香港野外定向会.doc

香港野外定向會 Hong Kong Orienteering Club 三十周年紀念 HKOC 2009 30th Anniversary 聲 明 書 DECLARATION 請用正楷填寫 Please Complete In BLOCK LETTERS 本人等聲明: 參加者的健康及體能良好，適宜參加上述活動。如果參加者因本人的疏忽或健康或體能欠佳，而引致於參加這項活動時傷亡, 主辦機構或其合辦、協辦機構則毋須負責。 參加者和18歲以下參加者的家長或監護人, 接納和遵守主辦機構所通告的指引、規則和條款。 I / We declare that: The participant should be healthy, physically fit, and suitable to participate in the above activity. The Organizing bodies, co-organizing bodies and supporting bodies shall not be liable for any injury or death which the participant may suffer in this activity, if the cause of injury or death is due to the participant’s own negligence or inadequacy in health and fitness. The participant and the parent or guardian (of participant aged below 18) agrees to and obeys the instructions, terms and conditions announced by the organizer. 活動日期 Date of Event 活動名稱 Title of Event 參加者 Participant 姓名 Name 電話 Tel. No.: 電郵 (可選) Email (Optional): 簽署 Signature 日期 Date 緊急聯絡人、18歲以下參加者的家長或監護人 Emergency Contact Person, Parent or Guardian of Participant aged below 18 關係 Relationship 姓名 Name 電話 Tel. No.: 電郵Email (Optional): 18歲以下參加者的家長或監護人 Parent or Guardian of Participant aged below 18 簽署 Signature 日期 Date