Registration

I am signing up as a*

I am signing up as a*

 Individual
 New Team
 Existing Team
Team ID*

Team ID*


Given to Team Leader upon creation of a team – to be then shared with all team members for their registration
Name of Registrant*

Name*

Country Of Residence (Optional)

Country Of Residence (Optional)

Category*

Category*

20 Km Run
20,000 Steps Walk
20 Special Challenge
Briefly describe your challenge and how you are doing it.

Briefly describe your challenge and how you are doing it.

Example: I am going to run 20 km wearing a red cape; or I am going to drink 20 teh tariks with by my friends via Zoom.
Profile Page
Display Name*

Display Name*

Display Photo

Display Photo
To give a face to your fundraising campaign and help your friends & family recognize you

JPG or JPEG format below 5MB. Preference for 1:1 ratio of max 500px by 500px. All photos will be automatically squared cropped

To give a face to your fundraising campaign and help your friends & family recognize you

Target collection amount (Optional)

Target collection amount (Optional)

Display Message*

Display Message*

Personal Information
Date of Birth

Date of Birth*

Mobile Number*

Mobile Number*

Email Address*

Email Address*

Declaration

Declaration

For participants 18 years and above: By completing the entry form, I hereby agree to abide by the Terms and Conditions for participation in this campaign.

For participants under 18 years: By completing the entry form, I certify that I,(Name of parent/guardian) am the parent/guardian of this participant who is under 18 years old and I give my consent for my child/my ward to participate in this campaign. I declare that my child/ward is physically fit to take part in this campaign and has not been otherwise advised by a qualified medical practitioner. I hereby agree to abide by the Terms and Conditions and am willing to undertake the risks involved in the participation of this campaign.

Medical Information
Medical Declaration*

Medical Declaration*

No Medical Conditions Drug Allergies Both
Medical Conditions
(optional)

Medical Conditions

Drug Allergies
(optional)

Drug Allergies

Blood Group*

Blood Group*

Emergency Contact Name*

Emergency Contact Name*

Emergency Contact Phone Number*

Emergency Contact Phone Number*

Relationship*

Relationship*

Survey (optional)

How did you get to know about A Very Special Walk 2020?

If ‘Others’, please specify

TERMS AND CONDITONS*

TERMS AND CONDITONS*

General

  1. By completing and submitting the registration form, you signify your agreement to accept and abide by the Terms & Conditions as stated by the Organiser, Autism Resource Centre (Singapore).
  2. The Organiser shall not be liable for any bodily injuries, loss and/or damage to property, whether personal or otherwise, and howsoever arising.
  3. All registration fees are non-refundable and non-transferrable even if the campaign does not end as anticipated.
  4. All monetary donations raised from this campaign will be directed to the Organiser.
  5. These will include any funds raised by you even if you do not take part/finish in the campaign on the dates stipulated.
  6. The Organiser reserves the right to remove social media posts contributed by you should the content be deemed inappropriate. A notice will be given to you.
  7. By providing your personal data through the registration link, it is deemed that you have given consent to the Organiser to collect, use and disclose and/or process the personal data for the purpose of this campaign. The Organiser may collect, use, or disclose your personal data to third parties without your consent, including but not limited to the following circumstances:
    1. It is necessary for any purpose that is clearly in your interest and consent cannot be obtained in a timely manner.
    2. It is necessary to respond to an emergency that threatens the life, health, or safety of yourself or another individual.
    3. It is necessary for national interest.
    4. The personal data is publicly available.
    5. It is necessary for any investigation or legal proceedings.
    6. It is required based on the applicable laws and/or regulations
  8. The Organiser reserves the right to use the personal data, photographs, videos, or any other media records submitted for this campaign for any legitimate purposes, including for this campaign and future informational and outreach purposes related to the Organiser
  9. Please take note of and undertake to adhere to all Government regulations with respect to Phase 2 and subsequent Phases of Safe Re-opening . The Organiser will not be responsible for any actions taken against you for contravening the announced measures.
  10. The Organiser reserves the right to modify and/or substitute any of these Terms & Conditions without prior notice.
  11. By submitting your application via this registration link, you agree to abide by the Terms and Conditions and by the decisions of the Organiser, which shall be final as to all campaign related matters.

Medical Advisory

  1. You are responsible for your own safety and physical condition and should seek professional medical clearance before registering for the campaign.
  2. You acknowledge that this is a virtual campaign and that the Organiser will not provide volunteers, marshals, or medical personnel assistance to you.
  3. You acknowledge that you will participate and complete your challenge in a manner chosen by you, at locations chosen by you and at your own risk.
  4. You acknowledge to have obtained your own insurance coverage for your nominated challenge.

Amendment of Registration Details

  1. Please email your request to avsw@autism.org.sg by 01 July 2020 if there are any amendments to be made. Kindly ensure that you get an acknowledgement reply from the Organiser.
Indemnity Form*

In consideration of being allowed to participate in “A Very Special Walk 2020” held from 7 – 26 July 2020, I acknowledge and agree that:

  1. I am in good physical health and believe that I can complete the challenge I sign up for.
  2. I agree that the risk of injury from participating in “A Very Special Walk 2020” exists, including but not limited to the potential for permanent paralysis and death, health risks and the impact of weather.
  3. I, for myself and on behalf of my heirs, assigns, personal representatives and next-of-kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the Organiser, its affiliates and representatives involved in this campaign directly or indirectly, WITH RESPECT TO ANY AND ALL PERSONAL INJURY, DISABILITY, DEATH or loss or damage to person(s) or property associated with my presence or participation in the campaign, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, FULLY UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.