This form will take 10 to 15 minutes to complete.
SECTION 1 of 3: PERSONAL INFORMATION
SECTION 2 of 4: REGISTRATION OF PROGRAMME
SECTION 3 of 4: SCHOOL/EMPLOYMENT BACKGROUND
SECTION 4 of 4: MEDICAL INFORMATION
Athletes/Unified Partners under the age of 21 must have a caregiver/legal guardian sign this release on their behalf.
I, the undersigned athlete (caregiver and/or legal guardian), hereby request permission to participate in the Special Olympics Singapore Program. I represent and warrant you that I am physically and mentally able to participate in Special Olympics Singapore sporting and non-sporting activities. I acknowledge that I will be using facilities at my own risk, and I hereby release, discharge and indemnify Special Olympics Singapore from all liability for injury to person or damage to property of myself. As a participating athlete, I am specifically granting permission to Special Olympics Singapore to use my likeness, voice and words in television, radio, film, newspaper, magazines and other media, and in any form not heretofore described for the purpose of advertising or communicating the purpose and activities of Special Olympics Singapore and in appealing for funds to support such activities. I agree to abide by Special Olympics Singapore rules, policies, procedure, and Code of Conduct. If I am unable to be consulted in case of necessity, Special Olympics Singapore is authorized at my account to take such measures and arrange for such medical and hospital treatment as is deemed advisable for my health and well-being. It is understood that my personal information will be held and processed by Special Olympics Singapore for the purpose of administering the Special Olympics Singapore in accordance with the Personal Data Protection Act 2012 (PDPA). My personal data will be disclosed to Special Olympics Incorporated to be included in the global census for the purpose of gathering information on Athlete/Unified Partner participation in Special Olympics sporting and non sporting activities.
I declare that, to the best of my knowledge and belief, all the particulars given in this form are correctly stated.