Entry Form – Kloof Conservancy

Name*

First Last

South African ID Number*

If you do not have a South African ID Number, please contact us on info@kloofconservancy.org.za. We're here to help.

Email*

Phone*

I am*

Male
Female

Indemnity

Please read the Waiver Form below and then indicate your acceptance.

Acceptance*

I have read and accept the terms of the below Waiver Form.

WAIVER FORM – RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT (“AGREEMENT”)

In consideration of being permitted to participate in any way in the the Kwa-Ximba Trail Run (“Activity”), I, for myself, my personal representatives, assigns, heirs and next of kin:

1. Acknowledge, agree, and represent that I understand the nature of Trail Running and walking Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity.

2. Fully understand that:

a. Trail Running/walking activities involve risks and dangers of serious bodily injury, including permanent disability, paralysis, and death (“Risks”);
b. These Risks and dangers may be caused by my own actions or action; or inaction’s of others participating in the Activity, the condition in which the Activity takes place, or the negligence of the “Releases” named below;
c. There may be other risks and social and economic losses either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs and damages I incur as a result of my participation or that of the minor in the Activity.

3. Hereby release, discharge, covenant not to sue the Kwa-Ximba Trail Run, their respective administrators, directors, agents, officers, members, volunteers, participants, any sponsors, advertisers, and, if applicable. Land owners and lessors of premises and land on which the Activity takes place, (each considered one of the “Releasees” herein) from all liability, claims, damages on my account caused or alleged to be caused in whole or in part by the negligence of the “Releasees” or otherwise, including negligent rescue operations; and I further agree that if despite this Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any litigation expenses, attorney fees, loss, liability, damage, or cost which any may incur as the result of such claim.

I have read this agreement, fully understand its terms, understand that I have given up substantial rights by accepting it and have done so freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.

Entrance Fee

Entry Fee*

Please note that entries to the 16 km and 22 km Kwa-Ximba Trail Runs are limited to runners 18 years or older.

Fun Run (9 km - R75.00)
Moderate Run (16 km - 18 years or older - R120.00)
Tough Run (22 km - 18 years or older - R200.00)

Join Kloof Conservancy (optional)

Kloof Conservancy is an active, vibrant organisation run by volunteers who aim to promote environmental awareness and conserve our area’s outstanding natural heritage for present and future generations. We believe that the efforts and contributions of people and businesses are key to the sustainability conservation in Kloof. Your membership, whether active or passive, is valuable to us as it adds public legitimacy to our efforts.

Membership starts at just R150 per year for a family.

Learn more

Please note that joining the Kloof Conservancy does not give free access to Krantzkloof Nature Reserve.

Membership Type

None
Family (R150.00/year)
Small Business (R600/year)
Corporate (R1,200/year)

Membership is renewed annually.

Company Name*

Address*

Street Address Address Line 2 City State / Province / Region Postal Code Country

Is your Postal Address different to your Physical Address?*

Yes
No

Address*

Postal Address Address Line 2 City State / Province / Region Postal Code Country

Payment

On submission of this entry form, you will be redirected to the safe and secure Payfast portal to make payment.

Total

R0.00

Submit Entry Form

By submitting this form, you confirm that you are 18 years or older.

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