54321义走(2017) - 参加义走 Walkathon Registration Form
日期 Date: 9/9/2017 (Sat)
时间 Time:早上8.30am – 12.00pm
集合地点 Meeting Place: 新加坡武吉巴督自然公园 Meeting Point 1 @ Bukit Batok Nature Park
报名费用,每位$10 Registration fee: $10 per pax
A】个人资料 Personal Information
A1. 电邮 Email
Your answer
A2. 名字 Name as in NRIC
Your answer
A3. 出生日期 Date of Birth
Your answer
A4. 身份证号码 NRIC
Your answer
A5. 性别
Gender
Required
A6. 电话/手机
Tel/Mobile
Your answer
A7. 紧急联络人Name of Emergency contact
Your answer
A8. 紧急联络人住家和手机号码Tel/ Mobile of emergency contact
Your answer
A9. 与紧急联络人的关系Relationship with the contact
Your answer
*所收集的个人资料会作保密处理,只用于购买保险,寄发收据及保持联系。Personal data collected will be kept strictly confidential and for insurance purpose, issuing receipts and communications only.
B】附注 Remarks
B1. 参加者请在31/8/2017或之前把 $10 报名费及“免责同意书”交回证主。Participant please submit the indemnity form and $10 registration fee by 31/8/2017
Required
B2. 所有参加者必须填写 “免责同意书(Indemnity Form)”。表格可从网站下载。Every event participant must also complete the indemnity and release form, which may be downloaded from this website.
Required
B3. 有关天气突变恶劣的安排 Cancellation in case of Adverse weather condition
如天文台于步行当日早上发出雷暴或恶劣天气警告,活动将会取消,并会以手机简讯通知参加者,大会将不会另订定日期举行,但奉献仍会继续用在指定用途。Notification of cancellation by Mobile or SMS should such situation becomes inevitable, and any fund collected will be used in accordance with the specific guidelines and targets of the Walkathon.
Required
C】捐款 Donation
C1. 捐款形式 Wayof donation
Required
C2. 按月奉献,请选择奉献数目 If you choose to contribute monthly please indicate the amount.*
*如阁下选择按月奉献,请透过财路转账到证主的 户口,为期1年。奉献者任何时间如欲终止,请以用电邮go@cc-sg.org通知我们。当我们收到阁下的电邮后,便会马上停止过账并通知阁下。* If you choose to contribute monthly¸ please fill up the GIRO form. The commitment will be 1 year. If at any time you want to stop contribution, please email to us at go@cc-sg.org and we will terminate the bank transfer at once and you will be informed.
Required
C3. 捐款递交方法 Mode of Submission:
D】义走T恤衫 Walkathon T-shirt
D1.义走男士T恤衫 Male Walkathon T-shirt
请选择以下T恤衫尺码以肩膀宽度为标準 Please choose the T-shirt size measure from the shoulder width.
1 件 / pc
XXSmall (35cm)
XSmall (37cm)
Small (42cm)
Large (46cm)
XLarge (48cm)
D2.义走女士T恤衫 Female Walkathon T-shirt*
请选择以下T恤衫尺码以肩膀宽度为标準 Please choose the T-shirt size measure from the shoulder width.
1 件 / pc
XXSmall (32cm)
XSmall (34cm)
Small (36cm)
Medium (38cm)
Large (41m)
XLarge (43cm)
D3.义走T恤衫领取日期在义走之前的一个星期从25-31/8/2017. Collection of the T-shirt start from 25-31/8/2017before the event.
请来之前,打电话通知并填何时来索取T恤衫,please call before you come and fill in the following date of collection.
E. 备注Remark
Your answer
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