CONFIDENTIAL

O U T W A R D B O U N D S IN G A P O R E
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Fitness Declaration Form

This form consists of 2 pages and may take you 5 minutes to fill in.
You will need the following information to fill in the form:
ƒ Individual details ie: class, waist size etc
ƒ Past and current CCA / activities involved.

Dear Applicant,
Greetings from Outward Bound Singapore! We would like to inform you that you are being
considered for participation in an Outward Bound course. We would like to find out a bit more about you before
making a decision. We seek your cooperation in completing this form. Kindly fill in all sections to the best of your
knowledge. Do note that however that completion of this form does not necessarily mean acceptance by Outward
Bound Singapore into the course.

When this form is fully completed, kindly return it to your child’s/ward’s teacher as soon as possible.

Applicant’s Personal Details

School / Organisation : _______________________________________________ Class : _____________

Name : _____________________________________________ Date of Course : ____________________

Fitness Details

Waist : _____________ inches / cm CCA (if any) : ____________________________________________

Do you engage in any sports / physical activity? †Yes † No

If Yes, what are they? ___________________________ How many times a week? _________

Do you participate in regular PE lessons in school? †Yes † No

Have you attended any outdoor camps before? †Yes † No

If Yes, when was the last time you attended one and where? _________________________________

Have you ever worn a climbing harness? †Yes † No

What is your recent physical fitness test result? Gold / Silver / Bronze / N.A (Why?)_____________

I declare that the information I have provided is true and correct to the best of my knowledge.

_______________________ __________________
Signature Date

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FOR OBS USE ONLY

1. Seen by H (TO) Yes / No

Accepted into course Yes / No ____________________
Signature & Date

2. Seen by H (MHS) Yes / No

Accepted into course Yes / No ____________________
Signature & Date

3. Decision noted by OBY Yes / No ____________________

Signature & Date

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