Use of Contact Information

Use of Contact Information

Dear Participant,

Part 1Use of Contact Information

In line with the Personal Data Protection Act, please tick in the box if you do not give consent to Council for Third Age (C3A) and Fei Yue Community Services to:

I would not like to be on mailing list for news, events and promotion updates about active living for seniors. [Please provide email address if you would like to be in mailing list. Email address ______]

I do not give C3A and government agencies rights to share, use, publish in print, broadcast & electric media, my quotes, works or photographs derived from this programme

I would not like to be contacted for seniors’ related surveys

Please send me information by Mail SMS Email ______

Part 2Statement of Undertaking

By signing this statement of undertaking, I, the a/m student, warrant that I have read, understood and agree to the following:

1. The course I am applying for is offered at the prerogative of the School and may be cancelled or rescheduled at any time, subject to the policies and procedures of the School.

1. Registration for the course named above is on a first-come, first-served basis and subject to the policies and procedures of the School. This document is not a guarantee of successful registration.

1. Withdrawal and refund policies are subject to the respective policies and procedures of the School.

1. Payment of the Course Fees is to be made to Fei Yue Community Services.

1. I agree to adhere strictly to the School’s Code of Conduct.

1. I shall not hold the School, Council for Third Age or Fei Yue Community Services (the “Parties”) liable for any death, illness, disability, personal injury, mishap, damage or loss of property or any other loss arising in connection with this course.

1. I agree to indemnify the Parties against any claims or damages by any third party in connection with my participation in the course, provided that it is not caused by gross negligence or wilful default of the Parties.

Name & SignatureDate

Initiated and supported by C3A.

Council for Third Age (C3A) was set up in May 2007 with the role of promoting active ageing in Singapore. C3A aims to create a vibrant pro-age Singapore through education, outreach and partnership – a society where seniors can participate as integral members according to their interests and abilities, and ultimately fostering a society where seniors live full, active and meaningful lives.

Organised by Family Central.

Family Central is a service by Fei Yue Community Services (FYCS). FYCS is committed in effecting life transformation through the provision of quality social services.

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