Diocesan Girls' School

Aquatics Club Membership (Pre P1/S1)

Please submit your completed and signed membership application form, together with one40mm (width) X 50mm (height)photo of the applicant (and of each family member where applicable, name at the back), one self-addressed and stamped envelope and a crossed cheque for 2018membership fee payable to "Diocesan Girls' School".

The membership fees for the period April 2018to August 2018 are:

HK$100 (Individual membership for a student),

HK$250 (Individual membership for an immediate family member of student),

HK$600 (Student’s family membership (under the same household) for a total of 4 persons) For all family membership applications, an additional HK$250 will be charged for every additional person.

This application form, photos, self-addressed and stamped envelope togetherwith a crossed chequeare to be submitted to:

Applicationfor DGS Aquatics Club Membership

Diocesan Girls' School

1 Jordan Road

Kowloon,HKSAR.

Your application will be processed upon receipt of your membership fee and a membership card will be delivered to the student in 2 to 4 weeks. Your membership will become effective upon issuance of your membership card(s).

Only members of the DGS Aquatics Club are eligible to enroll for swimming classes to be held at the DGS pool during non-school hours. Members who are 12 years of age or under and who are not attending swimming classeswill not be permitted to use the pool unless accompanied by a responsible member 18 years of age or older.

Diocesan Girls' School

Aquatics Club Membership Application Form

(Pre P1/S1)

April 2018 to August 2018

Category IPrincipal member (Student):

Surname:______Other Names in Full:______

For Pre P1/S1 Student only:

Meeting Number: ______Name of Parent / Guardian: ______

Category IIAffiliated family members (of the same household):

Surname*
(Dr/Mr/Ms/Mrs/Oth) / Other Names in Full / Current DGS/DGJS Class and Class No./DOGA Class of and Membership No.
(if applicable) / Gender* / Age / Date of Birth (dd/mm/yyyy) / Relationship with Student**
M / dd/mm/yyyy / Father
F / dd/mm/yyyy / Mother
M / F / dd/mm/yyyy
M / F / dd/mm/yyyy

HOME ADDRESS (Please complete in ENGLISH Block Letters)

Flat/Room / Floor / Block
Name of Building
Name of Estate / Number and Name of Village
Number and Name of Street / Lot Number
Area and District Name
Mobile Phone Number / Home Telephone Number
E-mail Address

In case of emergency, please contact:

Name: ______Relationship: (______)

Telephone number:______

Aquatics Club members who have duly paid membership fees and carry a valid membership card will be entitled to use the DGS swimming pool from 1stApril2018 to 31st August 2018, during opening hours. No rebate will be given in respect of any paid membership fees as a result of early termination or suspension of membership for whatever reason.
By signing below and returning your application to Diocesan Girls’ School, you agree to abide by, and will procure your affiliated family members to abide by, the DGSAquatics Club Rules and Regulations as may be amended from time to time as if the same were fully set out in this Application Form. Your attention is also drawn to the Personal Information Collection Statement at the end of this form.
Pool opening hours for registered members:
Please refer to DGS Aquatics Club Website:
The pool will be closed on all public holidays except most Sundays. As the pool may be closed on certain Sundays, members are encouraged to refer to the DGS website for details on pool opening dates before their arrival. The School further reserves the right to close the pool for special activities, periodic cleaning, maintenance and check-up, in which case details will be posted at the pool entrance.
I understand that the use of DGS swimming pool and any facilities and equipment therein through Aquatics Club is undertaken at the applying member and her affiliated family member’s (where applicable) own risk. I hereby agree to waive any and all rights which I or my affiliated family members may have against Diocesan Girls’ School, Diocesan Girls’ Junior School and its affiliates, staff, students, advisers and agents arising from any death, personal injury, damage, loss, cost, expense, or inconvenience which an applying member(s) hereunder may suffer to incur arising from my or his/her use of any facilities and/or equipment provided by Aquatics Club,Diocesan Girls’ School or Diocesan Girls’ Junior School. Furthermore, I undertake to bring the provisions of this Clause to the attention of my affiliated family members (where applicable). I shall indemnify and keep Diocesan Girls’ School and Diocesan Girls’ Junior School and its affiliates indemnified from and against any and all liabilities, costs and expenses and agree that this indemnity will continue to apply notwithstanding that the applying member may cease to be a member of Diocesan Girls’ School or Diocesan Girls’ Junior School for any reason whatsoever.
For category I: Signaturesand namesof Parent / Guardian:

For category II: Additional signatures and names of all other applicants who have attained the age of 18:

Date of Application: dd/mm/2018

Personal Information Collection Statement:
Any personal data collected and recorded in relation to an applicant by Diocesan Girls’ School will be considered private and confidential. Your personal information will only be used for processing and managing your membership and activities pursuant to the membership; otherwise no applicant’s personal data will be disclosed to any unauthorized party outside the Aquatics Club Membership management of Diocesan Girls’ School, unless Diocesan Girls’ School is satisfied that the applicant has consented to the disclosure.

DGS Aquatics Club Membership Application Form PreP1/PreS1