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Cape Cross MTB Transfer Request
12 October 2019

Personal Information
First Name(*)
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Surname: (*)
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Identity/Passport Number(*)
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Contact Numbers(*)
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E-Mail(*)
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Name & Surname of a Friend/ Family member(*)
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Contact Number of Friend / Family Member(*)
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Vehicle Information
Rental Vehicle
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Rental Company
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Registration Number [Enter "Rental" for hired cars](*)
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Make & Model [Enter "Rental" for hired cars](*)
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Transmission:(*)
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Colour [Enter "Rental" for hired cars](*)
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Cape Cross MTB
[12 October]
Early bird pricing, for bookings before 30 September 2019
Elgin to Somerset West [12 October 2019]
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Conditions

Payment Options
Please deposit the correct amount into the Bank Account listed below with booking code as reference. (Detail instructions to follow via e-mail)
Please send a Payment Confirmation to transfers@hsrotary.co.za
Helderberg Sunrise Rotary Club
Standard Bank Helderberg: Branch Code 033012
Current Account Number: 072317299
I acknowledge that service fees contributed are entirely non-refundable. Without limitation, if the event, or any part thereof, is cancelled, postponed or otherwise amended, or if any of the amenities, goods or services in relation to the event are no longer provided, whether due to force majeure, safety reasons, failure by service providers to perform, or any other reason or cause, service fees contributed will not be refundable.(*)
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Terms & Conditions
Vehicle Owners must sign Indemnity Forms
Vehicles must be roadworthy and have sufficient fuel for transportation
Vehicles must be comprehensively insured and the Insurance Company must be informed that a driver from
Helderberg Sunrise Rotary Club designated driver( includes any valid licensed driver appointed to drive who may not necessarily be a member of the Helderberg Sunrise Rotary Club) will be driving your car on the 12 October 2019
HSRC accepts no responsibility for incorrect event/options ticked(*)
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Indemnity Confirmation
I, the undersigned hereby warrant that my vehicle specified on this form is comprehensively insured with:(*)
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I also confirm that I have informed this insurance company that a fully licensed, designated driver of the Helderberg Sunrise Rotary Club designated driver( includes any valid licensed driver appointed to drive who may not necessarily be a member of the Helderberg Sunrise Rotary Club) will be driving on my behalf on the 12 October 2019.
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I hereby absolve the Helderberg Sunrise Rotary Club designated driver(includes any valid licensed driver appointed to drive who may not necessarily be a member of the Helderberg Sunrise Rotary Club) and the Helderberg Sunrise Rotary Club and hold them harmless in respect of any damage or claim of whatsoever nature which I, my vehicle or any third party may sustain arising either directly or indirectly from any act or omission by the said designated driver whilst driving my vehicle as set out above.
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I hereby confirm that the information above is true and accurate.(*)
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Comments [Special instructions]:
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Please retype security code:(*) Please retype security code:
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