Participant Event Form

First Name

Last Name

Email

ID / Passport Number

Mobile Number

Choose your event

Are you suffering from a medical condition, illness, or injury?

Yes

No

Do you have any Allergies?

Yes

No

Are you Pregnant or Breastfeeding?

Yes

No

If you answered yes to any question or if there is anything you would like the Arise Team to know, Please elaborate:

In Case of Emergency (ICE) Name:

Relation to ICE Person

ICE Phone Number:

Medical Aid Name:

Medical Aid Number:

I declare that the info I've provided is accurate and complete.

I am aware of the challenge and dangers of participating in this event and am physically and mentally able to participate.

I accept the Waiver, Release of Liability, Indemnification and Consent (View here)

I hereby confirm that I have read and fully understand all the contents of this form and accept all Terms and Conditions

Signature

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Date

Participant / Crew Form