REGISTRATION JAKARTA KIDS RUN 2013 PARENT DETAILS Parent Name (required) Mobile (required) Address (required) Email (required) Confirm Email (required) REGISTRATION DETAILS Kids Run Category (required) 3-6 yo(run with parent)7-9 yo10-12 yo Children Name (required) Date of Birth (dd/mm/yyyy) (required) Age (required) Gender (required) BoyGirl Tshirt Size (required) SML How Do You Know About Jakarta Kids Run 2013? (required) DuniaLariBrowsingFlyersFriendFamilyEmailfX Lifestyle AdsTwitterFacebookPath PARENT DECLARATION: I am the parent/ guardian of the Child. I understand that, on behalf of the Child, participating in this event is potentially hazardous, and that I should not enter them and allow them to participate unless the Child is medically able and fit. In consideration of the acceptance of this entry, I assume full and complete responsibility, of the Child, for any injury or accident which may occur while the Child is travelling to or from the event, during the event, or while the Child is on the premises of the event. I, on behalf of the Child, also am aware of and assume all risks associated with participating in this event, including but not limited to falls, contact with other participants, effect of weather, traffic, and conditions of the course. I, on behalf of the Child, for myself and my heirs and executors, hereby waive, release and forever discharge the event organizers, sponsors, promoters, Jakarta Kids Run, fX Lifestyle Center and each of their agents, representatives, successors and assigns, and all other persons associated with the event, for all the Child’s liabilities, claims, actions, or damages that I may have against them arising out of or in any way connected with participation in this event. I, on behalf of the Child, understand that this waiver includes any claims, whether caused by negligence, the action or inaction of any of the above parties, or otherwise. I, on behalf of the Child, hereby grant full permission to any and all of the above parties to use all results, any photographs, motion pictures, website images, recordings or any other record of this event. I, as the adult, will show good sportsmanship at Jakarta Kids Run 2013 event, by cheering on all children as well as my own. My support and encouragement to all children will play a major role in their enjoyment and sense of achievement, therefore I willingly help to create a fitter, healthier and happier family and nation. Let's do it! I AGREE AND ACCEPT TO THE ABOVE: Enter Code To use CAPTCHA, you need Really Simple CAPTCHA plugin installed.