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Name:
_________________________
IC No:
_________________________
H/P No:
_______________________ Email:
___________________
Please State Any
Medical Conditions or Allergies that may require special attention (If any): ........................................................
...............................................................................................................................................................................................
I, the above named
person wishes to participate in the team-building activities, understand that
it is a combination of physical games that is set to take place during the
workshop and I confirm that I am fully aware, understand and agree that being
such type of event there are inherent risks & certain unpredictability
that accompany the event.
As such, I agree to
indemnify and keep indemnified my Employer and Combative Resources, including
all staffs and trainers from any claims whatsoever and agree that I shall not
hold my Employer, Combative Resources and its organizers, owners, employees,
agents, servants responsible or be held liable for any personal injury,
mental anguish, loss of any kind whatsoever howsoever caused that may occur
during the event.
I further agree to
abide by all instructions issued by the trainers and facilitators of this
event to ensure that no unnecessary mishaps shall occur.
_______________________ ________________
(Signature)
Date:
* The completed form
must be submitted before the start of event.
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