W O R K F O R C E

REGISTRATION FORM

CAPTAIN’S DETAILSDesignate a team captain who will act as a point of contact.

NAME:

E-MAIL:

TELEPHONE:

Team Members Full Name DISCLAIMER SIGNATUREE-mail Address Organisation

CROSBY LAKESIDE ADVENTURE DAY

PAUL SAMPLE PAUL@HOTMAIL.COM BOOTS

HOW TO REGISTERTo register your team (all male, all female or mixed) simply complete the entry form below and return with a cheque for £50 to the address below (cheques payable to Sefton MBC).

Active Workforce2nd Floor Merton HouseStanley Road BootleL20 3JA

CLOSING DATE: All entries including payment must be received by the closing date of Friday 31st August 2012

Disclaimer

I acknowledge that I’m 16 years of age or over.

I accept that I participate in this event at my own risk and that Sefton Council accepts no responsibility for injury, illness, loss or damage to any personal belongings during the event.

I will abide by all rules stated in the entry requirements. Participant must sign in the above table before taking part in the event.

PLEASE TICK THE BOX BELOW TO SHOW THAT YOU HAVE READ AND ACCEPTED THE TERMS OF THIS DISCLAIMER.

Contact the Active Workforce Team on 0151 934 2079 or active.workforce@sefton.gov.uk

VENUE:CROSBY LAKESIDE ADVENTURE CENTRE

DATE:SATURDAY 8TH SEPTEMBER 2012

TIME:10AM - 3PM

COST:£50 ENTRY PER TEAM OF 10 PEOPLE

Changing rooms, showers and lockers are available. Car parking is availableat the facility and refreshments will be available following the event.

PRIZESFOR WINNINGTEAMS

www.active-sefton.co.ukActive Sefton is a partnership between Sefton Council, NHS Seftonand the local voluntary and community sectors