「賽馬會水上安全計劃－校園計劃」Jockey Club Water Safety for All (2026 Phase 1)

「賽馬會水上安全計劃－校園計劃」Jockey Club Water Safety for All (2026 Phase 1)

請注意以下事項︰
1) 根據個人資料（私隱）條例，此表格所收集的個人資料只會用於是次活動及有關用途。
2) 活動名額有限，如報名人數超過20人，將以抽籤方式選出參加者，並以電郵通知中籤者。
3) 參加者需繳付$500按金，按金將於參加者完成第一階段的課程及考試後退回。
4) 若中籤後棄權，或會影響日後參與活動的中籤機會。
5) 如報名人數不足，上述活動將會取消，校方將於截止報名後一個月內退回按金。
6) 校方有權拍攝或錄影學員活動情況以作日後宣傳及記錄之用。

Please read the terms carefully:
1) Under the Personal Data (Privacy) Ordinance, all personal data provided in this form will only be used for this application and related purposes.
2) Limited quota. If the number of applicants exceeds 20, participants will be selected by a lottery.
3) Participants are required to pay a deposit of HK$500.
Deposit is refundable upon the participant completing the Phase 1 Programme and examination.
4) Applicants who are selected but choose to withdraw may affect their chances of being selected for future events.
5) The University reserves the right to cancel activity if the number of applicants is below the requisite minimum. The deposit will be refunded after the deadline.
6) The University reserves the right to take photos during activity and use them for course promotion without prior consent from the individuals in the photos.

Programme Schedule
中文姓名 Full Name in Chinese
英文姓名 Full Name in English
身份 Status

身份 Status 教職員 Staff Member 學生 Students 校友 Alumni
職員編號/學號 Staff ID/Student ID
性別 Gender

性別 Gender Male Female
聯絡電話 Contact No.
(你或會收到Whatsapp 通知 You may receive our WhatsApp reminders)
電郵地址 Email Address
學生身份 Student Status

學生身份 Student Status 本科生 Undergraduate Student 研究生 Postgraduate Student 大學先修課程學生 Foundation Student
學科 - 本科生 Programme of Study
學科 - 研究生 Programme of Study - PG
年級 Year of Study

年級 Year of Study Year 1 Year 2 Year 3 Year 4
學生類別 Student Category

學生類別 Student Category 本地學生 Local student 內地學生 Mainland student 海外學生 Overseas student
本人確認有意參與，並能夠出席上述時間表中的所有課堂
I confirm my interest in participating and my ability to attend all classes in the above schedule.

本人確認有意參與，並能夠出席上述時間表中的所有課堂 I confirm my interest in participating and my ability to attend all classes in the above schedule. Yes
緊急聯絡人資料 Emergency Contact Information
緊急聯絡人姓名 Name of emergency contact person
與緊急聯絡人的關係 Relationship with emergency contact person
緊急聯絡人電話 Emergency contact person phone number
聲明 Declaration:

聲明 Declaration: 本人聲明自己的健康及體能良好，適宜參加有關活動。本人明白及同意如因本人的疏忽、技術不足、健康欠佳或任何原因，而引致參加這項活動時傷亡，香港樹仁大學或其合辦、協辦機構無須負責。
I hereby declare that I am physically fit, healthy and suitable to participate in the preferable physical activities. I fully understand and agree with the Hong Kong Shue Yan University, co-organizing bodies and its supporting bodies will not be responsible or liable for any injury or death resulting from the event, due to my own negligence, inadequacy in skill, health or any other reasons. 本人聲明上述資料均屬正確。
I declare that the above information is correct.
1. 如報名人數超過20人，將以抽籤方式選出參加者。報名結果將於報名截止日期後，以電郵通知各位。
If the number of applicants exceeds 20, participants will be selected by a lottery.The registration results will be notified via email after the registration deadline.

2. 參加者需繳付$500按金，按金將於參加者完成第一階段的課程及考試後退回。
Participants are required to pay a deposit of HK$500. Deposit is refundable upon the participant completing the Phase 1 Programme and examination.