Ozzie World Cup Record - World's Largest Dribble
Complete this form to register to be a part of an Official Guinness World Record - The Most People Dribbling a Soccer Ball Simultaneously (currently 2068).

Date - Thursday July 20
Time - 4pm - 5:30pm
Where - Seymour Shaw Park - 244 The Boulevarde, Miranda NSW 2228
Who - You + 10 x friends/family
Bring - A football for everyone (and your club pop up banner)
Why - To witness the finish of the first World Record with Ozzie - Longest journey dribbling a football - 300km. And be a part of another World Record - Most People Dribbling a Soccer Ball Simultaneously (currently 2068).

Prizes - There will be plenty of prizes to give away plus 2 x major prizes – 1.) The club with the most participants. 2.) The club with the most enthusiastic participants.

Please note - to register you must book as 1 x Steward + group of 10 x participants 

Steward responsibilities - collect wrist bands and sign 10x participants in, supervise 10x participants to follow the dribble instructions given 
Email *
Your full name / Steward full name? *

The role of the Steward is very important in helping Ozzie achieve the official Guiness World Cup Record. Guiness specifies that: “For the purpose of this record there must be one Steward present for every ten participants.” The Steward will be responsible for ensuring their group of 10 participants is continuously dribbling their football for the 5 min duration of the record attempt, through the designated course.

The Steward is also required to check the team in at 4pm on July 20 and collect wrist bands for the 10 x participants.

Football Club you are associated with? *
If other, please name the club you're from:
Names of 10 x people who will be taking part with you? (Please list 10 x full names - children and/or adults) *
I understand that I will need to arrive by 4pm and ensure all 10 x participants bring a football each? *
Required
Contact phone number?
Do you know someone who could be a volunteer to help on the day? Please provide contact details:

Waiver & Release

*
I am voluntarily participating in the Ozzie World Cup Record event and I am participating in the activity entirely at my own risk. I am aware of the risks associated with participating in this activity, which may include, but are not limited to, physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or others' negligence, conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume all related risks, both known or unknown to me, of my participation in this activity, including travel to, from and during this activity.

I acknowledge that I have carefully read this "waiver and release" and fully understand that it is a release of liability. I expressly agree to release and discharge Ozzie For Kids and all of its affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have to bring a legal action against Ozzie For Kids for personal injury or property damage.
Required
Thank You!
We can't wait to see you at the event to join in helping break a World Record together with Ozzie!

Visit the Ozzie website www.ozzieforkids.com
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