BORNEO SAFARI 2022 : registration form

Registration’s Closing Date: 8th October 2022

* Compulsory to submit both pages together with a copy of I.C./Passport

Driver Co-Driver Passenger

Full Name: Membership No:

IC/Passport No: Date of Birth:
Tel No: Blood Group:
Address:
Photo

Please Declare Any Medical Illness/Allergy:

COVID-19 Vaccination Status: Fully Vaccinated (with Booster) Partially Vaccinated (without Booster)
Emergency Contact Person (Full Name) :
Tel No: Email:
Relationship:

T-Shirt Size: XS S M L XL 2XL 3XL 4XL Photo

Member Expedition Category Member

Competitor
Non-Member (Tag-On) Non-Member
International International

Member Category:
Competitor's Support Official Crew
Non-Member
International
Remarks:
Take note that the event organiser will not guarantee the availability of complete event attire, attire sizes, event vehicle stickers, sponsored goodies
for late registration. Registration closing date is October 8th, 2022.

Payable to ‘PERSATUAN PACUAN EMPAT RODA NEGERI SABAH’ Account No: 101-9600-10047-068 Alliance Bank
Contact Person: Liew Vui Kwong (Treasurer) H/p: 019 861 5893 Email: 9w6vkl@gmail.com Fax your bank in slip to 088-724 333

VEHICLE INFO*
Car Registration No:
Make: Model:
Engine Capacity:
Winch Type:
PTO Electric * Please fill in if applicable

FOR OFFICE USE

Receipt No. :
Membership
BORNEO SAFARI Secretariat Office Status:
SABAH FOUR WHEEL DRIVE ASSOCIATION
2nd Floor, Block A, Lot 26, Kolombong Estate, Jalan Buah Duku, Remarks :
P.O.Box No. 21833, Luyang Damai, 88776, Kota Kinabalu, SABAH, MALAYSIA.
Contact Persons : VK Liew 019-861 5893 / Mindy 016-826 8336
Email: 9w6vkl@gmail.com Website: www.borneosafari.com.my

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 Registration Terms & Conditions

Only fully completed registration forms will be accepted. All Each team entrant must comprise of Driver and Co-driver.
participants must be 18 years old and above. You may be asked to Additional team member will be placed under the Competition
present an official identity card stating your age. team support vehicle.

Withdrawal - Intention to withdraw from event shall be made in

REGISTRATION FEES written notice Two (02) weeks before the event start. Any
application for withdrawal after the deadline will not be
Expedition Category (Tag-Ons) entertained and penalised with full forfeiture of payment.

a. Member - RM800.00 per vehicle (2 persons) REGISTRATION CONFIRMATION

Additional RM150.00 (member) per person
Additional RM500.00 (non-member) per person
Maximum of 4 persons
b. Non-Member - RM800.00 per vehicle
RM500.00 per person (Driver/Co-Driver)
RM500.00 per person (up to 2 passengers)
Maximum of 4 persons
c. International - RM800.00 per vehicle
RM500.00 per person (Driver/Co-Driver)
RM500.00 per person (up to 2 passengers)
Maximum of 4 persons
d. Corporate - RM3,000 per vehicle of 2 persons
Additional RM150.00 (member) per person
Additional RM500.00 (non-member) per person
Maximum of 4 persons
Competition Category
A registration confirmation receipt will be issued after the Borneo
Safari Secretariat upon receipt of fully completed registration form,
the related payment (if applicable). Participant may be requested
to present this registration confirmation at the registration counter
as proof of their registration.
LETTER OF INVITATION
Individuals requiring an official Letter of Invitation from the Borneo
Safari Organising Committee can request one by contacting the
Borneo Safari Secretariat. To receive a Letter of Invitation,
participant must first register to the event and submit any required
supporting documentation (if applicable).
The Letter of Invitation does not financially obligate the event
organizers in any way. All expenses incurred in relation to the
conference are the sole responsibility of the participant unless
stated.

a. Members - RM800.00 per team of 2 persons

RM400.00 for one Reserve Co-Driver*
b. Non Members - RM1,600.00 per team of 2 persons
RM800.00 for one Reserve Co-Driver*
c. Corporate - RM5,000.00 per team of 2 persons
RM800.00 for one Reserve Co-Driver*
d. International - Free Entrance Fee per team of 2 persons
RM800.00 for one Reserve Co-Driver*
*Reserve Co-Driver can replace injured or sick main co-driver. However,
the main co-driver will not be allowed to join back the competition even
though he has recovered and/or the reserve co-driver is unable to
compete further due to injury or sickness.
e. Competitor’s - RM800.00 per vehicle of 2 persons (Member)
Support Additional RM150.00 (member) per person
Additonal RM500.00 (Non-Member) per person
Maximum of 4 persons
- RM800.00 per vehicle (Non-Member)
RM500.00 per person
Maximum of 4 persons
* Competitor’s Support Vehicles maximum 3 cars
VISA REQUIREMENTS
It is the sole responsibility of the participant to take care of his/her
visa requirements. Participants who require an entry visa must
allow sufficient time for the application procedure. Participants
should contact the nearest Malaysia embassy or consulate to
determine the appropriate timing of their visa applications.
CANCELLATION OF EVENT
In the event that the event cannot be held or is postponed due to
events beyond the control of the Borneo Safari Organizers (force
majeure) or due to events which are not attributable to wrongful
intent or gross negligence of the Borneo Safari Organizers, the
Borneo Safari Organizers cannot be held liable by participant for
any damages, costs, or losses incurred, such as transportation
costs, accommodation costs, costs for additional orders, financial
losses, etc.

LIABILITY / INDEMNITY
The Participant agrees to abide by the instruction of the Borneo Safari Organizers and/or any of his appointed officials. The Participant
further understands that he/she participates in this event at his own accord and will not claim or hold the Borneo Safari Organisers, Sponsors
and or its committee members liable for any mishap that may occur to him/her throughout the event. Failure to comply with any instruction
from the Borneo Safari Organizers and/or his appointed official may results in the immediate dismissal from the event. Any comment on the
event should be communicated to the Borneo Safari Organizers and/or his appointed officials.
**All participants must be 18 years old and above.**
Please tick ( )
I have read and agreed to the
terms/conditions and liability/indemnity
stated above. Signature Date
Full Name :________________________________
IC/Passport No. :____________________________
Car Registration Number :____________________
Please Circle: Driver / Co-Driver / Passenger
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