To:School Sports Programme Unit, LCSD Fax: 2684 9076
Organised by the Hong Kong Amateur Athletic Association
Subvented by the Leisure and Cultural Services Department
Co-organised by the Education Bureau
School Sports Programme
2018 Easy Sport Competition － IAAF Kids Athletics Competition
Application Form / Pleasetickthe appropriate box
Division:(Please use one form for each division)
□ DivisionA: 8 to 9 years old
(Born between 2009and2010)
□ DivisionB: 6 to 7 years old
(Born between 2011and2012)
School Name: / Abbreviation of SchoolName:
(Max. 5 letters)
Address: / Fax No.:
Name of Applicant/ Teacher-in-charge: / Contact tel.no. Mobile no.: / /
Name of Leader: / Contact tel.no.
Mobile no.: / /

Team Name: (If applicable: Team 1 Team 2 )

List of Participants:

Student’s Name / Sex / Year of Birth / Student’s Name / Sex / Year of Birth / Student’s Name / Sex / Year of Birth
1 / 6 / 11
2 / 7 / 12
3 / 8 / 13
4 / 9 / 14
5 / 10 / 15

Remarks:

1. / Only primary schools which participatedin the “Easy Sport Programme － Athletics”training course between 1 September 2016 and31 December 2017 are eligible to apply. Participants must be current students of the school during the Competition.
2. / If the number of applications exceeds the quota, places will be allocated by ballot. Each school may submit applications for a maximum of two teams (each composed of 12 to 15 members),indicating priority by marking Teams 1 and 2. If there are remaining places, a second ballot will be conducted for Teams 2.
3. / A separate form is required for each team. Each student may only representone team.
4. / The information provided in this form will only be used for the purposes of enrolment inrecreation and sports activities organised by the Organiser and the Leisure and Cultural Services Department (LCSD), future contact, statistical reviews and opinion survey. Only officerswho are authorised by the Organiser orthe LCSDmayaccess such information for the aforesaid purposes. For correction of or access to personal data collected by means of this form, please contact the staff of the LCSDon 2601 7952 or 2601 7602.
5. / If an Acknowledgement Receipt is not received two days before the ballot date (i.e. 19 December 2017 (Tuesday)), please contact our staff on 2601 7952 or 2601 7602.
6. / The provision of personal data in this form is obligatory. If you do not provide the requisitepersonal data, the LCSD and the Organiser may not be able to process your application.
Declaration:I, the Applicant/Teacher-in-charge,hereby declare thatallinformation provided in this form is true and correct. All participants have already obtainedthe consent of their parent/guardian or the person authorised by their parent/guardian to participate in the above activity, and they do not suffer from any illness that renders them unfit for the activity. The Organiser and the LCSD shall not be liable for theinjury or death ofanyparticipant caused during the activityby his/her own negligence or inadequacy in health or fitness. In addition, our school participated in the “Easy Sport Programme － Athletics”training course between 1 September 2016 and 31 December 2017 andis eligible for application. / School Chop：
Signature of Applicant/Teacher-in-charge： Date:
Acknowledgement Receipt
To: Teacher-in-charge
We hereby acknowledge receipt of your application form. Your application will be processed accordingly.
School Sports Programme Unit
Leisure and Cultural Services Department / Date of Reply:
------
Official Chop