致香港业余游泳总会.pdfVIP

TO: HONG KONG AMATEUR SWIMMING ASSOCIATION 致香港業餘游泳總會 HKASA REGIONAL SWIMMING TRAINING SQUAD 香港業餘游泳總會地區青年游泳訓練組 Health Declaration Form for Member / 運動員健康申報表 Name ：__________________________ 中文姓名 ：___________________ Belonging Region / 所屬地區 ：(Please tick which is appropriate / 請剔所選擇項目) □ Hong Kong Island 香港 □ Kowloon 九龍 □ New Territories 新界 Declaration Details / 申報內容 ： I am hereby declare that I am physically fit without any physical defect, and suitable to resume and/or participate in the above activities / training. Organizers shall not be liable for any injury that may suffer in the activity / training. I understand and accept that I should provide documentary proof for the above information as necessary. 本人在此聲明本人的健康及體能良好並適宜參與上述活動 / 訓練課程。若因健康及體能 欠佳而引致受傷 ，主辦及協辦機構則無需負任何責任 。本人亦清楚明白並同意 ，如有需 要 ，本人必須提供有關文件以證明上述資料的真確性 。 ______________________________ ________________________ _______________ 申請者簽署 / Signature of Applicant 簽署人姓名 / Name of Signer日期 / Date ( 18歲以下人仕由父母或監護人簽署) (請用正楷填寫) (Signed by Parents/Guardian if age under 18) (In block letters) For Official Use only: Received on: _________________________ Checked by: ____________________________ HKASA REGIONAL SWIMMING TRAINING SQUAD 香港業餘游泳總會地區青年游泳訓練組 Leave Application Form for Coach / 教練請假申請表 Name ：__________________________ 中文姓名 ：___________________ Belonging Region / 所屬地區 ：(Please tick which is appropriate / 請剔所選擇項目) □ Hong Kong Island 香港 □ Kowloon 九龍 □ New Territories 新界 Leaving Period 請假日期 ： From / 由 ：_________________ To / 至 _________________ No. of lessons absent / 缺席堂數 ： ___________ Reasons of Leave: (Please tick which is appropriate / 請剔所選擇項目) □