The following form consists of two parts: the Confirmation Form and the Parents Consent Form.

Please complete the following before submitting via email to

ism_activity@utcc.ac.th. *Please sign and return this form to us via email within 16th May, 2024. *

Confirmation Form
UTCCiSM ASEAN CAMP 2024
“ASEAN Soft Power”

I, Nguyen Thi Huyen Anh , hereby confirm my availability to attend the UTCCiSM ASEAN Camp 2024
“ASEAN Soft Power” from 7th to 9th June 2024. I understand and agree to comply with all the
requirements and conditions outlined by UTCCiSM.
Participant Details:
(*The accuracy of your name’s spelling must be the same as your official document – ID Card/passport)

Full Name: Nguyen Thi Huyen Anh

Nickname:
Date of Birth: 09/07/2008
Gender: Female
Nationality: Vietnamese
Passport Number: P033701889
Email Address: Elianaowen150@gmail.com
Phone Number: 0866507802
Shirt Size: M

Emergency Contact:
Name: Do Thi Huong Giang
Relationship: Mother
Phone Number: 0989343069

*Consent: I will submit all the requirements by the specified deadline via email to ism_activity@utcc.ac.th
, I also confirm that my parents have completed and signed the Parent Consent Form on page 3. I
understand that failure to submit the requirements within the specified timeframe may result in my
disqualification from the UTCCiSM ASEAN Camp 2024
“ASEAN Soft Power”.

Participant Signature
Date 15/05/2024

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 The following form consists of two parts: the Confirmation Form and the Parents Consent Form. Please complete the following before submitting via email to
ism_activity@utcc.ac.th. *Please sign and return this form to us via email within 16th May, 2024. *

Parents’ Consent Form

UTCCiSM ASEAN CAMP 2024
“ASEAN Soft Power”

Child’s Name: Nguyen Thi Huyen Anh

(*The accuracy of your Child name’s spelling must be the same as the official document – ID Card/passport)

Age: 16
Address: Group 12, Long Bien ward, Long Bien district, HaNoi,VietNam
CONTACT INFORMATION
Primary Contact Parent/Guardian should be the individual who will be available to answer their phone
during the day.
Name: Do Thi Huong Giang
Address Group 12, Long Bien ward, Long Bien district, HaNoi,VietNam
E-mail Giang319@gmail.com
Phone No. 0989343069
Secondary Contact Parent/Guardian
Name: Nguyen Van Hoang
Address Group 12, Long Bien ward, Long Bien district, HaNoi,VietNam
E-mail Nguyengia.cnc@gmail.com
Phone No. 0986888096

Parent Consent Statement as the parent/guardian, I certify that my child has my permission to participate in
the UTCCiSM ASEAN Camp 2024 “ASEAN Soft Power”. I understand that he/she will be subject to the
regulations of University of the Thai Chamber of Commerce International School of Management. I also
agree that my child will follow the instructions of the UTCCiSM ASEAN Camp 2024 personnel and will
treat other participants/adults with courtesy and respect. I understand that if my child fails to do so, he/she
will not be allowed to participate in the UTCCiSM ASEAN Camp 2024. I understand that I am responsible
for signing out my child each day PROMPTLY. All risks associated with participating in the program,
including but not limited to bodily injury, are assumed by me, as indicated by the signature below. I
understand that photographs and videos may be taken to document activities. I give my permission for
photographs and/or videos to be taken of my child during the UTCCiSM ASEAN Camp 2024 to be used
for educational and/or promotional materials for UTCCiSM ASEAN Camp 2024. I understand that I will
be notified should a health emergency arise. If I cannot be reached by telephone, I authorize whatever
medical treatment is deemed necessary by medical personnel.

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The following form consists of two parts: the Confirmation Form and the Parents Consent Form. Please complete the following before submitting via email to
ism_activity@utcc.ac.th. *Please sign and return this form to us via email within 16th May, 2024. *

My child has the following known medical conditions:

Don’t has

My child takes the following medications:

Don’t has

My child is allergic to:

Other concerns/conditions of which we should be aware:

Parent/Guardian Signature
Date 15/05/2024

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The following form consists of two parts: the Confirmation Form and the Parents Consent Form. Please complete the following before submitting via email to
ism_activity@utcc.ac.th. *Please sign and return this form to us via email within 16th May, 2024. *