Renewal Lutheran Church - Event: Pickleball 2

Personal Information

First Name

Last Name

Phone Number

Invited by

Age Group

Embark (22-26 years old)

Elevate (27-40 years old)

Innovate (40s & 50s)

Physical Conditions (if any)

Some activities may require exertion or can be strenuous. Does the participant suffer from any sicknesses?

Yes

E.g., Asthma, congenital heart disease, respiratory disorders, frequent fainting spells with dizziness & headaches, etc.

Medicine in Use

Allergies

I would like to participate in this event and agree to abide by the conditions imposed by the organizer throughout the whole event. I am aware that the schedule is subject to unforeseen changes. I/We and any immediate family members will not hold the organizer responsible for any mishaps I may sustain before, during, or after the event.

Signature

Name as per IC

IC Number/Passport Number

Help us plan the next event (optional)

Is this your first time joining us?

Yes

What should we do for the next event?

What did you like about our last event?