PEOPLE'S ASSOCIATION WATER-VENTURE GROUP RENTAL APPLICATION

This form may take you 3 minutes to fill in. You will need the following information to fill in the form: NRIC number or membership card respectively if you are applying under those categories. The workers work permit no. or Foreign Identification Number (FIN) The workers work permit or S pass application date

BOAT NUMBER : ( RUDDER NUMBER : (

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ACTIVITY DETAILS
Kayak,single Kayak,double Laser Topper Pico Windsurf Board Double Sit-On-Top Single Sit-On-Top 10-Crew Dragon Boat 20-Crew Dragon Boat Others (please specify)___________________________________

Type of Equipment: (Please indicate the quantity of equipment in box) Rental Time (START):

Rental Time (END):

DATE (compulsory ): : DATE (compulsory)

PERSONAL PARTICULARS OF PERSON-IN-CHARGE

Organisation/Billing Details

*NRIC / FIN (Foreign Identification Number)/Passport No.

*S / F / G :

Name of Organisation : Address :

Full Name (in CAPITAL LETTERS) : Mr / Ms / Mrs / Mdm / Dr / Prof

Telephone No : RULES AND REGULATIONS FOR USE OF EQUIPMENT
1) Only Water-Venture members with the relevant certificates issued by the People's Association Water-Venture or other relevant organisations that are recognised by the National Sports Associations are allowed to rent close-deck kayaks. 2) Users without certification are only allowed to rent Sit On Top kayaks. 3) Rental is also available for guests of Water-Venture members at Non Member's Rate. Rental is allowed only when the above-mentioned relevant proficiency certificates are produced as documentary proof. 4) All users must put on a Personal Floatation Device (PFD) and be properly attired when engaging in the water sport activities. 5) Sharing of rented equipment is not allowed. 6) Check all equipment for sea-worthiness, i.e. no leaks, damages etc, before going out to sea. Defects must be reported to the outlet staff immediately. 7) Users will be held responsible for any damages to the equipment during rental. 8) Water-Venture will not be liable for any mishap or injury that may occur to users or their guests as a result of using the equipment. 9) In case of poor visibility or bad weather, such as a thunderstorm, please head for the nearest shore. 10) In the event of a capsized, please stay with your equipment and wait for rescue. 11) Sail, windsurf or kayak within the demarcated areas. The demarcated areas plan is displayed on the outlet notice board. 12) All rented equipment must be back at the outlet by 1700hours (5.00pm) and thoroughly rinsed with fresh water before being kept in the storage rack or space. 13) All members and guests must strictly adhere to all safety regulations by the relevant authorities and Water-Venture. 12) In case of poor visibility or bad weather, such as a thunderstorm, please head the nearest shore. 13) If you capsize, do not leave the kayak. You should hold on to your kayak and wait for rescue. 14) Sail, windsurf or kayak within the demarcated areas. The demarcated areas plan is displayed on the outlet notice board. ALL USERS Of EQUIPMENTS ARE TO FILL UP THE DECLARATION IN THE LIST FOUND OVERLEAF (Person In-Charge inclusive if he/she is using the equipments)

Fax No:

NO. 10-Man Boat :

AMOUNT

20-Man Boat :

Group Locker :

Total :
Date Of Payment Receipt Number Payment Mode

Remark :

DECLARATION All applicants in the list below agree abide by the rules and regulations stated and hold themselves solely responsible for any mishap or injury that may occur during, or as a result of their participation, including rental of equipment from the outlet and of equipment from the outlet and certify that they do not have a pre-existing medical condition as declared below. (A copy of the Water-Venture Safety Guidelines is available at the counter) All applicants in the list below declare that all information provided is true and correct; and agree to abide and be bound by the Terms and Conditions of the Community Club Management Committees, other People's Association Organizations; and authorize the People's Association to disclose their personal information to its employees, service providers, vendors and affiliated partners. 1) 2) 3) All users of equipments will have to fill up all details in this section Applicants are to fill up individual rental form with certification by Medical Examiner if any medical condition is ticked Applicants who are under 21 years of age are to indicate if they have obtained permission from their/ parents/guardian to use the equipments

I have obtained permission from my parent/guardian to use the equipment as I am under 21 years of age 1 HAVE YOU EVER HAD (a) Chest pain, high blood pressure, heart problems such as heart murmur, extra heart beat or other heart abnormality (b) Asthma, bronchitis, tuberculosis, sinusitis, other lung problems (c) Fits, epilepsy, fainting attacks, migraine, severe head injury (d) Eye problem/poor vision (e) Ear problem/deafness (f) Nervous illness (g) Diabetes

Please tick if you have any of the condition stated

(b) Special diet 3 DO YOU HAVE (a) Any disability (b) Any other medical information to note, e.g. food, drug allergy

(h) Bone or joint injury (i) A carrier status for any infectious disease (j) Medical treatment within last two years (k) Are you pregnant? 2 DO YOU REQUIRE (a) Routine medication

No.
1

Name

NRIC/PASSPORT No. Foreign I D No.

Date of Birth (DD/MM/YYYY)

Emergency Contact No.

Name / Relationship

Signature/Date

REMARKS (DETAILS FOR ANY MEDICAL CONDITIONS THAT IS TICKED ( A separate form with the certification of fitness should be filled if any of the conditions are ticked)

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