Registration Form: Panaad sa Kinaiyahan 2019
Event Timing: January 19-20, 2019
Event Address: Mt. Da-at, Mabinay, Negros Orinetal
Contact us at Elan Mandy 09989731200, Masa 09068205582, Lane 09272010536, Yves Adrian 09365790307, Jufel -09051179171
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Fullname *
Nickname
Civil Status
Date of Birth
Age
Sex
Address
Contact No.
Email Address
Occupation/Profession
Club Affiliation (if any)
Blood Type
Allergies
Contact Person in case of Emergency
Event Shirt Size *
Event Shirt
Registration Fee : 700 Pesos *
Required
After sending your payment, Please scan or take picture of your receipt or transaction slip and PM us in our FB account Baktas or send to Elan Mandy N. Cadayday email : elanmandy@gmail.com and send him a noticed txt through this no.09989731200
Participants Waiver
                                 I know that joining this event is potentially hazardous activity, which could cause injury or death. I will not enter and participate unless I am medically able and properly trained, and by my signature, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I agree to abide by any decision of the organizer relative to any aspect of my participation in this event, including the right of any official to deny or suspend my participation for any reason whatsoever.  I assume all risks associated with in this event, including but no limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, flood, all such risks being known and appreciated by me. I understand that I will abide by all rules. Having read this waiver and knowing these facts and inconsideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Baktas Mabinay Mountaineers Club and all event sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.  I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purpose.
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