The University of Hong Kong s3

Date of receipt: ______0216H33 THE FAMILY MEMBERSHIP (SPOUSE AND CHILDREN AGED 2-24 ONLY) OF HKU ALUMNI THE UNIVERSITY OF HONG KONG INSTITUTE OF HUMAN PERFORMANCE

This application form is for the spouse and children (aged 2-24) of IHP Alumni (the principal) who would like to join IHP sports membership. The principal should fill in a different form specifically for HKU Alumni (please visit our webpage at www.ihp.hku.hk (Sport  Sports Membership) for details) for joining or renewing the sports membership). Please read the notes overleaf thoroughly. The completed form (Please type or write in English clearly) should be returned by the principal to the Flora Ho Sports Centre (Address: 111-113 Pokfulam Road, Pokfulam, Hong Kong) together with the required documents stated overleaf. Alumni (Principal Member) Personal Details Name: Mr/Miss/Mrs ______Chinese name (if applicable): ______(exactly as it is printed on your HKID card/Passport)

HKID Card / Passport No: ______HKU Facility Access Card No (if applicable): ______Membership expiry date: ______Telephone number: Office: ______Home: ______Mobile: ______E-mail: ______Correspondence Address: ______Personal Details of Family Member(s) Name Application Type HKID Card / Date of Birth Membership No. For (same as it is printed on (please circle as Age Passport No. dd/mm/yyyy (if applicable) Office’s use HKID Card/Passport) appropriate) Spouse New / Renewal Child New / Renewal Child New / Renewal Number of applicant(s) and Fee (HKU Facility Access Card (FAC)) Total Number Fee Sub Total Applicant(s) excluding principal cardholder (Alumni) x $2,200 = The first issuance of FAC* excluding principal cardholder (Alumni) x $35 = Total = Membership Card(s) Collection (please refer to the details overleaf) I would like to collect the cards (please tick as appropriate):  at the time of collecting my new or renewed IHP sports membership during the IHP General Office’s opening hours.  at the reception of Flora Ho Sports Centre 7 working days of IHP General Office after this application submission on the condition that my IHP sports membership is valid. Declaration I understand that I am fully responsible for all liabilities and obligations of the applicant(s) above and this application is subject to IHP’s final approval. Meantime, I have read the conditions overleaf and confirm my acceptance of them, and hereby apply for their IHP sports membership. I enclose herewith a crossed cheque (No: ______) amounting to HK$______of ______(Issuing Bank) payable to “The University of Hong Kong” for the required annual membership fee.

I also hereby affirm that my family member(s) are in good physical condition to partake in physical activities and/or exercise. Their participation is purely voluntary and in no way mandated by The University of Hong Kong. I also understand that my family member(s) should monitor their own condition throughout exercise/physical activities. They should stop the activity or exercising anytime if they have any discomfort or even without any particular reason. In no event shall The University of Hong Kong, its officers, employees, or agents be held liable for any injury, death, or property loss which they may suffer during the activities if caused by either their own negligence, inadequacies in health and fitness or by accident. Date: ______Signature:______(Principal Cardholder – HKU Alumni) For IHP’s Use ⃝ Principal's HKID & Info. Inspection: FAC ⃝ Marriage Cert. ⃝ Birth Cert. ⃝ Address Proof ⃝ All of the above Date: ______Verified by: ______Verified by: ______Verified by: ______Verified by: ______Verified by: ______FAC issued / encoded by: ______(Date: ______) LMS inputted by: ______(Date: ______) Remark: ______Eligibility Family members (spouse and children aged 2-24 only) of HKU Alumni are permitted to apply for the HKU alumni’s family sports membership of IHP (IHP) provided that: a. the principal member (HKU Alumni) holds a valid IHP b. the prescribed membership fees (non- Date of receipt: ______0216H33 THE FAMILY MEMBERSHIP (SPOUSE AND CHILDREN AGED 2-24 ONLY) OF HKU ALUMNI sports membership refundable) are paid c. applicant(s) agree(s) to comply with IHP’s rules and d. the required documents (as stated below) are regulations submitted Entitlements for HKU Alumni’s Family membership Adult members aged 19 or above, can have the following entitlements / use the following IHP facilities subject to availability:  Swimming pools, tennis courts, badminton courts, squash courts, table tennis tables, multi-purpose courts, dance studio, combat room, golf driving bays, golf sand bunker & putting green, all-weather area, and fitness room (subject to user’s accreditation).  Booking entitlement: 7-day advance booking or upon availability for using facilities. - Booking can be made by phone at 2817 3768 and 2819 4427 or in person. - To view sports facilities availability before booking, see http://www.ihp.hku.hk (Sport  Sports Facilities  Booking) - To check facilities closure, see: http://www.ihp.hku.hk (Sport  Sports Facilities  General Information); - Check-in upon arrival is required.  Car parking is subject to availability and IHP’s policy: http://www.ihp.hku.hk (Sport  Sports Facilities  Booking  Car Parking Policy)  Valid members can invite a maximum of 4 guests to use the sports facilities upon paying the stipulated guest fee for each visit / each 1-hour activity session as appropriate as per the IHP’s guest policy: http://www.ihp.hku.hk (Sport  Sports Membership  Guest Policy). Remarks: Child members, aged below 19, should be accompanied by valid IHP adult member(s) and they are not eligible to make any booking and bring guest to use the facilities. Application Procedures (Note: Application submitted by fax or by email will not be accepted.) An application form either for new application or renewal is required. The completed form, to be filled out by the principal member (HKU alumni), should be returned to Flora Ho Sports Centre, 111-113 Pokfulam Road, Hong Kong by post or in person together with the following documents: For New Application: For Renewal: 1. A passport size colour photo taken within the past 6 months of each applicant with 1. A crossed cheque for their name written on the back of the photo. the membership fee 2. [Postal application]: A photocopy of HKID card / Passport of each applicant, and a payment (payable to “The photocopy of Marriage / Birth Certificate (if applicable) as a relationship proof of University of Hong Kong). family members, plus a photocopy of the principal’s HKID card and FAC; 2. Photocopying of [In-person application]: Original copy or photocopy of the aforesaid identity existing “Alumni Family documents of each applicant, plus original copy or a photocopy of the principal’s Member” FAC(s) HKID and FAC, for verification on the spot. 3. A crossed cheque for the membership fee payment (payable to “The University of Hong Kong). 4. FAC of the Alumni’s spouse and children aged 2-24 if applicable. Sports Membership Collection I) Principal (Alumni) holding valid IHP Alumni Sports Membership: HKU Alumni’s Family membership can be obtained by the PRINCIPAL MEMBER in person at the Flora Ho Sports Centre reception counter either:  at the time of submitting the application form and the required documents stated above during the IHP General Office’s opening hours (Mon-Fri: 8:30am – 12:30pm, 2pm-5:45pm; Sat: 9am – 12:30pm; Closed on Sundays, Public / HKU’s holidays and IHP’s early closure dates. Please visit IHP website (Sport  Sports Facilities  General Information for details); OR  7 working days of IHP’s General Office after the submission of the application form and the required documents.

II) Principal (Alumni) without IHP Alumni Sports Membership: HKU Alumni’s Family membership can only be processed at the time when the principal collects his/her new sports membership or renews his/her membership during the IHP General Office’s opening hours (as stated above). For details of new application or the renewal of the principal’s IHP Alumni sports membership, please refer to IHP’s webpage: www.ihp.hku.hk (Sport  Membership). For enquiries on membership, please contact us at 28173657 or 28174046.

Membership Duration and Fees The membership period is on a 12-month basis or at IHP’s discretion at the time of application submission. The duration of their family membership will be the same as that of the principal member. (Please note that the application processing time will be included in the membership period.) All fees are non-refundable in the case of any withdrawal or termination by IHP. Reissuance of each FAC card (incl. replacement of lost FAC card) is subject to a fee of HK$150 (by cheque). Any withdrawal or termination of the principal’s IHP sports membership will cease that of the spouse and children at the same time. All members have to present their valid FAC at all times to gain access to the IHP’s facilities. The fee of family membership with a duration less than 12 months will be charged on a monthly pro-rata basis, rounded up to the nearest HK$5. Applicants please also put down their contact telephone number and FAC number (if any) on the back of their cheque.

Use of Fitness Room Facilities Date of receipt: ______0216H33 THE FAMILY MEMBERSHIP (SPOUSE AND CHILDREN AGED 2-24 ONLY) OF HKU ALUMNI Applicants are advised to visit this webpage: http://www.ihp.hku.hk (Sport  Sports Facilities  Fitness Centres) for details on the regulations / instructions on using the fitness room facilities.

Rules & Regulations on Using IHP’s Facilities Unless with the prior approval of the IHP, private teaching / coaching activities are strictly prohibited within the IHP’s facilities. For the detailed rules and regulations on using the facilities, please refer to http://www.ihp.hku.hk (Sport  Sports Facilities  Booking  Individual Booking).

Collection of Personal Data – Statement of Purposes Applicants please visit: http://www.ihp.hku.hk (Sport  Sports Membership  Collection of Personal Data – Statement of Purposes) for details.

THE IHP RESERVES THE RIGHT TO ALTER THE TERMS & CONDITIONS OF MEMBERSHIP AT ANY TIME. (Feb 2016) v1