PARTICIPATION FORM

The Event: Saraca Hall Orientation Camp

EVENT
DETAILS
Date: 1-3 August
Organiser: Saraca Hall

A. PARTICIPANT’S PARTICULARS (Please write in BLOCK letters)

Name of
NG YAN X6
Participant:
NRIC No.
(last 4 digit, 794K Gender: M
e.g. 689H):
Contact No YANXIONG1026@GMAIL.C
(Mobile/Ho 85089656 Email:
OM
me*):

Allergies, Illnesses & Medical Limitations (please declare):

N.A.

Dietary Requirements: Halal

B. PERSON TO NOTIFY IN CASE OF AN EMERGENCY

Relationshi
Name: NG KOK KEONG FATHER
p:
Contact No Contact No
985115119 -
(Mobile): (Home):

C. DECLARATION

1. I agree to voluntarily participate in this event (‘Event’) of my own accord.

2. I agree to assume any and all risks which might be associated with the Event. To the extent permitted by law,
I agree that Nanyang Technological University (‘NTU’) shall not be liable in any way for any loss or damage
caused by or sustained as a result of my participation in the Event.
3. To the extent permitted by law, I also agree and undertake to indemnify NTU and keep NTU indemnified from
and against all liabilities, claims, actions, damages, costs or expenses of any type that may arise from my
conduct during the Event or breach of my undertakings herein.
4. I agree to comply with all applicable rules/regulations, instructions and requirements as may be prescribed from
time to time by NTU and/or the engaged Event organiser.
5. I declare that I have not been advised by a qualified professional from participating in events of the nature
similar to the Event.

28/7/2023
Signature of Participant Date

D. PARENTAL ACKNOWLEDGEMENT/WAIVER (FOR PARTICIPANT BELOW 21 YEARS OF AGE)

I, (name) , Parent/Guardian* of (name of participant), confirm

that I fully understand and appreciate the effect of the above Declaration and agree to allow my child/ward* to
participate in the Event. To the extent permitted by law, I agree that NTU shall not be liable in any way for any loss
or damage caused by or sustained as a result of his/her participation in the stated Event.
To the extent permitted by law, I also agree to indemnify NTU and keep NTU indemnified from and against all
liabilities, claims, actions, damages, costs or expenses of any type that may arise directly from my child/ward’s
conduct during the Event or breach of the undertakings herein.

Name of Parent/Guardian* Signature Date

* Please delete accordingly