Before completing your registration, please take note of the terms and conditions below. Then print, sign and return this page to COINS USA.

• All the participants must be 18 years of age before the date of the event
• We ask all teams to raise $5,000. To secure your teams participation in the event, we must receive an initial deposit of $500.00, plus a minimum of a further $1,000 one week prior to the event. Should you drop out within ten weeks of the event, these sums will be retained as donations.
• The remaining funds should be settled within 2 months following the event.
• To maximize safety on the event, each team will need four walkers to start each of the three mountains. Teams unable to fill this team size may not be allowed to walk at that location. Please contact us for further details. The event staff will try to match you with other teams should you not have the required 4 walkers. 
• Due to the size of the event, each team is allowed to bring only one vehicle, which can be a minivan or a 12-15 seat minibus.
• Time penalties will apply to teams that fail to bring the specified event kit. All teams and team members should bring ALL items on the kit list.
• Each team member will be required to sign a Participant Agreement, Release, and Assumption of Risk form prior to the event.
• Each team member will be required to sign a medical form in due course. COINS has the right to refuse a participant if they are deemed medically unfit to take part. 
• Participants participate at their own risk and agree to indemnify COINS against claims for loss or damage to personal property, its employees, servants and agents.
• Participants will be required to sign a briefing document which is a written version of the verbal briefings you will receive on the day of the event in order to comply with strict health & safety and to ensure each participant is fully briefed before the event. This will be distributed and signatures required at the event. 
• If your team is unable to participate in the event for any reason or the event is cancelled for any reason beyond our control, then these amounts will be retained as a donation.
• If you provide notice that your team is unable to participate ten weeks prior to the event date, your $500 deposit will be refunded.
• As part of your support we provide teams with access to online resources.

Team Name: _____________________________________

Team Leader: _____________________________________  

Signature: _____________________________________

Please fax the signed page to 518-242-7298, Attention COINS 3 Peaks Challenge.