Indemnity Form

ST. JOHN AMBULANCE SINGAPORE ST. JOHN AMBULANCE BRIGADE For The Service of Mankind Patron: The President of the Republic of Singapore National Day Parade 2009 (Marching Contingent) INDEMNITY FORM RELEASE OF LIABILITY I understand that elements in the National Day Parade 2009, which require me to march a total distance of 2.4 km, may be physically and emotionally demanding. I affirm that my health is good, and that I am not under a physician's care for any undisclosed condition that bears upon my fitness to participate in the Marching Contingent for National Day Parade 2009. I recognize that there may be inherent risk and disability in this activity. I understand that a participant must assume the risk of injury that could result from any of these activities. I release St. John Ambulance Brigade (SJAB), the Singapore Arms Forces (SAF) and all staffs from any liability for any injury to me from the participation of National Day Parade 2009. Participant’s Name:

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Participant’s NRIC:

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Participant’s Signature: ___________________________________________ Address: _____________________________________________________ Telephone: _____________________________________________________

FOR PARTICIPANTS 21 YEARS OLD AND BELOW Parent / Guardian’s Name : ______________________________________ Parent / Guardian’s Signature : ___________________________________ Parent / Guardian’s Contact Number : _____________________________

In Case of Emergency, Please do Contact (Name) _________________________ ________________________ (Contact). Thank you.

420 Beach Road. Singapore 199582 Telephone: 6298 0300 (Office hour) 6293 9574 Fax: 6296 5797

ST. JOHN AMBULANCE SINGAPORE ST. JOHN AMBULANCE BRIGADE For The Service of Mankind Patron: The President of the Republic of Singapore

420 Beach Road. Singapore 199582 Telephone: 6298 0300 (Office hour) 6293 9574 Fax: 6296 5797