截止報名日期：2017年3月12日 Application Deadline: 12 March 2017 2017年4月2日一同起跑！ Let’s Run On 2 April 2017! jrun.jessicahk.com
比賽詳情及網上報名Information & Online Application Enquiry Hotline: 2202 5206 / 2202 5378查詢電郵 Enquiry Email: jrun@scmedia.com.hk 名額有限，先到先得!
第四部份 Part 4：付款方法 Payment Methods
報名費及善款可以以下方式付款 □ 以支票付款
發咭銀行 Card Issuing Bank：
Entry fee and donations will be settled by the below methods
Pay By Credit Card
支票號碼 Cheque No： ＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿
以即期劃線支票祈付「JESSICA LIMITED」（於背面寫上參賽者之姓名及聯絡電話），連同填妥之報名表一併寄回「旭茉 JESSICA 巿場部 – 柴灣豐業街五號華盛中心三樓」。付款以最後收妥為準。
A crossed cheque made payable to JESSICA LIMITED (participant's name and contact number must be written at the back of the cheque) should be submitted with a completed entry form and mail to "JESSICA Magazine Marketing – 3rd Floor, Wah Shing Centre, 5 Fung Yip Street, Chai Wan".
參賽者簽署： Participant's signature
□
VISA CARD
□
＿|＿|＿|＿| - |＿|＿|＿|＿| - |＿|＿|＿|＿| - |＿|＿|＿|＿|
（英文）
＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿|＿| ＿ | ＿ | 月mm | ＿ | ＿ | 年 yy ＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿
免責聲明：本人謹此聲明本人 / 受監護人 / 狗狗之身體狀況良好，並經由執業醫生確認本人之體適能適合參加此活動及技術水平適合參與此賽事及其相關活動。本人亦謹此聲明本人清楚明白本人 / 受監護人 / 狗狗所參與賽事之條款及要求，並承諾會遵守賽事中之一切比賽規則及條例，並將囑咐參與此賽事之本人 / 受監護人 / 狗狗作出相同承諾。本人是自願參加此活動和願意承擔本人 / 受監護人 / 狗狗的意外風險及責任，本人同意所有參加者均須自行承擔所有風險及責任。本人謹此代表本人/ 受監護人 /狗狗，同時亦代表本人 / 受監護人 /狗狗的遺產繼承人、執行人、管理人及直系親屬豁免賽事的主辦機構或主辦機構的代理/ 代表 / 贊助商 / 捐獻人 / 賽事工作人員 / 職員或任何對此賽事或/及其活動直接或間接相關之個別人士對本人/受監護人/狗狗在往返賽事場地期間發生的或在賽事進行中或/及其相關活動時所發生的或因賽事引致的疾病、傷亡、財物損壞或損失所須負上的所有責任，並放棄索償及追究任何相關的損失、支出及損壞的權利（因賽事的主辦機構或主辦機構的代理 / 代表 / 贊助商 / 捐獻人 / 賽事工作人員 / 職員疏忽所引起的傷亡除外）。本人亦謹此聲明上述填報資料正確無誤，並代表本人 /受監護人 / 狗狗准許主辦機構使用本人所提供之上述資料，作為本活動的行政及未來活動的宣傳用途。本人明白主辦機構及賽事相關之合作及或贊助機構保留一切合法使用任何賽事照片、錄影、錄音或任何資料紀錄之權利（當中包括商業廣告用途）。
Waiver of Liability and Declaration： I declare that I and (if participating) my custodian or my dog are physically fit and have not been otherwise advised by a qualified medical practitioner, and have the skill level required to participate in the above race and any other related activities. I also declare that I understand the terms and conditions of the race which I and/or my custodian or my dog has or have entered, and will abide by its rules and regulations, and will procure my custodian or my dog to do the same. I understand that by participating in the race and any related activities, I and (if participating) my custodian or my dog may be exposed to risks of injury, death, and/ or loss. I accept that all participants enter at their own risk and responsibility. I on behalf of myself and/or my custodian or my dog's behalf, and on behalf of myself and/or my custodian or my dog's heirs, executors, administrators, and next of kin hereby discharge, waive, and release all rights or claims for costs, expenses, or damages that I or my custodian or my dog may have against the organizer(s) of the race, its agents, representatives, sponsors, contributors, appointed officials or staff or any other individual organization connected directly or indirectly with the race and/or its related activities for any illness, injury, or death, or damage to or loss of any properties that I and/or my custodian or my dog may sustain during, or as a consequence of, or while travelling to or from, the race and/or other related activities (other than personal injury or death resulting from the negligence of the organizer(s) of the race, its agents, representatives, sponsors, contributors, appointed officials or staff). I also declare that all the above details are true and correct. I and (if participating) my custodian or my dog's behalf permit the organizer(s) to use the above personal data in the operation of this race. I acknowledge the right of the organizer(s) and all cooperating parties and sponsors of the event to use any photographs, motion pictures, recordings, or any other record of the race fro any legitimate purpose, including commercial advertising. This declaration is written in both English and Chinese. If there are any conflicts in meaning, the English version shall prevail.