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1、TO: HONG KONG AMATEUR SWIMMING ASSOCIATION 致香港業餘游泳總會 HKASA REGIONAL SWIMMING TRAINING SQUAD 香港業餘游泳總會地區青年游泳訓練組 Health Declaration Form for Member / 運動員健康申報表 Name：_ 中文姓名：_ Belonging Region / 所屬地區：(Please tick which is appropriate / 請剔所選擇項目) Hong Kong Island 香港 Kowloon 九龍 New Territories 新界 Declaration
2、 Details / 申報內容： I am hereby declare that I am physically fit without any physical defect, and suitable to resume and/or participate in the above activities / training. Organizers shall not be liable for any injury that may suffer in the activity / training. I understand and accept that I should pro
3、vide documentary proof for the above information as necessary. 本人在此聲明本人的健康及體能良好並適宜參與上述活動 / 訓練課程 。 若因健康及體能 欠佳而引致受傷，主辦及協辦機構則無需負任何責任。本人亦清楚明白並同意，如有需 要，本人必須提供有關文件以證明上述資料的真確性。 _ _ _ 申請者簽署 / S i g n a t u r e o f A p p l i c a n t ( 18歲以下人仕由父母或監護人簽署) ( S i g n e d b y Pa r e n t s / G u a r d i a n i f a g
4、 e u n d e r 18 ) 簽署人姓名 / Na m e o f S i g n e r ( 請用正楷填寫) ( In b l o c k l e t t e r s ) 日期 / D a t e For Official Use only: Received on: _ Checked by: _ HKASA REGIONAL SWIMMING TRAINING SQUAD 香港業餘游泳總會地區青年游泳訓練組 Leave Application Form for Coach / 教練請假申請表 Name：_ 中文姓名：_ Belonging Region / 所屬地區：(Please
5、 tick which is appropriate / 請剔所選擇項目) Hong Kong Island 香港 Kowloon 九龍 New Territories 新界 Leaving Period 請假日期： From / 由：_ To / 至 _ No. of lessons absent / 缺席堂數： _ Reasons of Leave: (Please tick which is appropriate / 請剔所選擇項目) Study Leave for attending Training Course 出席訓練課程 (please provide relevant ti
6、metable /請提供有關上課時間表) Study Leave for Examination 出席考試 (please provide relevant examination timetable /請提供有關考試時間表) Sick Leave 病假 (please provide Medical Certificate / 請提供醫生証明) Leave for outside training and/or competitions 出外訓練 / 比賽 (please provide competition programme or certified letter from Club
7、/ 請提供比賽賽程或屬會証明信) Others 其他 (Please specify / 請註明：_ ) _ _ _ Coach s Signature Coach s Name in Block Letter Date 教練簽署 教練姓名 (請用正楷填寫) 日期 For Official Use only: Substitute by: _ ( ) Club: _ Contact Tel. No. _ Received on: _ Checked by: _ HKASA REGIONAL SWIMMING TRAINING SQUAD 香港業餘游泳總會地區青年游泳訓練組 Leave Appl
8、ication Form for Member / 運動員請假申請表 Name：_ Registration No. / 註冊編號：_ 中文姓名：_ Belonging Region / 所屬地區：(Please tick which is appropriate / 請剔所選擇項目) Hong Kong Island 香港 Kowloon 九龍 New Territories 新界 Leaving Period 請假日期： From / 由：_ To / 至 _ No. of lessons absent / 缺席堂數： _ Reasons of Leave: (Please tick wh
9、ich is appropriate / 請剔所選擇項目) Study Leave for Public Examination 出席公開考試 (please provide relevant examination timetable / 請提供有關考試時間表) Sick Leave 病假 (please provide Medical Certificate / 請提供醫生証明) Leave for outside training / competitions 出外訓練 / 比賽 (please provide competition programme or certified let
10、ter from Club / 請提供比賽賽程或屬會証明信) Others 其他 (Please specify / 請註明：_ ) (please provide relevant proof / 請提供有關証明) _ _ Applicants Signature (Signed by Parent if Age under 18) Name (Signature Person) in Block Letter 申請者簽署( 18 歲以下人仕由父母簽署) 簽署人姓名 (請用正楷填寫) _ Date / 日期 For Official Use only: Received on: _ Chec
11、ked by: _ HKASA REGIONAL SWIMMING TRAINING SQUAD 香港業餘游泳總會地區青年游泳訓練組 Squad Member Withdrawal Confirmation Form / 運動員退隊確認表 Name：_ Registration No. / 註冊編號：_ 中文姓名：_ Club/屬會：_ Belonging Region / 所屬地區：(Please tick which is appropriate / 請剔所選擇項目) Hong Kong Island 香港 Kowloon 九龍 New Territories 新界 Withdrawal
12、Effective Date 退隊生效日期： _ _ _ Applicants Signature (Signed by Parent if Age under 18) Name of Signatory in Block Letter 申請者簽署( 18 歲以下人仕由父母簽署) 簽署人姓名 (請用正楷填寫) _ _ _ _ _ _ Club Person In Charge s Signature & Authorized Club Chop Date / 日期 屬會負責人簽署及屬會蓋印 For Official Use only: Received on: _ From: _ Confirmed By : _ Regional Swimming Training Squad Convener s Signature 地區青年游泳訓練組負責人簽署
