INDEMNITY FORM

This is to confirm that I ________ will be participating in the following activity at the time and place specified below:

Activity : Construction site visit.

Place : Sekyen 2A, Antara Gapi, Hulu Selangor, Selangor

Date : 19 November 2015

I understand that Taylor`s University will take all reasonable precautions to ensure my safety and my property. I will not hold Taylor`s University and/or the Management and/or the staff responsible for any loss, damage or injury suffered directly or indirectly by myself in the course or as a result of my participation.

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Signature :

Date :

Student No :