning any reason whatsoever and I hereby undertake that I will make no claims against the Club in respect of any costs or losses that I may incur as a result of  the Club exercising the right.
Required
Terms and conditions: *
1. To confirm registration, each participant is to make a 50% NON-REFUNDABLE payment of the cost by 11 Aug. Balance of the cost shall be made on the day before the start of the event.
2. No refund shall be made in the event of no-show up by the participant.
3. Should the event does not happen due to lack of participants or any unforeseen circumstances, any payment that was made shall be fully refunded.
4. Proof of sent is not proof is receipt.
5. Participant shall be fully responsible for the accuracy of the provided information in the participation form. The organizer shall not be held responsible for any damages due to inaccuracy of the provided information.
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy