SINGAPORE CHALLENGE 2012 SATURDAY 14 JULY 2012 9.00AM – 6.00PM REGISTRATION FORM Please refer to Appendix 1 for the rules and regulations. Please complete and print registration and indemnity forms for each individual team member *circle where applicable Information required Please complete the fields below Your team name Your role in the team* Salutation * Team leader / Team member Mr / Miss Surname / Last name Given name / First name Student admission number Date of Birth (DD/MM/YY) Nationality Singapore PR* Institution* Yes / No NYP / NP / RP / SP / TP Course of study Mobile number Email address (We will email you updates about the event) Dietary requirements (if any) Information required Please complete the fields below Medical history (if any, e.g. occasional asthmatic attacks, allergy to bee stings, allergy to grass etc) Would you be interested to share an art form or Yes, please contact me / No, thanks culinary art to represent your country / institution in a cultural sharing event We will contact interested participants separately to share details. with underprivileged youths in Singapore? * Page 2 of 6 Singapore Challenge Indemnity Form *delete where applicable Parent / Guardian Consent (for students under 21 years of age) 1. I, ______________________________________ _______________________ (NRIC/passport (name number), of guardian), parent/guardian* of __________________________________ (name of child/ward*), hereby approve the participation of my child/ward* in participation in The Singapore Challenge on 14 July 2012 organised by the Singapore International Foundation (“SIF”). 2. In consideration of the SIF agreeing at my request to select my child/ward* for participation in The Singapore Challenge: 2.1 I do wholly release and discharge the SIF and their Governors, Directors, representatives, agents and employees from any and all claims and causes of action which my child/ward* or my personal representatives, dependants or estate may have for any injury, disease or mishap (including, but not limited to, those resulting in death), however caused and for loss of or damage (however caused) to my child’s/ward’s* personal belongings suffered at any time during or in relation to my child’s/ward’s* participation in participation in The Singapore Challenge; and 2.2 I hereby agree to indemnify the SIF and their Governors, Directors, representatives, agents and employees from and against any and all losses, claims, actions, damages, proceedings, costs and expenses whatsoever arising from or in connection with any of my child’s/ward’s* actions or omissions in the course of my child’s/ward’s* participation in participation in The Singapore Challenge ____________________________________ ________________________ Name and Signature of Parent/Guardian* Date Page 3 of 6 Participant Consent I, , (name of participant) , (student admission number) accept the rules and regulations set out in the registration form and understand and acknowledge that I am not an employee, agent or servant of the Singapore International Foundation (“SIF”). In consideration of my participation in Singapore Challenge: 1 I do wholly and irrevocably waive, release and forever discharge the SIF, its Governors, agents and employees from any and all claims, demands, actions, suits, causes of action, whether class, individual, or otherwise in nature, damages, liabilities of any nature whatsoever, including costs, expenses, penalties, punitive and exemplary damages, and legal fees, which I, my personal representatives, dependants or estate may have for any injury, disease or mishap (including, but not limited to, those resulting in death), however caused and for loss of or damage (however caused) to my personal belongings suffered at any time during or in relation to my participation in Singapore Challenge; and 2 I hereby irrevocably and unconditionally undertake to indemnify the SIF, its Governors, agents and employees from and against any and all claims, demands, actions, suits, causes of action, whether class, individual, or otherwise in nature, damages, liabilities of any nature whatsoever, including costs, expenses, penalties, punitive and exemplary damages, and legal fees, which may be made, or instituted against or incurred by the SIF, its Governors, agents and employees arising from or in connection with any of my actions or omissions in the course of my participation in Singapore Challenge. This Waiver and Indemnity shall be governed by and construed in accordance with the laws of the Republic of Singapore and I hereby irrevocably agree to submit to the exclusive jurisdiction of the courts of Singapore. ____________________________________ ________________________ Name and Signature of participant Date Page 4 of 6 REFERENCE FOR PARTICIPANT (NOT REQUIRED FOR REGISTRATION) Appendix 1 Rules and Regulations 1. Eligibility and Team Formation All participants must be current polytechnic students. Each team must consist of exactly 8 members. Each team must comprise of at least three different nationalities, of which one must be a Singaporean. Each team must bring along at least one fully charged digital camera with USB cable, which will be used as the main camera to submit photographs on behalf of your team. Every participant must bring along his/her student card for identification purposes. 2. Registration Obtain hardcopies of the application forms available at your respective polytechnic’s International Student Office. Each member is required to complete the set for him/herself. Submit the completed forms to your international student office by Friday, 29 June 2012, by 5.00pm 3. Challenge Guidelines An administrative email will be sent out by SIF to your email account with details on the week of the event. Please look out for the email. If you do not hear from us, please check with your team leader and/or international student office for updates. 3.1. Resources Each team will receive Challenge kit on the day itself. The kit will include : Team’s programme booklet (with the assigned Challenge routes and instructions) Pen for each member A bottle of mineral water for each member Cash for lunch for each member Singapore street directory for reference CEPAS cards for each member to travel on public transport (MRT and public buses) on 14 July 2012 only (to be returned at the end of the race) 3.2 Format Teams are required to fulfill a task at each checkpoint. Teams would not be considered to have completed the Singapore Challenge until they complete the last group activity at the ending point. Teams must follow the route indicated in the programme booklet. Teams which fail to fulfill this requirement will be disqualified from the race. Teams are required to visit the various checkpoints strictly via MRT, public bus or on foot. All teams must report back to the end point by a time stipulated by the organisers to continue with the next activity that is part of the Challenge. Teams which arrive later than the stipulated time will be penalized. 3.3 Safety Obey all laws of Singapore; especially traffic and civil laws. Refer to the Singapore Road Safety Council website for details: http://www.srsc.org.sg/advisories/pedestrian-road-safety-accidents/ 3.4 Judging criteria Page 5 of 6 Three teams with the highest score after completing all the tasks and activities as part of the Challenge will be awarded with prizes. Page 6 of 6