PEOPLE'S ASSOCIATIONWATER VENTURECOURSE / ACTIVITY APPLICATION
COURSE / ACTIVITY DETAILS
COURSE / ACTIVITY DATE:
Non MemberPassion MemberWater-Venture Member
KAYAKING SAILING OTHERS
Orientation ProgrammeBasic LaserWindsurfing Orientation/ClinicOvernight Orientation ProgrammeBasic PicoWindsurfing Level 1 Proficiency Course1 Star Personal Skills AwardProfi 1 AssessmentWindsurfing Level 2 Proficiency Course2 Star Personal Skills AwardProfi 2 AssessmentPowered Pleasure Craft Driving Course / Refresher 3 Star Training CourseRacing ClinicDragon Boat Orientation Programme3 Star AssessmentOthers:Others:
PERSONAL PARTICULARS ( to be completed fully in CAPITAL LETTERS )
If you are a Water-Venture member,simply fill in your NAME AND NRIC
Race
ChineseIndianMalay
Home AddressSex
MaleFemale
E-Mail Address
Postal Code:
Telephone NumbersEmergency Contact
HomeName of Contact PersonOfficeRelationshipHandphonePhone No. 1Phone No. 2
DECLARATION
I agree to abide by the rules and regulations stated overleaf and hold myself solely responsible for any mishap or injury that may occur during, or as a result of, my participation in the stated course or activity organised by, includingrental of equipment from the outlet, and certify that I do not have a pre-existing medication condition as declared overleaf.Signature of ApplicantDate
Consent of Parent/Guardian for Applicants below 21 years old
I, *Dr/Mr/Mrs/Mdm/MissNRIC No.allow my *child/ward to participatein the Club course and activity, and rent equipment under the conditions as mentioned above.Signature of Parent/GuardianDate
*Delete as necessaryPA/SS/03/2005
*
NRIC / FIN/Passport
Full Name
* Dr / Mr / Mrs / Mdm / Miss
Date of Birth
(dd/mm/yyyy)
Others
(please specify
)
This form may take you 5 minutes to fill in. You will need the following information to fill in the form:NRIC number; and valid student or membership card respectively if you were applying under those categories.
of 00
Water Venture (PA) Course Application Form
2,059 Reads
Info and Rating
| Category: | Uncategorized. |
| Rating: | |
| Upload Date: | 01/13/2008 |
| Copyright: | Attribution Non-commercial |
| Tags: |
Leave a Comment