The Hong Kong Institution of Engineers
40th Anniversary Sports and Family Fun Day
Registration Deadline:
Sunday, 15 November 2015
Email: [email protected]
Fax:
2882 6825
Registration Form
(For Divisions/Companies/Organisations)
Division/Company/Organisation
:
Contact Person
:
Position
:
Tel (Office)
:
Tel (Mobile)
:
Fax
:
Email
:
Address
:
Part A
(English)
(Chinese)
Application for Track and Field Competitions
I / We would like to take part in the following competition(s):
A1 Individual Competitions
(I)
Track and Field Competitions
(*Please tick “” as appropriate)
Name of Applicants
(in English and Chinese)
Membership No
Men
100m
Women
Track*
400m
Men
Women
Field*
800m
Women
1500m
Men
Long Jump
Men
Women
High Jump
Men
Women
1
2
3
4
Please add rows if necessary.
1
A2 Team Competitions (Information to be filled in by representative of each team only)
(II) Track – Mixed Relays (4x100m): (1) HKIE Members (2) HKIE Divisions
Types of
Mixed Relay*
1
2
(*Please delete as appropriate)
Name of Team Member
(in English and Chinese)
Team Name
Gender*
HKIE Members/
(Team Leader)
M/F
HKIE Divisions
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Back-up)
M/F
(Back-up)
M/F
HKIE Members/
(Team Leader)
M/F
HKIE Divisions
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Back-up)
M/F
(Back-up)
M/F
Membership No
Mobile No
Membership No
Mobile No
Please add rows if necessary. A minimum of 1 male and 1 female is required for Mixed Relays.
(III) Team Games
(*Please delete as appropriate)
Types of Games*
1
Name of Team Member
(in English and Chinese)
Team Name
Gender*
The Cautious Ball
(Team Leader)
M/F
Runners#/
(Team Member)
M/F
The Big Feet
(Team Member)
M/F
Running Man#/
(Team Member)
M/F
The Drawing
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Back-up)
M/F
#
Hobbits
2
2
(Back-up)
M/F
The Cautious Ball
(Team Leader)
M/F
Runners#/
(Team Member)
M/F
(Team Member)
M/F
Running Man /
(Team Member)
M/F
The Drawing
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Back-up)
M/F
(Back-up)
M/F
The Big Feet
#
#
Hobbits
Please add rows if necessary.
# Rules of the Games:
1.
A minimum of 1 male and 1 female is required for Team Games.
2.
The Cautious Ball Runners: A team of eight members will carry a ball by using a 1.5m long bouncy bed and run for 100m. The first team reaches the finish line would win the game.
3.
The Big Feet Running Man: A team of eight members will each run for 25m with a pair of big bouncy shoes and pass the shoes to the next member. The first team of which the eighth member reaches the
finish line would win the game.
4.
The Drawing Hobbits: A team of eight members will carry a giant inflated pencil and run for 100m to the finish line, and write down the assigned words like “HKIE” or “SPORTS DAY” etc by using the
giant inflated pencil. The first team finishes the writing would win the game.
(IV) Tug-of-war (*Please delete as appropriate)
Name of Team Member
(in English and Chinese)
Team Name
1
Gender*
(Team Leader)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
(Team Member)
M/F
Membership No
Mobile No
3
(Team Member)
M/F
(Back-up)
M/F
(Back-up)
M/F
Please add rows if necessary. A minimum of 3 female is required for Tug-of-war.
Total No of participants and guests
:
Shuttle Bus Service (Please “” as appropriate)
Free shuttles to the Stanley Ho Sports Centre will be arranged for participants and guests. Please select your preference for pick-up and drop-off point:
(Exact time for pick-up/drop-off to be confirmed in due course)
Part B
 I/We would like to go to the Stanley Ho Sports Centre by shuttle bus.

I/We would NOT need the shuttle bus service.
No of passenger(s)
Locations
Pick-up
1.
Cyberport (near Cinema)
2.
Kennedy Town MTR Station (Exit A)
3.
Kowloon Tong MTR Station (Exit B)
Drop-off
Note: No parking space is available at the Stanley Ho Sports Centre.
Part C
Participation Certificate(s)
(Please “” as appropriate)
 I/We would like to receive the Participation Certificate(s).

I/We would NOT like to receive the Participation Certificate(s).
Note: The number of certificate(s) will be given according to the number of participants registered.
Part D
Order for The HKIE 40th Anniversary Polo Shirt [Optional]
To commemorate the 40th Anniversary of the Institution, a designated souvenir of Polo Shirt printed with the 40th Anniversary Logo is available for sale at HK$100 each. You are welcome to
place order until stock lasts. The details and design of the Polo Shirt are set out as follows:
Fabric type
:
Dry-fit
Colour
:
Blue
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Order Details:
Size^
Body
Length
Chest
Width
Sleeve
Length
Price each
HK$
XS
22 1/2”
17”
14 1/4”
100
S
24 1/2”
18”
15 1/8”
100
M
27”
19 1/2”
16 1/4”
100
L
28 1/2”
21”
17 7/8”
100
XL
30”
22 1/2”
19”
100
Quantity
Item total HK$
Total Price
^ The size of Polo Shirt is available on a first-come, first-served basis.
Name:
Daytime Tel No:
Fax No:
Delivery Address:
Payment Method
(Please “” as appropriate)
 By cash (only applicable to order placed in person or picked up at the HKIE Reception)
 A cheque payable to “The Hong Kong Institution of Engineers” after confirmation
 Please debit my *Visa / Mastercard account (applicable only to total amount over HK$100) after confirmation.
Card Holder Name:
Expiry Date:
Card No:
for Polo Shirt + #delivery charge HK$
with the amount HK$
(to be filled in by the HKIE)
Signature:
#A delivery charge (to be confirmed) will be applied to each order.
*Delete as appropriate
The Polo Shirt will be sent by registered mail and please allow up to ten days for delivery. Payment by credit card in person is acceptable if done within office hours (Monday to Friday, 9:00am – 12:30pm,
1:30pm – 5:00pm).
Part E
Name:
Emergency Contact Person
Mobile No:
5
Part F
Declaration
(Please “” as appropriate)
 I/We, the undersigned, am/are applying to participate in the HKIE 40th Anniversary Sports and Family Fun Day (“Fun Day”), and agree to abide by the terms and rules of the HKIE and
declare the followings:
1.
I/We certify that the particulars on this form are true and correct in every particular, to the best of my/our knowledge and belief.
2.
I/We declare that I/we have read and understood the rules and regulations for the Fun Day and agree to be bound by them.
3.
I/We accept that the HKIE is not under any liability for the loss of property or injury to me/us.
4.
I am/We are physically healthy and fit and have the ability to participate in the Fun Day. The HKIE reserves the right to disallow/disqualify any person who is known or suspected to
be physically unfit to participate in the event.
5.
I/We agree athletes must retire and leave the race course immediately if requested by any race official, medical staff, race director or security staff.
6.
I/We agree to indemnify or reimburse the HKIE in respect of any additional expenses or costs incurred by the HKIE arising from or in connection with intentional damage during
my/our participation in the event.
7.
I/We grant permission to the HKIE or its agents to use any photograph or video of the event for any lawful purpose including advertising the event.
8.
I/ We agree that in case of dispute, the decision of the HKIE shall be final.
Name
:
Signature
:
Company/Division Chop
:
Date
:
Remarks:
1. Participation Certificate(s) will only be given upon request.
2. Each applicant can only apply for a maximum of 3 individual competitions.
3. Each applicant can only apply for a maximum of 2 out of the 3 Team Games: The Cautious Ball Runners, The Big Feet Running Man and The Drawing Hobbits.
4. A minimum of 1 male and 1 female is required for Mixed Relays and Team Games.
5. A minimum of 3 female is required for Tug-of-war.
6. All events are for HKIE members only, except Boys events, Girls events, Inter-Professional Relay and Family Relay.
7. All competitions are final and their results will be determined by time (except Tug-of-war).
8. If the number of participants/teams for any event is less than 3, the event will be cancelled.
9. Please append additional sheet(s) if necessary.
10. Please complete and return the registration form to the Corporate Communications Section of HKIE Secretariat on or before Sunday, 15 November 2015 by email at
[email protected] or fax at 2882 6825.
11. Each successful applicant will receive HK$50 cash coupon for redemption of food and drinks at the food kiosk of the Stanley Ho Sports Centre. The HKIE reserves the right on the final
decision of coupon distribution.
12. If the number of registration received exceeds the maximum limit of each individual/team competition, participants/teams will be selected by drawing lots and successful
participants/teams will be informed by email.
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