How to enter Amateur Divisions Online: Visit www.noosafestivalofsurfing.com and hit the registration button Email: Complete this form, scan and email to info@noosafestivalofsurfing.com Mail: As above and send to - Phil Jarratt Communications, 5 Koel Street, Noosaville, QLD 4566 Australia How to pay: Fill in credit card details below or make cheque/money order payable to Phil Jarratt Communications Pty Ltd Entries close: March 1, 2015 (or when division fills) Name: Mailing Address: Suburb/Town: Phone: Email (essential): Organisation: M F DOB: Age at 01/01/15: State: Cell/Mobile: Club: Shirt Size (tick one): S Zip/Postcode: M L XL XXL PLEASE NOMINATE THE DIVISIONS YOU WISH TO ENTER. NOTE: ONE AGE DIVISION ENTRY ONLY PER COMPETITOR. OLD MAL IS NOT AN AGE DIVISION. 25% discounted entry fees listed below. To receive discount, entry forms and fees must be received by 1 September 2014. Amateur Divisions Mens Open (18 and over) $143.00 Fee Before 1/09/14 $110.00 Mens 40 and over $143.00 $110.00 Mens 50 and over $143.00 $110.00 Mens 55 and over $143.00 $110.00 Mens 60 and over $143.00 $110.00 Mens 65 and over $143.00 $110.00 Mens 70 and over $143.00 $110.00 Junior Mens (under 18) $99.00 $77.00 Boys (under 15) $99.00 $77.00 Womens Open (18 and over) $143.00 $110.00 Women 35 and over $143.00 $110.00 Junior Women (under 18) $99.00 $77.00 Old Mal Open $143.00 $110.00 Total Full Rate Sub-total $ PRO, TEAMS & SPECIALTY EVENTS OPENING LATER IN THE YEAR. CHECK WEBSITE FOR INFO. Recent Results/Placings: www.noosafestivalofsurfing.com Enquiries: info@noosafestivalofsurfing.com or phone 0439 666 172 Entry Confirmation: All entries must be completed and paid for before they are confirmed. Confirmation will be the addition of your name to the competitor lists at noosafestivalofsurfing.com Withdrawal: All cancellations and withdrawals must be in writing and received before March 1, 2015 for full refund less $10 processing fee. After that date no refunds can be made. Participant’s Agreement: This is a legal document that affects your rights. By accepting these conditions I agree to compete in this event on the following basis: 1. I acknowledge that competitive surfing involves the real risk of serious injury or even death from various causes including overexertion, equipment failure, dehydration, accidents with other competitors, spectators or road users, and course or weather conditions to name a few. 2. I understand that I should not compete in this event unless I have trained appropriately and a medical practitioner has verified my physical condition. 3. By competing, I accept all risks necessarily flowing from my participation that could result in loss of life or permanent injury. Accordingly, I release all people associated with the conduct of the event from, and will indemnify them against, all liability (including liability for their negligence) for all injury, loss or damage arising out of or connected with my participation in this event. For clarification, the people released include event organisers Phil Jarratt Communications, Sunshine Coast Council, Noosa Malibu Club, promoters, sponsors, managers, government and public authorities, Surfing Australia; its members state and territory surfing associations and all of their respective directors, officers, employees, agents, contractors and volunteers including event medical and paramedical personnel. This release and indemnity continues forever and binds my heirs, executors, personal representatives and assigns. 4. I acknowledge that I can be exposed to dangerous surf conditions and that my participation in the event in which I have entered is at my own personal risk. 5. I consent to receiving any medical treatment that event organisers think desirable during or after the event. I agree to reimburse the expenses incurred in providing me with necessary medical treatment. 6. I consent to event organisers using my name, image and likeness, before during or after the event, for event promotional broadcasting or reporting purposes in any media. 7. I understand that insurance cover affected for participants in this event may not cover me for all injury, loss or damage sustained by me. 8. Safety precautions undertaken by organisers (such as supervision, event safety briefings, equipment safety checks) are a service to me and other competitors but are not a guarantee of safety. 9. I am fully responsible for the security of my personal possessions at the event. 10. My registration is not transferable to other people. If I am unable to compete, or if the event is cancelled, my registration fee is non-refundable and may not be transferred to another event. 11. I have attached to my entry form details of any medical or physical conditions from which I suffer that might affect my performance or be relevant if medical treatment is needed. 12. I agree to abide by all competition results and directions issued by the event organiser. 13. I certify that I am 18 years of age or older and I have read this document and fully understand it. 14. Event organisers may change the event format or other event conditions at their discretion. If that occurs, this agreement applies to the changed conditions. 16. I acknowledge that the Event is susceptible to extreme, changeable weather conditions that are beyond the control of the Organisers. I agree that if the event is cancelled due to storm, rain, inclement weather, winds or other ‘Act of God’ conditions or safety concerns, or if I do not participate in the event for any other reason, my entry fee shall be nonrefundable. Payment Details: Payment: (please tick) Visa Mastercard Cheque Card No: Expiry Date: Money Order Total Amount: $ Card Name: Today’s Date: Signature: Please make cheques payable to Phil Jarratt Communications Pty Ltd. Mail your entry to: Phil Jarratt Communications Pty Ltd 5 Koel Street Noosaville, Queensland 4566 Australia Or Email to – info@noosafestivalofsurfing.com Medical Conditions: Signature: Date: www.noosafestivalofsurfing.com