Fiche d’inscription Année scolaire 2014 - 2015 Registration form School year 2014-2015 Activité principale Club LFS / Club LFS major activity Prénom / First name N°Passeport / FIN/IC N° Adresse / Address Tel domicile / Tel home Tel portable / Tel HP Email Statut / Status Parent / parent Externe / External Personnel / Staff Personne à prévenir en cas d’accident / Person to contact in case of emergency Nom / Name Tel I, (name & first name) , hereby agree and declare to pay or indemnify the Lycee Francais de Singapour for all claims, coasts and losses of any nature which the school may incur. I also declare to have underwritten a personal liability (PL) insurance which will be valid during my involvement in these*. PL policy insurance n°---------------------------------------- with -------------------------------------------* In addition, I acknowledge that the Lycee francais de Singapour will not assume any liabilities in case of an accidental bodily injury or material loss or damage, in any circumstances whatsoever. I accept that neither the Lycee francais de Singapour employees nor the activity leaders shall be liable for any loss or injury arising. I have read the Club Lycee francais de Singapour rules and regulation (“Charte du club”) and I accept and agree them. Cotisation annuelle* Yearly fee Pour les externes For external people Pour le personnel LFS & parents For LFS staff and parents Inscription après le 02/02/2015 Registration form 02/02/2015 S$ 250 S$ 150 S$ 150 S$ 75 *L’inscription est forfaitaire et définitive pour l’année scolaire. Aucun remboursement ne sera effectué en cas d’intempéries, d’absences (maladie, voyage…) ou d’abandon d’activité. Payment by cheque only payable to LYCEE FRANCAIS DE SINGAPOUR LTD. I certify that all the above information is correct. Date and Signature: Administration – Tel : (65) 6488 1160, Fax : (65) 6487 2821 Ecole élémentaire – Tel : 6488 1192  Vie scolaire – Tel : 6488 1168  Service comptable – Tel : 6488 1173 Site internet : www.lfs.edu.sg  E-mail : [email protected]