Participants who are 21 and above are required to complete this form

Indemnity Form
Please bring this form duly completed with you when you make payment for the Event SPLASHDOWN 2012. I, _________________________________ (Name of Participant)

________________________________ (Passport No. / NRIC No. of Participant), hereby declare that I am participating in the Annual NUS Mass Swim & Swimathon, SPLASHDOWN 2012, 8th September 2012, on my own free will and volition. I am aware of the risks involved and in consideration of being permitted by NUS UNIVERSITY LIFEGUARD CORPS, A MEMBER OF NUS STUDENTS SPORTS CLUB, National University of Singapore (NUS) to participate in the Event, I, my successors, personal representatives and assigns: (a) do hereby absolve, acquit and discharge NUS and its officers, servants, employees, agents or volunteers from all or any responsibility, actions, causes of action, claims, demands and obligations whatsoever arising from any loss or damage (including, without limitation and to the extent permissible by law, physical injury, loss of life or property damage) caused by or sustained as a result of my participation in the Event; and

(b)

will indemnify and keep indemnified, save and hold harmless NUS and its officers, servants, employees, agents or volunteers against all losses, claims, demands, actions, proceedings, damages, costs or expenses, including legal fees, and any other liability arising in any way from my participation in the Event.

_________________________________ Signature of Participant

_________________________ Date

*Please delete accordingly

Participants who are 21 and above are required to complete this form

Declaration of Swimming Ability

Please bring this form duly completed with you when you make payment for the Event SPLASHDOWN 2012.

I,

_________________________________

(Name

of

Participant)

________________________________ (Passport No. / NRIC No. of Participant), hereby declare that I am participating in the Annual NUS Mass Swim & Swimathon, SPLASHDOWN 2012 on 8th September 2012. I am are aware that the Event may involve activity conducted in water or in the sea and I am able to swim continuously, without any floatation aid, for at least 50m under 2 minutes.

_________________________________ Signature of Participant

_________________________ Date

*Please delete accordingly.

--------------------------------------------------Official Use only--------------------------------------------PAYMENT PARTICIPANT NAME: ___________________________ CASH COLLECTED:_________________ DATE COLLECTED:_________________ NRIC: _____________________

COLLECTED BY:_______________ ULC STAMP: