Instructions

 Each participating team should comprise four members with at least two Singapore
Citizens. You may also register as an individual or as a group of two or three. The
Organiser will help you form a team with other applicants where possible.
 Junior College and Integrated Programme Year 5 and 6 students will be classified
under the JC/IP group. Access to online training will be provided for JC/IP teams.
 University and Polytechnic students will be classified under the Uni/Poly group.
Uni/Poly teams may indicate in the form if the team wishes to have access to the
online training, and if the team requires laptops for the event. Laptops will be issued
on a first-come-first-served basis. Participants are encouraged to bring their own
laptops and equipment.
 Participation in the online qualifier is mandatory for all participating teams.
 Please submit via email to cddc@dsta.gov.sg:
o Completed registration form (in the original .docx format)
o Photo/digital copy of completed Undertaking Form of all members (refer to
ANNEX A or ANNEX B)
 Closing date for registration is 29 Apr 2018
 Late submissions or incomplete registration forms are to be avoided.
 Successful applicants will be notified before 13 May 2018.
 For enquiries, visit www.dsta.gov.sg/cddc/faqs, or email us at cddc@dsta.gov.sg.

Team Information

Registration
Group: Team Gmail Email Address:

Team Name: Please indicate if access to online

training is required (only for Uni/Poly
Participating as: team):
 Team Member 1

Personal
Name: Vignesh Ezhil Identification:T00702 Gender:M
29Z

Date of Birth: Nationality:

Dietary Requirements: Others please specify:

Contact Information
Email Address: Mobile Number:

Postal Address:

Education
School/Institute: Course of Study Year of Study

In about 150 words, tell us why you are keen to participate in

the camp:

Misc
Do I need organiser to provide laptop (only for University/Poly
team):
 Team Member 2

Personal
Name: Identification: Gender:

Date of Birth: Nationality:

Dietary Requirements: Others please specify:

Contact Information
Email Address: Mobile Number:

Postal Address:

Education
School/Institute: Course of Study Year of Study

In about 150 words, tell us why you are keen to participate in

the camp:

Misc
Do I need organiser to provide laptop (only for University/Poly
team):
 Team Member 3

Personal
Name: Identification: Gender:

Date of Birth: Nationality:

Dietary Requirements: Others please specify:

Contact Information
Email Address: Mobile Number:

Postal Address:

Education
School/Institute: Course of Study Year of Study

In about 150 words, tell us why you are keen to participate in

the camp:

Misc
Do I need organiser to provide laptop (only for University/Poly
team):
 Team Member 4

Personal
Name: Identification: Gender:

Date of Birth: Nationality:

Dietary Requirements: Others please specify:

Contact Information
Email Address: Mobile Number:

Postal Address:

Education
School/Institute: Course of Study Year of Study

In about 150 words, tell us why you are keen to participate in

the camp:

Misc
Do I need organiser to provide laptop (only for University/Poly
team):
 ANNEX A

Undertaking Form (for participants aged 18 or under)

I, (Name, NRIC/Passport No. *) , father/mother/guardian * of (Name, NRIC/Passport No. *)

, agree and undertake not to hold the Defence Science and Technology Agency (DSTA) or its
employees and agents liable for any damage to or loss of property or any injury or loss of life
which may be sustained by my (child/ward*) as named above, during the Cyber Defenders
Discovery Camp 2018 held on 08 and 11 Jun 2018 or arising from any cause in connection
with the event, where such damage to or loss of property or injury or loss of life is not
caused by the negligence or wilful act of DSTA or its employees and agents.

I am also aware that the information disclosed and skills imparted to my child during the
Cyber Defenders Discovery Camp 2018 are for awareness and illustrative purposes only.
Any misuse or unauthorised use is prohibited under the Computer Misuse Act, the breach of
which may be prosecuted under Singapore Law. I hereby, further undertake that I will not
hold DSTA liable in any way whatsoever for any misuse or unauthorised use of any
information acquired by my child, as named above, in the course of the Cyber Defenders
Discovery Camp 2018.

Name and Signature of Parent/Guardian Date

 ANNEX B

Undertaking Form (for participants aged above 18)

I, (Name, NRIC/Passport No. *) , agree and undertake not to hold the Defence Science and
Technology Agency (DSTA) or its employees and agents liable for any damage to or loss of
property or any injury or loss of life which may be sustained during the Cyber Defenders
Discovery Camp 2018 held on 08 and 11 Jun 2018 or arising from any cause in connection
with the event, where such damage to or loss of property or injury or loss of life is not
caused by the negligence or wilful act of DSTA or its employees and agents.

I am also aware that the information disclosed and skills imparted to me during the Cyber
Defenders Discovery Camp 2018 are for awareness and illustrative purposes only. Any
misuse or unauthorised use is prohibited under the Computer Misuse Act, the breach of
which may be prosecuted under Singapore Law. I hereby, further undertake that I will not
hold DSTA liable in any way whatsoever for any misuse or unauthorised use of any
information acquired by me, as named above, in the course of the Cyber Defenders
Discovery Camp 2018.

Name and Signature of Participant Date