(Q2 + Q3 2019) Assumption of Risk and Release of Liability Form (below 18)

THE FUN EMPIRE

WAIVER AND RELEASE OF LIABILITY

You are required to read and complete this form before you and/or your child/ward participates in any of our activities.

By submiting this form, you also acknowledge that you have read and agree to our Data Protection Policy.
Event ID
Group Pax
Activity Type*

Bubble BumpCombat ArcheryPoolballLaser TagNinja TagSaber TagBullet StrikeSaberFitBullet BallGiant Whack A MoleTerrrariumArt JammingLeather WorkshopCandle Making WorkshopHybrid Amazing RaceOther Activities/Games
Event Date *

DayMonthYear
Date
Time

:HourMinutesAM/PM Option
Event Location *
PARENT/GUARDIAN'S INFORMATION
Adult's Full Name*

First NameLast Name
Adult's Date of Birth*

DayMonthYear
Date
Adult's NRIC / FIN / Passport Number (Last 3 digits + checksum. Example 123D)*
Adult's E-mail*
example@example.com
Adult's Phone Number*
CHILD 1 INFORMATION
Child 1's Full Name*

First NameLast Name
Child 1's Date of Birth*

DayMonthYear
Date
Child 1's NRIC / FIN / Passport Number (Last 3 digits + checksum. Example 123D)*
Add Another Child?*

YesNo
CHILD 2 INFORMATION
Child 2's Full Name

First NameLast Name
Child 2's Date of Birth

DayMonthYear
Date
Child 2's NRIC / FIN / Passport Number (Last 3 digits + checksum. Example 123D)
Add Another Child?

YesNo
CHILD 3 INFORMATION
Child 3's Full Name

First NameLast Name
Child 3's Date of Birth

DayMonthYear
Date
Child 3's NRIC / FIN / Passport Number (Last 3 digits + checksum. Example 123D)
Add Another Child?

YesNo
CHILD 4 INFORMATION
Child 4's Full Name

First NameLast Name
Child 4's Date of Birth

DayMonthYear
Date
Child 4's NRIC / FIN / Passport Number (Last 3 digits + checksum. Example 123D)
Add Another Child?

YesNo
CHILD 5 INFORMATION
Child 5's Full Name

First NameLast Name
Child 5's Date of Birth

DayMonthYear
Date
Child 5's NRIC / FIN / Passport Number (Last 3 digits + checksum. Example 123D)
Form Submission Date

DayMonthYear
Date