Volunteer Register Form Personal Information Full Name (as per IC/passport) Gender Male Female Age Nationality Malaysia Non-Malaysia Contact Information Email Phone Address City State / Province / Region ZIP / Postal Code Country Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Costa Rica Côte d’Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor (Timor-Leste) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Fiji Finland France Gabon The Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar (Burma) Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria North Macedonia Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Sudan, South Suriname Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Yemen Zambia Zimbabwe Emergency Contact Full Name (as per IC/passport) Relationship to you Phone Number Volunteer Program Package Select package Public (RM800) Malaysian Student (RM500) Company Name Company Address DECLARATION & INDEMNITY I shall assume all liability(ies), including death, to myself which resulted from any accident(s)/occurrence(s) during my attachment to the Sea Turtle Conservation Project at Redang Island as a volunteer. I hereby agree to exempt Universiti Malaysia Terengganu, its officers, or employees or any sponsoring organization, its owners or employees (Organizer), and release and discharge them from all liability(ies) and all damage(s), and any claim(s) or demands(s) there of on account of injury, including death, to myself which results from the accident(s) or occurrence(s) during my attachment to the project, whether caused by negligence of the Organizer or otherwise. I further agree to protect, indemnify, save and hold harmless Universiti Malaysia Terengganu, other sponsors, and their officers and employees from all damage(s), claims(s), suit(s), expenses, and payments(s) on account of or resulting from any such injury, including death, to myself which results from any accident(s) or occurrence(s) or otherwise for the duration of this project. I understand and agree that payment made are not refundable at all cost and circumstances. Payment will be used to support the Sea Turtle Conservation Project carried out by Universiti Malaysia Terengganu. I declare that I am physically fit and able to undertake the night patrols and other physical tasks involved in the Sea Turtle Conservation Project at Redang Island as a volunteer without any special assistance. I, the undersigned, understand and accept the risks and responsibilities associated with being a volunteer in the Universiti Malaysia Terengganu Sea Turtle Conservation Project. I have read and voluntarily signed the Waiver of Liability and Indemnity Agreement, and further agree that the Organizer has made no other oral representation, statement or inducement other than this written agreement to me. SUBMIT