Unison Hikathon 2011
HIKE for Equality and Harmony in Diversity!
邁進四色林，踏出融和路！

Application Procedures:

Please fill in the form below. By clicking the Submit button, you and your team members (if applicable) acknowledge that you are one of the applicants named below and that you have read the disclaimers and indemnity below and agree to be bound by it. On the event day, all participants will be asked to sign the same disclaimer and indemnity for our records.

The application fee (cheque or proof of payment) should be sent to Hong Kong Unison on or before 5 October 2011. Payment can be made by
  • Bank transfer to HSBC account 534-642509-001
  • Crossed CHEQUE, payable to "Hong Kong Unison Ltd"
  • Online credit card payment through PayPal at our event website
All donations raised should be sent to Hong Kong Unison on or before 23 November 2011.

Application Fee:
Individual or Team – HKD $100
Student – HKD $50
參加手續:

請填妥此表格。在遞交資料之前，請細閲「參加者聲明及保證」。如果您及您的隊員(如有)接受條文， 請點擊"遞交"按鈕。活動當日，融樂會將會要求所有參加者簽署一式一樣的「參加者聲明及保證」以作記錄。

請將報名費（支票或付款收據）於2011年10月5日或之前遞交至香港融樂會。 報名費付款方法如下：
  • 銀行轉帳往本會匯豐銀行戶口 #534-642509-001
  • 抬頭為「香港融樂會有限公司」的劃線支票
  • 登入活動網站透過PayPal以信用卡進行網上繳費
請於2011年11月23日或之前將籌款交回香港融樂會。

報名費:
個人 / 團隊 – 港幣 $100
學生 ─ 港幣 $50

Application Form / 報名表格

組別 Category Individual / 個人
Student / 學生     (**Applies to full-time student between ages 12 – 25 適用於12-25歲之全日制學生)
Team / 團隊     (**A maximum of 5 members in each team is allowed 團隊最多限5人參加)
Trails 路線
 Tai Po 4-Colour Forest Walks, Tai Po Kau 大埔滘四色林
Blue Walk / 藍路 - Total Length 全長 4 KM 公里
    (Recommended for family and leisure hiker適合家庭和休閒行山者)
Yellow Walk / 黃路 - Total Length 全長 10 KM 公里
    (Recommended for regular hiker 適合有中等經驗的定期行山人士)

個人或團隊資料
Individual / Team Information

Individual/
Team Leader
個人參加者 /
隊長		 Team Name/隊伍名稱:
Member
隊員 1
 Member
隊員 2
 Member
隊員 3
 Member
隊員 4
中文姓名 / Chinese Name




英文姓氏 / Last Name*



英文名字 / Given Name*
性別 / Gender  
出生日期 / Date of Birth*
YY年/MM月/DD日
聯絡電話 / Contact Number*
地址 / Address*
電郵 / Email
Emergency contacts cannot be participants in the event / 緊急聯絡人不可為本活動參加者
緊急聯絡人
Emergency Contact*
緊急聯絡人電話
Emergency Contact Number*
收取本會有關之宣傳品?
Receive Promotional Materials?
* 必填項目/Mandatory fields

Remarks 備註

Participants aged 12 or below must be accompanied by an adult; with each adult can only accompany 2 children at maximum.
12歲或以下的參加者需由成人陪同參與，且每名成人不可帶領超過兩名兒童。

Participants aged below 18 will be requested to have consent from parent in signature prior participating.
未滿18歲之參加者將被要求由家長簽署同意書後方可參加。


The personal data collected will be treated as strictly confidential and will be used for this event, receipting and other contact only
所收集的個人資料將保密處理，並只作為本活動、寄發收據及與閣下通訊之用


   



I, by clicking on the Submit button on this page, declare my wish to enter Unison Hikathon 2011. I confirm and agree that:

Disclaimers and Indemnity

I or with participants below age of 18 take part in this event entirely at my own risk and that I will not hold the organizer of this event, any sponsor of this event or any organization or person providing medical, catering, logistical, IT or other support or services for this event responsible for death or any injury or for any damage to or loss or destruction of property or any other economic loss or for any consequential loss, in any such case arising from any accident or mishap or otherwise arising from or connected with this event, and whether during or after this event, in preparation for it, traveling to or from it or otherwise. I or with participants below age of 18 also agree to indemnify or reimburse the organizer of this event in respect of any additional expenses or costs incurred by the organizer of this event arising from or in connection with my participation in this event.

Undertaking to raise sponsorship

I acknowledge that Unison Hikathon 2011 is a fundraising event and I confirm and agree that I/we will do all my best to fulfill the target raised amount required in my category to be raised for Unison. I also undertake that all funds raised directly or indirectly from my participation in Unison Hikathon 2011 will be paid in full to Unison and that I will not seek to raise funds for other organizations through my participation.

Agreement to grant rights in respect of image and voice

Unison may (without reference to, and without the prior approval of, or any payment to, any person) use, in any publicity material connected with Unison Hikathon 2011 (including but not limited to any of Unison’s websites) or in connection with any of Unison’s promotional or fundraising activities, any photograph, film, videotape, record or other reproduction of the image and/or voice of me and my team members who take part in Unison Hikathon 2011 and its related activities.

Should there be discrepancies between the terms in the Chinese and English version, the English version will prevail.



本人現參加 融樂行2011，在點擊"遞交"按鈕同時謹此聲明並作出保證：

參加者聲明及保證

本人或隨行之未成年人士倘於參加 融樂行2011期間或其後，或者在練習期間，或者在往返途中，或者在其他場合，因意外或不幸事故，或者在由此活動引起或 與此活動相關的情況下死亡、受傷、財物損毀、遺失，或遭受任何其他經濟損失或任何隨之發生之損失，將自行承擔一切責任。此活動之主辦機構、贊助機構及 其他支援機構或人士，毋須就此作出任何賠償或負上任何法律責任。倘若在活動期間發生事故，因而導致此活動之主辦機構支付額外費用，本人或隨行之未成年 人士願意向此活動之主辦機構作出賠償。

籌款保證

融樂行2011是一項籌款活動，本人同意及確認為融樂會籌集捐款，並會盡全力籌集達到融樂會訂下所屬組別之目標籌款額，且透過參與融樂行2011 而直接或 間接籌得之款項，將悉數捐予融樂會。本人絕不會將有關款項捐予其他機構。

授權使用影音製品

本人知悉融樂會可以在有關 融樂行2011 之任何宣傳物品中(包括但不限於融樂會之任何網站)，或就融樂會之任何推廣或籌款活動，使用對於本人及/或隊友 參與融樂行2011 及其相關活動期間之影像及/或聲音進行攝影、攝錄或錄音所得之任何照片、影片、錄影帶、錄音帶或其他影音製品，而事先毋須諮詢任何人 或取得任何人批准，亦毋須就此向任何人支付任何款項。

如中英版本有任何歧異，概以英文版本為準。