Haribon MHW Registration Form (Coke Employees)


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Haribon Million Hectare Walk
Nov 16 Sunday

Sorry for Coke employees only

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Haribon MHW Registration Form (Coke Employees)

  1. 1. REGISTRATION FORM Agreement and Release/Waiver: 1. Register by filling up this form completely. Please send all completed Registration forms to: Please carefully review the following before completing and signing: In consideration of being permitted to participate in the Victor Z. Manlapaz MILLION HECTARE WALK (the “Event”), I hereby Project Officer, Environment declare, agree and confirm as follows: Coca-Cola Foundation Philippines, Inc. 1890 Paz Guazon Ave. 1. That I am physically fit to participate in the Event Paco, Manila and that i have no medical condition/reason that Tel. (02) 866-2582 would restrict my ability to participate in the Event Fax (02) 866-2398 or would cause or aggravate any medical Mobile (0917) 886-6054 condition. 2. I agree to the use of my picture, name and/or city/ Forms must be received by the Coca-Cola Foundation no later town of residence, without compensation, for than October 24, 2008 Friday publicity reasons. By participating in the Event, I on behalf of myself and those 2. Registration Fee of P300 per volunteer shall be shouldered by minors (if any) listed below and for whom I am parent and/or legal the Coca-Cola Foundation. * Not inclusive of P8 entrance fee to guardian, hereby release, waive and forever discharge all Ninoy Aquino Parks and Wildlife Center sponsors, officials, organizers and all other associations involved in the Event, together with each of their respective employees, agents, directors, officers, members and officials(collectively referred to as the “Releasees”), of and from any and all proceedings, claims, demands, damages, costs, expenses, actions and causes of action (whether known or unknown) whatsoever, both in law and equity, which I now have or may hereafter have for or by reason of or in respect of my participation in the Event, whether as a spectator, participant or otherwise, and notwithstanding that same may have been contributed to, or occasioned by, the negligence of any of the Releasees. Walker Information: I further hereby undertake or hold and save harmless all of the Releasees from and against any and all liability incurred by any or ___ Haribon Member ____ Non-Member all of them as a result of, or in anyway connected with, my ___ Current ____ Would you like to participation and/or the participation of any of the minors listed ___ For Renewal become a member/donor? below in the Event. ___ Mr ___ Mrs ___ Ms By submitting this entry, I acknowledge having read, understood and agreed to the above waiver/release. First Name: _______________________________ The provisions of this agreement, waiver/release shall enure to the respective heirs, executors, administrators, personal Last Name: _______________________________ representatives, successors and assigns of each of the Age: _________ Releasees and shall be binding upon my heirs executors, administrators and personal representatives. Address: ________________________________ The provisions of this waiver/release shall be governed by the _________________________________________ laws of the Republic of the Philippines. Cellphone: (__ __ __ __) __ __ __ - __ __ __ __ I am signing this waiver/release on behalf of myself and the following minors (if any) for whom I am a parent and/or legal Email: ____________________________________ guardian. Day-time contact number: __ __ __ - __ __ __ __ (If under 18 years of age, Parent/Guardian must sign) Company : Coca-Cola Philippines Date: ___________________________________________ Estimated t-shirt size: S M L XL Other: ________ Signature:___________________________________________ Which route? _____ Short: 360 meters Printed name over Signature _____ Long: 1.5km