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CLIMB X 2012 Registration Form

Temasek Junior College Climbing Competition 31ST March and 1ST April
Please return this form by email (climbx.tjc@gmail.com), and make payment no later than 19th March 2012. Name of School/Institution: Name of Club Secretary: Contact No: Email: / Inter-Varsity ] *(Please circle accordingly) NRIC/ Passport Contact No. Singlet Size S/M/L

Women [ * Inter-JC
Name

Email

Men [ * Inter-JC / Inter-Varsity ] *(Please circle accordingly)


Name NRIC/ Passport Contact No. Email Singlet Size S/M/L

I,__________________,NRIC/Passport No._______________, accompanying *coach/teacheric, declare that all particulars are correct and hereby agree to abide by all rules and regulations of the competition. I am aware that my students will be participating at their own risk and that the organiser will not be liable for any injuries sustained, death or loss/damage to personal property during the competition. Signature Date

Temasek Junior College | 22, Bedok South Rd, Singapore (469278) | Tel: 6442 8066 Fax: 6442 8762

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