GENERAL CONSENT FORM FOR FST EDUCATIONAL VISITS AND

FIELD TRIPS

Food Science and Technology Programme

Department of Chemistry
National University of Singapore

I, (Dr, Mr, Mrs, Mdm) ________________________________________________ (the

parent) being the parent/guardian of (name of student)
____________________________________ (hereinafter referred to as the
“participant”) hereby grant my permission to allow my son/daughter/ward to
participate in any of the organized educational visits and field trips as part of
the Food Science and Technology Programme at the National University of
Singapore.

I, (name if student) __________________________________________ hereby confirm

that I am participating in the course and the visits voluntarily and of my own
free will and I further agree to abide by the rules and regulations set by the
Programme Director (the “Director”) or a person so designated by the Director
who is responsible for planning the visits.

WE HEREBY AGREE to the following conditions:

1) We agree to abide by the rules and regulations as set from time to time
by the Food Science and Technology Programme, National University of
Singapore (the “University”), who are supervising the field trips/visits.

2) The participant is taking part in the field trips/visits as a student of the

University. He/she will maintain good discipline, behave honourably and
endeavour to maintain the reputation of the University at all times during
the field trips/visits. The parent is aware that failure by the participant to
do so may result in the participant being sent back to the University, prior
to the conclusion of the field trips/visits at costs which shall be borne by
the parent or participant. Such costs may include the costs associated in
providing a chaperone to accompany the participant back to the
University.

3) We are aware of the possible risks involved in the field trips/visits and
accept the same notwithstanding the fact that the trips/visits are intended

1
 only for those without medical problems and who are in a state of
sufficient physical fitness to participate in the same. Participation in the
trips/visits is at the participant’s sole risk.

4) The University, its employees, servants and/or agents shall not be

responsible nor liable for the death, injury, disability, loss or damages
whatsoever and howsoever caused by the participant in connection with
the trips/visits or his/her participation therein.

5) The parent hereby fully indemnifies the University, its employees,

servants and/or agents against all claims, proceedings, costs, expenses,
loss or damages whatsoever and howsoever arising in respect of the
participant’s death, injury, disability or loss arising from his/her
participation in the trips/visits.

6) We shall be responsible for all claims liabilities, loss or damages suffered

by the University by reason of any breach of the terms herein by the
participant including without limitation the participant’s negligence,
recklessness or dishonesty in connection with the participation of the
participant in the trips/visits.

7) The participant shall agree, unless specific prior arrangements have been
agreed, to participate fully in the trips/visits for its entire duration.

____________________________________________ _____________________
Name of student Matriculation No.

____________________________________________ _____________________
Signature Date

____________________________________________ _____________________
Name of parent/guardian I/C or Passport No.

____________________________________________ _____________________

2
Signature Date