FissureForm SpecialD 1305452868 by 107629oW

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									                              Fissure
                       By Louise Ann Wilson

                     Produced by Artevents
     as part of The Re-Enchantment national arts programme

                      Special Discount
All audience members are required to fill out the following
and return the form to us, by email (arteventsuk@gmail.com)
Please phone 077958 41942 for any queries.

Name:
Age:
Address:
Post Code:
(you will need to show proof of your postcode upon arrival)
Contact Tel:
Email:
Emergency Contact Person & Number (please note this cannot be
someone who is also on the walk with you):

If you are coming as a group of people, please let us know
their names:




HEALTH AND SAFETY INFORMATION:-
Are you fit to walk?
Have you ever been diagnosed with a heart condition? 

Yes / No
If yes please specify what and when:


Do you have a bone or joint condition that could be made worse
by a change in your physical activity?

 Yes / No
If yes please specify what and when:


If you have answered yes to one of the above questions, we
recommend that you seek medical advice before signing up.


Terms and Conditions:-

Fissure is a three day walking cum performance event in the
Yorkshire Dales from 20 to 22 May 2011. It will begin at 6pm
on Friday 20 May at Settle Station, Station Road, Settle,
Yorkshire BD24 9AA and end at 12 noon on Sunday 22 May. The
second day, Saturday 21 May, involves a 12 mile walk across
hilly terrain. There will be an extremely early start – around
dawn – on Sunday. The entire walk has been graded by our risk
assessors as strenuous* and is conducted according to
recommended Health and Safety requirements.

* Strenuous level of walking: The walk is over 12 miles and
there may be difficult terrain where the ground is uneven,
rocky or steep. Walkers should be equipped with sturdy,
waterproof boots and extra warm layers of clothing, including
a waterproof / windproof outer layer, hat and gloves.

Audience members are required to have the necessary fitness
level to go on the walk. You are solely responsible for
judging your level of fitness. However Artevents reserves the
right to estimate a participant’s fitness levels and to turn
away participants at any stage of the walk.

All participants are requested to be on time for pick-ups as
Artevents will not keep the group waiting for latecomers.

Fissure is an all-weather performance and will continue even
in the event of heavy rain or other weather conditions that
are severe but not dangerous.

Fissure by its nature cannot be rescheduled or restaged.
Artevents reserves the right to cancel the performance or
alter the route for Fissure, without notice, in case of
inclement weather or other circumstances beyond the
organisers’ control.

Fissure is a guided walk, along public footpaths as well as
through private land. Audience members are required to follow
the route set by the trained guides and remain with the
walking group at all times.

Please make cheques payable to Artevents Limited. Please post
to Unit 2.3, Hoxton Workspaces Ltd, 128 Hoxton Street, London
N1 6SH by recorded delivery.
For bank transfers please pay Artevents Account Number
02026400 Sort Code 30-93-80.

If your cheque / bank transfer covers the cost of another
person(s) please include their name(s)
Note that a form should be filled in for each individual and
returned along with the cheque or emailed to us if you are
paying by wire transfer.

Tickets are non-refundable and non-transferable.

Indemnity

I am above 14 years of age and I understand that I walk at my
own risk. *

I understand that this event is held in accordance with both
recommended Health and Safety Requirements.

I confirm that I am aware of the organisers’ information and
requirements in connection with this event.

I accept the hazards involved in country-side (or cross-
country) walking and acknowledge that I am participating at my
own risk.

Other than the organiser’s liability for causing death or
personal injury by negligence, I confirm that I understand
that the organiser accepts no liability to me for any loss or
damage of any nature to myself or property arising out of my
participation in this event.

I consent to the above data being held on to and processed by
the organisers.

I have read the rules and agree to abide by them.

I have enclosed a cheque / made BACS payment (please tick) to
cover the cost of the above.



Print name:                                Date:
(This represents your signature
on emailed forms)

								
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