REGISTRATION FORM

DRAGON BOAT RACE – 22nd June 2013 REGISTRATION FORM Your Details (please complete in BLOCK CAPITALS Please make cheques payable to SOS Bus NI. All money raised will support SOS Bus NI’s vision to inspire hope and build better futures for everyone, whilst working in partnership on the streets of Northern Ireland to help people in their time of need. Thank you for your support. Public liability insurance is in place but this does not cover personal accidents. We have taken all reasonable steps to eliminate the risk of injury but there is a certain minimal risk in every activity and you should withdraw from the event if you have any doubts. We reserve the right to remove any participant who does not abide by the rules. I have read, understood and agree with the above statement: Signed (parent / guardian if under 18) PLEASE RETURN YOUR REGISTRATION FORM AND FEE TO: Gillian Thomson, SOS Bus NI, Manley House, 56 Newforge Lane, Belfast, BT9 5NW. Telephone: 028 9066 4505 Email: gillian.thomson@sosbusni.com If you have a special reason for supporting us and are prepared to be part of our publicity drive to support fundraising and awareness, we would love to hear from you. Just tell us in a few words why SOS Bus NI is close to your heart:

REGISTRATION FORM

REGISTRATION FORM

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Registration form

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Registration Form Name: ……………………………………………. Hospital ….…………………………………………

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Registration Form