ENTRY FORM
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Legs Chosen:
Colombo
Matara
Matara
Kataragama
Kataragama
Arugam Bay
Arugam Bay
Batticaloa
Batticaloa
Trincomalee
Trincomalee
Mullaitivu
Mullaitivu
Jaffna
Jaffna
Mannar
Mannar
Chilaw
Chilaw
Colombo
AROUD THE PEARL
Amount Enclosed:
Total No. of legs:
Date of Birth:
First Name:
Surname:
Telephone No:
Mobile No:
Email:
Address:
Emergency Contact Name:
Emergency Contact No:
Medical Conditions (if applicable):
Rider Profile (maximum 150 words):
The participant understands that during the course of the trip certain risks and dangers may occur, including but not
limited to the hazards of riding a bicycle or in a motor vehicle, etc. It may also involve accident or illness in remote places,
potentially due to the forces of nature, without medical facilities. The client agrees to assume all risks associated with the
trip and agrees that no liability will be attached to the company or its outfitters, employees or agents, or to any members
of the organizers in the respect of death, personal injury,illness or delay of the passenger, or for any loss of (or damage
to) the property of the participant during the course of the trip, however caused.
I have read and agree with the terms & conditions of this booking form.
Signature:
Date:
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