Mass Aerobics by 4KdI1P

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									                                PUBLIC SERVICE SPORTS CARNIVAL
                                   SAT, 26 NOV 2011, MARINA BARRAGE

                               MASS AEROBICS - REGISTRATION FORM

Instructions:
1. This form is only for those who are not taking part in the Fun Walk @ Gardens by the Bay.
2. Complete all required fields in BLOCK letters. Incomplete forms will be considered void.
3. Family members are eligible to take part in the event.
4. Please remember to bring your aerobic gears.
5. Please submit this form by Friday, 21 October 2011
6. This form must be submitted by Ministry/organization Sports Liaison Officer to Manager, Sports, Civil
     Service Club, 60 Tessensohn Road, Singapore 217664 (FAX: 6292 6894)



 Name of Ministry/Organisation


Particulars of Team Captain

                                                                                  NRIC:
 Name
                                                                                  Postal Code:
 Address (Office)

                       (R)                  (O)               (HP)                (P)
 Contact Number

                                                                                  Fax:
 E-mail Address


Particulars of Participants

  S/N NRIC                   Name      of   Participants Name of Family Member* Relationship
                             (Staff)
  1
  2
  3
  4
  5
  6
  7
  8
  9
  10
  11
  12
  13
  14
  15
  16
  17
  18
  19
  20
  21
  22
  23
  24
  25
  26
  27
  28
  29
  30
*Eligible to take part in the event if accompanying the staff

CLOSING DATE: FRIDAY, 21 OCTOBER 2011

I certify that the particulars of the participants given above are correct and that they are
staff of my Ministry/organisation.

I/We will not hold the Civil Service Club, the Organising Committee, appointed
contractors, sponsors, appointed officials and staff responsible for any mishap, injury or
loss of life that may be suffered by the participants before, during or after the event.

 Signature of Sports Liaison Officer:                           Date:


 Name:                                                          Contact No:

								
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