SINGAPORE PAINTBALL SERIES TEAM REGISTRATION FORM
To participate in this event, please complete this form in full and send it to us with the full payment.
By Hand:
1) SPS Headquarters/Paintballers World Pro Shop, One Commonwealth Building, 1 Commonwealth Lane, #03-03,
Singapore 149544
By Email: info@singaporepaintballseries.com
*Partial payment registration will not be accepted. Only upon completion of full payment and the submission of
completed registration forms will the team be registered with the SPS. Incomplete forms and/or incomplete payment
mean that the team is not registered for the event.
TEAM CONTACT DETAILS
Team Name
Team Owner
(if any)
Full Name of
Contact Person
Address
Email Address
Postal Code
Mobile No
S(
)
EVENT
X
Inter Tertiary Paintball Championship 2011 – Leg 1 – 20th February 2011
Inter Tertiary Paintball Championship 2011 – Leg 2 – 26th June 2011
PAYMENT DETAILS
Please select the preferred payment mode below by placing a “X” in the appropriate box.
Cheque (made payable to “Extreme Sports LLP”)
Cash
Internet Banking Transfer (Bank: OCBC/ Account Type: Current Account/ Account Number: 804370001/
Bank and Branch Code: 7339-528)
SINGAPORE PAINTBALL SERIES
Items
Team Registration Fee (by 13 February 2011)
Cost of ITPC Registration
$450.00 per team of 6 players (w/GST $481.50)
*All fees paid are non-refundable.
SINGAPORE PAINTBALL SERIES
INDIVIDUAL PLAYER REGISTRATION FORM
PLAYER #1 – T E A M C A P T A I N
Given Name
Family Name
Birth Date
Player Nick
DD
MM
YY
Gender
M / F
(Please insert photo here.)
Email Address
Mobile No
Name of
institution
My Paintball Playing Experience/ Achievements/ Contributions :
No
MM/YY
Event/ Competition/ Others
Results
Team Joined
Division
For Official Use Only:
*The participant is solely responsible for ensuring that the particulars provided in this form are accurate and correct. Incorrect or inaccurate
information may lead to disqualification of the player/team without refund.
SINGAPORE PAINTBALL SERIES
INDIVIDUAL PLAYER REGISTRATION FORM
PLAYER #2
Given Name
Family Name
Birth Date
Player Nick
DD
MM
YY
Gender
M / F
(Please insert photo here.)
Email Address
Mobile No
Name of
Institution
My Paintball Playing Experience/ Achievements/ Contributions :
No
MM/YY
Event/ Competition/ Others
Results
Team Joined
Division
For Official Use Only:
*The participant is solely responsible for ensuring that the particulars provided in this form are accurate and correct. Incorrect or inaccurate
information may lead to disqualification of the player/team without refund.
SINGAPORE PAINTBALL SERIES
INDIVIDUAL PLAYER REGISTRATION FORM
PLAYER #3
Given Name
Family Name
Birth Date
Player Nick
DD
MM
YY
Gender
M / F
(Please insert photo here.)
Email Address
Mobile No
Name of
Institution
My Paintball Playing Experience/ Achievements/ Contributions :
No
MM/YY
Event/ Competition/ Others
Results
Team Joined
Division
For Official Use Only:
*The participant is solely responsible for ensuring that the particulars provided in this form are accurate and correct. Incorrect or inaccurate
information may lead to disqualification of the player/team without refund.
SINGAPORE PAINTBALL SERIES
INDIVIDUAL PLAYER REGISTRATION FORM
PLAYER #4
Given Name
Family Name
Birth Date
Player Nick
DD
MM
YY
Gender
M / F
(Please insert photo here.)
Email Address
Mobile No
Name of
Institution
My Paintball Playing Experience/ Achievements/ Contributions :
No
MM/YY
Event/ Competition/ Others
Results
Team Joined
Division
For Official Use Only:
*The participant is solely responsible for ensuring that the particulars provided in this form are accurate and correct. Incorrect or inaccurate
information may lead to disqualification of the player/team without refund.
SINGAPORE PAINTBALL SERIES
INDIVIDUAL PLAYER REGISTRATION FORM
PLAYER #5
Given Name
Family Name
Birth Date
Player Nick
DD
MM
YY
Gender
M / F
(Please insert photo here.)
Email Address
Mobile No
Name of
Institution
My Paintball Playing Experience/ Achievements/ Contributions :
No
MM/YY
Event/ Competition/ Others
Results
Team Joined
Division
For Official Use Only:
*The participant is solely responsible for ensuring that the particulars provided in this form are accurate and correct. Incorrect or inaccurate
information may lead to disqualification of the player/team without refund.
SINGAPORE PAINTBALL SERIES
INDIVIDUAL PLAYER REGISTRATION FORM
PLAYER #6
Given Name
Family Name
Birth Date
Player Nick
DD
MM
YY
Gender
M / F
(Please insert photo here.)
Email Address
Mobile No
Name of
Institution
My Paintball Playing Experience/ Achievements/ Contributions :
No
MM/YY
Event/ Competition/ Others
Results
Team Joined
Division
For Official Use Only:
*The participant is solely responsible for ensuring that the particulars provided in this form are accurate and correct.
SINGAPORE PAINTBALL SERIES
Release of liability, assumption of risk, indemnity and publicity agreement.
READ BEFORE SIGNING
Note: This form must be read and signed before the participant is allowed to take part in any paintball event, or have access to the players’ area or field of play.
Name of Team
and Name of
Institution:
In consideration of being permitted to participate as a player, referee, or in any other way in paintball activities organized by Extreme Sports LLP, I acknowledge and agree
that:
1. The risk of injury in paintball activities is significant, including the potential for permanent disability and death. Although protective equipment and personal discipline may
reduce this risk, the risk of serious injury and death remains. I knowingly and freely assume all such risks, known and unknown, even if arising from the ordinary and gross
negligence of persons released from liability below, and assume full responsibility for my participation.
2. I understand that the activities of paintball are physically and mentally intense. I understand the rules of play and will comply with all rules relating to the activity and rulings
of the officials. Notwithstanding the foregoing, if I observe any unusual or unnecessary hazard during my participation, I will avoid the hazard and promptly bring it to the
immediate attention of the nearest activity official. I realize paintball is only a sport and that my responsibility to myself and others for my safety is paramount, and I will refuse
to participate in any manner which I believe may include any unusual or unnecessary hazardous condition even if it may result in my disqualification. If I am a referee or other
official, I will interpret and enforce the rules to avoid unusual or unnecessary hazardous conditions.
3. I will only use paintballs which is provided by the organizer.
4. I, for myself and on behalf of my heirs, assigns, personal representatives, relatives, and anyone claiming through me, hereby release and hold harmless from liability of EK
Paintball LLP and Extreme Sports LLP., the owners or lessors of premises and facilities used to conduct the paintball activities, and all of their officers, officials, agent,
independent contractors and/or employees (“releases”), with respect to any and all injury, disability, death, or loss or damage to person or property, whether caused by the
ordinary or gross negligence of the releases or otherwise, except that which is the result of intentional misconduct or other conduct for which such a release is invalid as a
matter of law. I shall defend and indemnify the releases from all claims brought against them which have been released by this Agreement or which arise from the breach of
my obligations under this Agreement. This Agreement is for the benefit of the releases only.
5. I consent to the use of my name, biographical and statistical information, voice and likeness on or in connection with any print media, DVD, tape, web cast, websites, radio,
or television program relating to any activities by Extreme Sports LLP., any advertising, publicizing or other such commercial use (“Publicity”) of such program as may be
designation by Extreme Sports LLP. I waive all rights to compensation for Publicity. Extreme Sports LLP and its sub licensees and assigns may use, reproduce or otherwise
disseminate or publish Publicity, directly or indirectly, for any commercial or other legitimate purpose in any manner and at any time desired.
6. This Agreement covers each and every paintball activity in which I have participated in the past and may participate hereafter.
7. This Agreement is governed by the law of The Singaporean government. I consent to the exclusive jurisdiction of the courts of Singapore government and of each
jurisdiction in which I participate in an activity to resolve any issue related to or arising under this Agreement or my participation.
I have read this release of liability, assumption of risk, indemnity and publicity agreement, fully understand its terms, understand that I have given up substantial rights by
signing it, and sign it freely and voluntarily without any representation or warranty.
Full Name
Age
NRIC/FIN/ Passport No
Signature
Date Signed
Captain:
Player 1:
Player 2:
Player 3:
Player 4:
Player 5:
SINGAPORE PAINTBALL SERIES
FOR PARTICIPANTS OF MINOR AGE UNDER LAW OF ACTIVITY LOCATION
(ONLY FOR PARTICIPANTS AGE 14-17 AT TIME OF REGISTRATION)
I, for the above participant, myself, heirs, and assigns: (1) consent and agree to the entire above Agreement; (2) agree to release, defend and
indemnify all releases from any and all claims and liabilities incident to or arising from the above participant’s participation in Activities; and (3)
represent and warrant my authority to make such representations and agreements with the intent that they be relied upon.
Name of Parent/ Guardian
Contact No
-
Age
NRIC/FIN/ Passport No
END OF REGISTRATION FORM
Signature
Date Signed
-
SINGAPORE PAINTBALL SERIES