22-23 July 2023 Kids VS Wild  -  Health Declaration Form 
AGREEMENT
1. The Acme Pro has the right to take photo of or video-record the activity for the purpose of publicity and activity promotion. Participants who do not wish to be captured by photo or to be shown in any other means, please kindly notify our crew in advance.
2. The participant agrees to take measures to minimize possible loss or injury or damage to the self or others. The participant agrees to observe and abide by the safety rules, regulations and advice of Acme Pro. The participant is aware of and agrees to undertake possible risks of loss or injury or damage associated with the activities.
3. The participant understands and agrees to surrender the rights of legal and financial claims upon the loss, injury or damage associated with the activities.
參加活動約定
1. ACME PRO將安排拍攝及錄影活動情況，相片和影片將被用作活動記錄及宣傳推廣。若不欲於課程被拍攝或將有關資料作其他用途，歡迎直接向我們的團隊反映，團隊樂意為閣下作出相應安排。
2. 參加者同意導師採取適當行為和方法確保安全及避免自身和他人受傷。參加者必須遵守ACME PRO提供的安全條例，規則及建議。在選擇參加活動，參加者了解及自願接受當中可能涉及個人受傷或損失的風險*。
3. 參加者明白及同意不會向ACME PRO及其工作人員追究因參加活動而引起的個人或財物損失或責任。
I hereby declare the accuracy of the above information and have read and agreed to the contents in the agreement.
            茲證明以下資料屬實並盡本人所知填寫，並已閱讀及明白「參加活動約定」的內容。
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Participant name in English (full name & English name preferred) 參加者英文姓名 *
Participant gender 參加者性別 *
Required
Participant date of birth 參加者出生日日期 *
MM
/
DD
/
YYYY
Emergency Contact Person Name 緊急聯絡人姓名 *
Emergency Contact Person Contact no.緊急聯絡人電話號碼 *
Relationship with participant 與參加者關係 *
Is the participant known to be allergic to any medicine or food? 參加者是否對某種食物或藥物會產生敏感反應? *
Required
Is the participant under any medication or treatment? 參加者現在是否定期接受藥物冶療? *
Required
Has your doctor ever said the participant should only do physical activity recommended by a doctor? 參加者是否只可進行醫生建議的體能活動? *
Required
Have you/ the participant been diagnosed with the following disorders? 參加者是否患有以下疾病? *
Required
Have you been traveled to other countries within 14 days? If yes, please specify the location and date of travel. 你在十四天內是否有外遊經驗？如有，請說明地點及外遊日期。 *
Required
Other information you consider necessary 其他補充資料 (You may directly contact our counsellor 你亦可直接與我們聯絡)
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