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Register for Killarney’s Ultimate High Peaks Challenge 2018

Full pre-payment of €95 is required to register for this event.

After completeing this registration form you will be automatically forwarded to our Paypal payment page where you can pay using your credit card or by using a Paypal account, if you have one.

Please complete the payment process or the form will be void and your registration will not be processed. Numbers are strictly limited.

Please note this payment is non-refundable.

Feel free to contact us by emailing info@killarneypeakschallenge.com with any other queries you might have.

Your Name

Your Email

Your Address

Daytime Tel

Mobile

Gender

Do you intend to camp?
Friday nightSaturday nightBoth nightsNot at all

Date of Birth

Relevant Experience

(MOUNTAIN CHALLENGES OF THIS NATURE ARE AN EXTREMELY TOUGH AND CHALLENGING PROPOSITION AND SO IT IS A CLEAR AND OBVIOUS PREREQUISITE THAT PARTICIPANTS POSSESS A VERY HIGH LEVEL OF FITNESS AND MOUNTAIN COMPETENCE. THIS EXTREME EVENT IS MARSHALLED BUT NOT GUIDED AND HENCE ALL PARTICIPANTS MUST BE HIGHLY EXPERIENCED, COMPETENT AND EFFICIENT MOUNTAIN GOERS & NAVIGATORS AND HIGHLY CONFIDENT ON EXTREMELY STEEP,RUGGED TERRAIN WITH NO PATHS OR TRAILS IN AT TIMES EXTREME WEATHER CONDITIONS! MANY PREVIOUS PARTICIPANTS HAVE SEVERELY UNDERESTIMATED THE SERIOUSNESS AND NATURE OF THIS EVENT AND WE ASK YOU PLEASE DO NOT EVEN CONSIDER REGISTERING IF YOU DO NOT POSSESS THE HIGH LEVELS OF FITNESS AND EXPERIENCE REQUIRED.)

Emergency Contact Name

Relationship

Emergency Contact Number

How did you hear about the event?

Medical Statement (confidential)

All participants should have an appropriate level of health and fitness for the activity. If pregnant or previously had any medical conditions please check your suitability with your doctor. Relevant medical conditions, problems or history which may affect my participation in the activity are:

Medications

I agree to accept responsibility for omissions regarding my failure to disclose any relevant existing or past health conditions.
 

Terms and Conditions:

 
I have read and agree with all terms and conditions below.
 

Participants must be aware that participation in mountaineering activities (which is the basis of this event) involves an increased level of risk, danger and personal injury. Participants accept this risk and responsibility. The participant assumes any risk of harm, injury or worse which may occur due to participation in the activity. They release the Killarney’s Ultimate High Peak Challenge T/A HIGH PEAKS EVENTS from all liability, costs and damages which may arise from their own negligence while participating in the activity.

 

For myself and my heirs and executors, hereby waive, release and forever discharge the event organizers, sponsors, promoters and each of their agents, representatives, successors and assigns, and all other persons associated with the event, for all my liabilities, claims, actions, or damages that I may have against them arising out of or in any way connected with my participation in this event. I understand that this waiver includes any claims, whether caused by negligence, the action or inaction of any of the above parties, or otherwise. I understand that the entry fee is non-refundable and non-transferable. By submitting this application I agree to be bound by all the rules of the event.

 

I understand that I enter Killarneys Ultimate High Peaks Challenge at my own risk and that neither Na Chruacha Dubha Events, Private Landowners, Department of the Environment and local government or any of its employees, servants or agents, any sponsors, associate sponsors, or patrons and any associates will be held responsible for any accident suffered or injury sustained by myself from any cause whatsoever. I agree to abide by all instructions issued to me by the event organisers and marshals over the course of the two days. I have read, understand and agree to all of the above.

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Contacts Information

Killarney’s Ultimate High Peaks Challenge,
Beaufort, Killarney, Co. Kerry, Ireland.

Email: info@killarneypeakschallenge.com
Phone: +353 (0)87 744 0523

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