Liberty Life Team Entry Form

LIBERTY LIFE CORPORATE GAMES
DATE & TIME
SATURDAY
14TH
OCTOBER 2006 - 09h00 to 16h30
WHAT IS IT?
The Liberty Life Games provide a platform for different companies to
netw ork and interact on a social level w ith their families, friends and
colleagues, a part of our lives we so often tend to forget.
The day will also be a family day with lots of activities for the kids to
enjoy.
ACTIVITIES INCLUDE:
1.
2.
3.
4.
5.
6.
7.
8.
5-A-SIDE SOCCER TOURNAMENT
ACTION CRICKET CHALLENGE
NETBALL CHALLENGE
VOLLEYBALL COMPETITION
POOL (DOUBLES ONLY)
TABLE TENNIS ( DOUBLES & SINGLES)
2 HR AEROBICS MARATHON
50 METER NAPPY DASH
WHAT ELSE?
FOOD STALLS, CASTLE CORNER, PONY RIDES, FACE PAINTERS,
JUMPING CASTLES, LIBERTY LIFE IDOLS COMPETITION AND COCA
COLA ROAD SHOW TRUCK AND OTHER FUN ACTIVITIES
THROUGHOUT THE DAY
To enter the 5-a-side Soccer Tournament complete the forms
below and return them to Interactive Sport on FAX 086 612
1552
CALL 086 111 2010 for more information
For information on sporting codes 2 to 8 please contact:
Chiquita on (011) 408-3550 or 083 680 2394 or
[email protected]
5-A-SIDE SOCCER TOURNAMENT
Total Prize Money of R15 000 Plus Other Fantastic Prizes
Teams Must Consist Of No More Than 10 Players
(incl. Manager and/or Coach)
Each Player Receives a T-Shirt and W ater Bottle on the Day
COST
R1000 PER MEN'S TEAM
R700 PER LADIES TEAM
Entry Fee is Payable with the entry form to be received by Interactive
Sport by no later than 11 t h October 2006.
Team
Name
Company
Contact 1
Contact 2
Name
Cellphone
M ARK ‘X’ FO R SELECTION
MEN
L ADI ES
Email
Office
No
V AT Reg No
Name
Surname
ID Number
Cell
Email
UP TO 10 PL AYERS C AN BE REGISTERED (Format 5-a-side)
CLOSING D ATE FOR ENTRI ES:
11 t h October 2006
Fax Back to 086 612 1552
TE AM INDEMNI TY FORM
TE AM S WONT BE ALLOWED TO PL AY I F THIS FO RM IS NOT SUBMI TTED
I, the undersigned,
______________________________________
(ID Number _____________________)
do hereby -
1
warrant
that
I
am
duly
authori sed
to
sign
for
and
on
behalf
of
__________________________________________ (“the Company”) and to conclude
this indemnity on the Company’s behalf;
2
authorise
the
participation
of
__________________________________
(“the
Company’s Team”) in the Liberty Life Corporate Games 5-a-side Soccer Tournament
("the Tournament") taking place on the 14th October 2006, to represent the Company
in the Tournament;
3
b i n d m y s e l f a s s u r e t y a n d c o - p r i n c i p a l d e b t o r i n s o l i d u m wi t h t h e C o m p a n y a n d t h e
Company’s Team, for the due and punctual performance of any and all obligations
( " t h e o b l i g a t i o n s " ) o f t h e C o m p a n y a n d t h e C o m p a n y ’ s T e a m o we d t o I n t e r a c t i v e S p o r t
CC (CK number 2002/001032/23) its members, representatives, employees, agents,
sponsors, their directors, agents, repr esentatives, sponsors employees and/or any
other related parties (collectively, "the Indemnified Parties") arising out of or in
c o n n e c t i o n w i t h t h e C o m p a n y T e a m ' s p a r t i c i p a t i o n i n t h e T o u r n a m e n t a s a n d wh e n
such obligations arise and/or become due and paya ble including, but not limited to,
any fees related to the Company Team's participation in the Tournament;
4
a c k n o wl e d g e a n d a g r e e t h a t wi t h o u t p r e j u d i c e t o a n y o f t h e r i g h t s o f t h e I n d e m n i f i e d
Parties at law or in terms of this indemnity, the Company and t he Company's Team
(and to the extent permissible, the Company's successors -in-title) hereby irrevocably
and unconditionally indemnify and agree to hold the Indemnified Parties harmless
against any and all, costs (including costs on the scale as between att orney and own
client and any additional legal costs), damages (whether to personal property or
o t h e r wi s e ) , l i a b i l i t i e s ( a c t u a l a n d c o n t i n g e n t ) , e x p e n s e s , l o s s e s , i n j u r i e s , c l a i m s ,
actions and demands of any nature whatsoever howsoever arising, brought agai nst
a n y o r a l l o f t h e m a r i s i n g o u t o f o r i n c o n n e c t i o n wi t h t h e C o m p a n y ' s T e a m
participation in the Tournament including, but not limited to any accident or other
o c c u r r e n c e p u r s u a n t t o a n y n e g l i g e n t o r wi l f u l a c t b y a n y m e m b e r o f t h e C o m p a n y ' s
Team or any other party during the entire Tournament;
5
agree that each member of the Company's Team participating in the Tournament
agrees to abide by the rules and procedures of the Indemnified Parties; and
6
a c k n o wl e d g e t h a t t e a m s a n d p l a y e r s m a y b e b a n n e d f r o m t h e T o u r n a m e n t , w i t h o u t
r e f u n d , w h i c h b a n n i n g s h a l l b e d e t e r m i n e d b y t h e I n d e m n i f i e d P a r t i e s wh o s e d e c i s i o n
as to such banning is final and all of whose rights remain fully reserved.
Signed and accepted at
on
2017
Signed
N a m e o f I n d i vi d u a l :
Signed and accepted at
on
for
2017
N a m e o f C o m p a n y:
F o r a n d o n b e h a l f o f t h e C o m p a n y, wh o
w a r r a n t s t h a t h e i s d u l ya u t h o r i s e d h e r e t o
Fax Back to 086 612 1552