PWD-BCA CLUB

Social & Outdoor Activities Committee (SOAC)

Organisation Representatives: -

BCA (10th flr) / Geoffrey Tay / ENV/ PUB / Ivy Poon
BCA (10th flr) / Ong Teck Soon / LTA / Lim Sun Kiat
BCA (10th flr) / Julia Leu / NParks / Teng Siew Hoon
BCA (9th flr) / Phua Hui Chun / MOE / Gan Thiam Wah
BCA (9th flr) / Grace Chng / AVA / Ng Kim Choo
BCAA(10th flr) / Grace Teo / MOF / Chew Ah Cheng
CPG / Florence Lee / URA / Ang Ee Eng

REGISTRATION FORM

Name of Activity: International High-Tea Buffet at Carousel @ Royal Plaza On Scotts
Date of Activity: Saturday, 13 August 2016 / Time: 3.30pm to 5.30pm
Member’s Name: / Statutory Board/Dept:
Club Membership No: / Marital Status:
Member’s Tel. No.: / Amt Paid, Cash/Cheque No.:
Names of member &
immediate family / Guest / Public Price / Member Price
(after Subsidy) / Amount
My name: / □ Adult : $56.50 / $34.00 / $______
My family member’s name/guest’s name:
______
(each member can only bring 1 family member or 1 guest on subsidised rate.
Please tick the relevant box accordingly) / □ Adult or child (12 years &
above) : $56.50 / $34.00 / $______
□ Child(4 - 11 years old) :
$37.66 / $22.00 / $______
TOTAL / $______

Closing date of booking:- Friday, 29 July 2016 @ 12.00noon

Note: If you are going with other members as a group, please indicate their names here:

______(up to 6 names). In the event that balloting is required; the Club allows the whole group to be considered balloted if your name is drawn.

PWD-BCA CLUB

Social & Outdoor Activities Committee (SOAC)

We agree to the following conditions:

1.  My family and I participate in this activity at our own risk. We will not hold the Club responsible ie. the Club is fully indemnified at all times and on all matters with regard to this activity. The Club shall not be liable for any claims whatsoever.

2.  Collection, Use and Disclosure of Personal Data

a)  I consent to the collection, use and retention of my personal data by PWD-BCA for the purposes of processing and managing my registration for and participation in the above event.

b) I consent to be contacted via email and/or text messages for all matters relating to the event.

c)  I consent to inform PWD-BCA of any updates to my contact details and/or personal data in order that PWD-BCA is able to contact me for all matters relating to the event.

d)  I consent to the disclosure of my personal data by PWD-BCA to authorize third parties for the latter to collect, use and retain for the purposes of processing, administering and managing my registration for and participation for the event.

e) I declare that the personal data of my next of kin is true and accurate and that he/she is aware and consent to PWD-BCA managing his/her personal data for authorised purposes.

f) I understand that photography and/or videography may be taken during the event for news and publicity purposes and may be used for print and on online/electronic platforms. I acknowledge that PWD-BCA owns all rights to the photographs and video purposes.

g) If I do not wish to have any photographs or video recordings taken of me, I will inform the PWD-BCA during the event.

______

Member’s Signature Date

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