Student Idemnity Form
Student Idemnity Form
FIS-SA-F39/Rev00 Last Updated 20 Apr 2015. All Rights Reserved.
I. STUDENT’S PARTICULARS 学生资料
1. Name in Full 姓名
*
2. Class 班级
*
G0701
G0801
G0901
G0902
G0903
G1001
G1002
G1003
G1004
G1005
G1006
G1007
G1008
G1101
G1102
G1103
G1104
G1105
G1106
G107
G1210
G1211
G1212
3. Student ID 学生号
*
Maximum of
4
digits allowed.
Currently Entered:
0
digits.
II. PARENTS’ PARTICULARS 家长资料
4. Name in Full 姓名
*
5. Address 地址
*
6. Handphone 手机号
*
Maximum of
11
digits allowed.
Currently Entered:
0
digits.
7. Relationship to Student 与学生关系
*
Mother 妈妈
Father 爸爸
Sister 姐姐
Brother 哥哥
Guardian 监护人
III. ACTIVITY 活动
8. Type of Activity 活动选项
*
University Tour (4/1/2019)
BBGB- SWAMI Home (12/1/2019)
Activity-Botanic Garden (11/1/2019)
A Different Kind of "B"-Line (19/1/2019)
Activity-National Museum (18/1/2019)
G0701/0801/0902-Class Bonding (22/1/2019)
CIP-Willing Hearts (26/1/2019)
G1005-Class Bonding (25/1/2019)
G1006-Class Bonding (25/1/2019)
Activity-East Coast Park (25/1/2019)
G1007-Class Bonding (24/1/2019)
Debate Club Activity (26/1/2019)
9. Declaration 宣言
*
9. Declaration 宣言
I confirm my participation in the above activity . I declare that I will cooperate fully with FIS, will undertake to diligently comply with all safety instructions and possible risks involved. I confirm that I am enrolling on my own volition and hereby agree not to hold FIS or their appointed staff responsible for any mishaps, losses or damage whatsoever arising from any cause in connection with the activity or my participation therein. I grant my consent for my personal particulars to be given by FIS to the relavant authorities/parties to facilitate programme execution, travel notices and for emergency purposes.
10. Email 邮箱
*
11. Draw your signature into the box below. 请在此签字。
*
Draw
or
Type
I understand this is a legal representation of my signature.
Clear
Full Name
I understand this is a legal representation of my signature.
11. Date 日期
11. Date 日期
/
MM
/
DD
YYYY