Registration And Indemnity Form

NANYANG TECHNOLOGICAL UNIVERSITY

HUMANITIES AND SOCIAL SCIENCES CLUB c/o STUDENT AFFAIRS OFFICE

NANYANG AVENUE, SINGAPORE 639798 E-MAIL: [email protected] WEBSITE: HTTP://CLUBS.NTU.EDU.SG/HSSFAMILY/

REGISTRATION AND INDEMNITY FORM Camp Name: Humanities and Social Science (HSS) FOC 2009 Name of Student Organization: HSS Club Camp Period: 20th to 24th July •

Message to all freshmen participating in Freshmen Orientation Camps (FOC):

The main objectives of FOC are to orientate freshmen in their new environment and to cultivate a sense of belonging. However, as the student population becomes more cosmopolitan, exposure to diversities in cultures becomes inevitable. As a participant, you are encouraged to take part in all the activities that the camp organizer has planned for you. However, you are not bound to participate in any activity that you are not comfortable with, e.g. if it is against your culture or religion. Please inform your group leader of your reasons if you do not wish to participate. Camp participants are also welcome to give the University your feedback on how the camps are being conducted. All comments and suggestions received will be looked into. You may send your feedback to Mdm Wendy Gwee, Senior Assistant Director of Student Affairs Office at email address: [email protected]

1.

APPLICANT’S PARTICULARS

Name (as in passport) Gender (pls circle)

Date of Birth

Male / Female

(dd/mm/yy)

Mailing Address Postal Code Contact No

ome)

Email Address T- Shirt Size Swimmer

2.

bile)

(mo

Blood Group

S/M/L/XL

Course

Yes/ No

Allergies, Sicknesses & Medical Limitations Dietary Requirements (if Halal any)

S

(h

Vegetarian

No restriction

PERSON TO NOTIFY IN CASE OF EMERGENCY

Name

Relationship

Mailing Address Postal Code Contact No

(home)

)

S

(mobile

Email Address

3.

INDEMNITY FORM (TO BE SIGNED BY PARTICIPANT)

(office)

I acknowledge and agree that participation in HSS Freshmen Orientation Camp 2009comes with inherent risks. I have full knowledge of the foregoing risks and assume all such risks myself. In consideration of my participation in the programme / event, I shall not hold Nanyang Technological University, its officers, agents and employees liable for any damage to or loss of property or any injury or loss of life where such damage to or loss of property or any injury or loss of life is not caused by the negligence of Nanyang Technological University, its officers, agents and employees. I undertake to ensure strict compliance with all rules, regulations, requirements and instructions related to the programme / event. I understand that, should I be admitted to this programme / event on the basis of any false or inaccurate information declared by me, I may render myself liable to any appropriate action and such false or inaccurate declaration may result in the voidance of any insurance claim arising from or in connection with the programme / event.

______________________________ Name of participant

____________________ Signature

____________ Date

Parent’s or Guardian’s Undertaking (To be completed by the parent/guardian if the participant is below the age of 21 years)

I, being the parent, guardian or person having the care and custody of __________________ (name of participant), do consent that s/he may participate in HSS Freshmen Orientation Camp 2009 , and, in consideration of Nanyang Technological University, its officers, agents and employees permitting him/her to so participate, undertake that I will not, whether on behalf of my child / ward or in my own right, hold Nanyang Technological University, its officers, agents and employees liable for any damage to or loss of property or any injury or loss of life where such damage to or loss of property or any injury or loss of life is not caused by the negligence of Nanyang Technological University, its officers, agents and employees.

_________________________________________ ____________________ Name of parent, guardian or person Signature Date having the care and custody of the participant

__________