Registration FormSelf-esteem building(Mind Champs) 2009
I wish to register for the Self Esteem Camp (15-17 December 2009)Name:____________________________________________ Sex: M / FContact Numbers:(HP) __________________________________________ (H) ____________________________________________ E-mail: ______________________________________________________
Next-of-kin contact
:Name: ______________________________ Relationship:________________ Contact Numbers (HP)______________________ (H)____________________ (O) ______________________ _______________________________________________________________ Course:Food requirements: Vegetarian / Halal / None (Circle as appropriate)Pre-existing medical conditions: (e.g. allergy to mud etc) _______________________________________________________________ _______________________________________________________________ Please return this form with the registration fee( $150 ) to the camp commandanton the
14
th
of December 2009.
For more details contact Mr. Naidu at 97115907.Further details will be given to you upon registration
INDEMNITY FORM
PLEASE READ THE FOLLOWING CAREFULLY
If you are below 21, please ask your parent/guardian to fill in and sign PART A .If you are above 21, please fill in and sign PART B.
PLEASE REMEMBER TO FILL IN THE CONSENT/INDEMNITY FORM
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