NANYANG TECHNOLOGICAL

UNIVERSITY
HUMANITIES AND SOCIAL SCIENCES CLUB
c/o STUDENT AFFAIRS OFFICE
NANYANG AVENUE, SINGAPORE 639798
E-MAIL: HSSFAMILY@NTU.EDU.SG
WEBSITE: HTTP://CLUBS.NTU.EDU.SG/HSSFAMILY/

REGISTRATION AND INDEMNITY FORM

Camp Name: Humanities and Social Science (HSS) FOC 2009

Name of Student Organization: HSS Club
Camp Period: 20th to 24th July

• Message to all freshmen participating in Freshmen Orientation Camps (FOC):

The main objectives of FOC are to orientate freshmen in their new environment and to cultivate a
sense of belonging. However, as the student population becomes more cosmopolitan, exposure
to diversities in cultures becomes inevitable.

As a participant, you are encouraged to take part in all the activities that the camp organizer has
planned for you. However, you are not bound to participate in any activity that you are
not comfortable with, e.g. if it is against your culture or religion. Please inform your group leader
of your reasons if you do not wish to participate. Camp participants are also welcome to give the
University your feedback on how the camps are being conducted. All comments and suggestions
received will be looked into. You may send your feedback to Mdm Wendy Gwee, Senior
Assistant Director of Student Affairs Office at email address: ycgwee@ntu.edu.sg

1. APPLICANT’S PARTICULARS
Name (as in passport)

Gender (pls circle) Male / Female Date of Birth

(dd/mm/yy)

Mailing Address
Postal Code S
(h (mo
Contact No ome) bile)
Email Address Blood Group
T- Shirt Size S/M/L/XL Course
Swimmer Yes/ No
Allergies, Sicknesses & Medical Limitations
Dietary Requirements (if Halal Vegetarian No restriction
any)

2. PERSON TO NOTIFY IN CASE OF EMERGENCY

Name Relationship
Mailing Address
Postal Code S
(mobile
Contact No (home)
)
(office)

Email Address

3. INDEMNITY FORM (TO BE SIGNED BY PARTICIPANT)

I acknowledge and agree that participation in HSS Freshmen Orientation
Camp 2009comes with inherent risks. I have full knowledge of the foregoing
risks and assume all such risks myself.

In consideration of my participation in the programme / event, I shall not hold

Nanyang Technological University, its officers, agents and employees liable for
any damage to or loss of property or any injury or loss of life where such damage
to or loss of property or any injury or loss of life is not caused by the negligence
of Nanyang Technological University, its officers, agents and employees.

I undertake to ensure strict compliance with all rules, regulations, requirements

and instructions related to the programme / event.

I understand that, should I be admitted to this programme / event on the basis of

any false or inaccurate information declared by me, I may render myself liable to
any appropriate action and such false or inaccurate declaration may result in the
voidance of any insurance claim arising from or in connection with the
programme / event.

______________________________ ____________________ ____________

Name of participant Signature Date

Parent’s or Guardian’s Undertaking

(To be completed by the parent/guardian if the participant is below the age of 21 years)

I, being the parent, guardian or person having the care and custody of
__________________ (name of participant), do consent that s/he may participate in
HSS Freshmen Orientation Camp 2009 , and, in consideration of Nanyang
Technological University, its officers, agents and employees permitting him/her to
so participate, undertake that I will not, whether on behalf of my child / ward or in
my own right, hold Nanyang Technological University, its officers, agents and
employees liable for any damage to or loss of property or any injury or loss of life
where such damage to or loss of property or any injury or loss of life is not
caused by the negligence of Nanyang Technological University, its officers,
agents and employees.

_________________________________________ ____________________ __________

Name of parent, guardian or person Signature
Date
having the care and custody of the participant