RACE PARTICPATION FORM
NAME: _______________________________________________________________
ADDRESS (street): ______________________________________________________
ADDRESS (PO BOX): ___________________________________________________
PHONE NO.: HOME: _____________________ MOBILE: ______________________
IN CASE OF AN EMERGENCY CONTACT:
NAME: _______________________________________ RELATION: _____________
PHONE NO.: MOBILE: _______________________ OFFICE: ___________________
HOME: _________________________
MEDICAL CONDITIONS:
Is there any medical conditions, allergies, medication, etc. that the race committee should be aware of?
YES _________
NO ___________
If yes, please explain: ______________________________________________________
RACING ATTIRE: MODSD top, black shorts, DSD cap.
Race Requirements: Commitment, Fitness, Open minded, and Enthusiasm.
Preferred paddling side: ______________
Height: ________ Weight: ____________
I hereby certify and declare that I am physically fit and healthy to participate in dragon boat training and
competition with the Move One Dubai Sea Dragons. In consideration of the foregoing, I for myself, my heirs,
my executors and administrators, do hereby waive and release any and all rights, claims and causes of action I
have or may have against Move One DSD or any of its committee members, all its sponsors promoters,
supporters and all other contributors from any and all liability arising from illness, injury, death, loss and
economic consequences I may suffer as a result of participating in dragon boat training and competition with
MODSD from any cause whatsoever, including negligence.
I agree to follow the constitution and the race rules set out by the Move One Dubai Sea Dragons team.
Signature: ______________________
Date:_____________