Youth â Builders of A Better Tomorrow - Rotary International District ...
Youth â Builders of A Better Tomorrow - Rotary International District ...
Youth â Builders of A Better Tomorrow - Rotary International District ...
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YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
ROTARY YOUTH LEADERSHIP AWARDS<br />
12 – 15 March 2011<br />
“<strong>Youth</strong>s – <strong>Builders</strong> <strong>of</strong> a <strong>Better</strong> <strong>Tomorrow</strong>”<br />
TABLE OF CONTENTS<br />
a) Letter <strong>of</strong> Invitation by the President <strong>of</strong> <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera<br />
b) Information on <strong>Rotary</strong> <strong>Youth</strong>s Leadership Awards (RYLA)<br />
c) Information on the venue Outward Bound Sabah (OBS) (Appendix A)<br />
d) Map Location <strong>of</strong> the Venue (Appendix A)<br />
e) Master Programme (Appendix B)<br />
f) Registration Form A (Participant Details)<br />
g) Registration Form B (Medical Declaration)<br />
h) List <strong>of</strong> Things to Bring (Appendix C)
The <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera<br />
Club No. 55923 <strong>District</strong> 3310<br />
(Charter Date: June 21 st 2001)<br />
P.O.Box 20594, 88763 Luyang<br />
Kota Kinabalu, Sabah, Malaysia<br />
2010-2011<br />
BOARD OF DIRECTORS<br />
PRESIDENT<br />
Rtn Ian Thow Yin Lap PHF<br />
Tel: 088-430091 Fax: 088-430091<br />
ianthow@gmail.com<br />
IMMEDIATE<br />
PAST PRESIDENT<br />
Rtn Judy Hiew<br />
Tel: 088-288108 Fax: 088-288104<br />
chancery@streamyx.com<br />
PRESIDENT ELECT<br />
Rtn Lai Kin Ken PHF<br />
Tel: 088-268785 Fax: 088-268785<br />
kklai268@yahoo.com<br />
VICE PRESIDENT<br />
Rtn Paul Chong<br />
Tel: 088-717448 Fax: 088-256161<br />
paulchghk@gmail.com<br />
SECRETARY<br />
PP Rtn Christina Aluda PHF<br />
Tel: 088-212415 Fax: 088-224700<br />
c_aluda@yahoo.com<br />
TREASURER<br />
Rtn Fatimah Yassin PHF<br />
Tel: 019-8525768<br />
timah_y@hotmail.com<br />
DIRECTORS<br />
PP Rtn Datuk Verus Aman Sham<br />
PHF<br />
Tel: 088-268819<br />
verus60@yahoo.com<br />
PP Rtn Datuk Gabriel William JP<br />
Tel: 088-750311 Fax: 088-750312<br />
exesec@outwardbound.com.my<br />
SERVICE CHAIRS<br />
CLUB ADMINISTRATION<br />
IPP Rtn Judy Hiew<br />
Tel: 088-288108 Fax: 088-288104<br />
chancery@streamyx.com<br />
MEMBERSHIP<br />
Rtn Fatimah Yassin PHF<br />
Tel: 019-8525768<br />
timah_y@hotmail.com<br />
President <strong>of</strong> <strong>Rotary</strong> Clubs<br />
<strong>District</strong> 3310 25 th January 2011<br />
Dear Sir/Madam,<br />
Re: Pan Borneo RYLA Camp “<strong>Youth</strong> – <strong>Builders</strong> <strong>of</strong> A <strong>Better</strong> <strong>Tomorrow</strong>”<br />
Fellow Presidents, I am pleased to inform you that the Pan Borneo RYLA<br />
Camp 2011 will be organised by the <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera (RCKS)<br />
in close collaboration with the Outward Bound Sabah (OBS) from 12th to 15th<br />
March, 2011.<br />
The main purpose <strong>of</strong> this letter is to give early notice <strong>of</strong> the Event so as to<br />
enable outstation participants to make the necessary travel arrangements.<br />
Arrangement has also been made with the Management <strong>of</strong> OBS to allow<br />
outstation participants to come one day earlier and stay at OBS dormitories at<br />
no extra charge. The same arrangement is available for those who may have to<br />
extend their stay by an extra day to suit their travel itinerary.<br />
Places are limited to 100 participants only. It is therefore imperative to register<br />
as soon as possible. Selection will be on “First Come, First Served” basis.<br />
I enclose herewith the Registration Forms and other general information <strong>of</strong> the<br />
Camp for your necessary action. If you need further clarification please contact<br />
either:<br />
President Ian Thow (H/P: 0128280188 ; email: ianthow@gmail.com),<br />
Datuk Gabriel William (H/P: 0198607330 ; email:<br />
exedir@outwardbound.com.my)<br />
Benjamin Benedict (H/P: 0138501201 ; email:<br />
asst_director@outwardbound.com.my).<br />
Looking forward to your full cooperation.<br />
Warmest regards,<br />
Yours in <strong>Rotary</strong>,<br />
Rtn Ian Thow<br />
President <strong>of</strong> RCKS<br />
PUBLIC RELATIONS<br />
PP Rtn Christina Aluda PHF<br />
Tel: 088-212415 Fax: 088-224700<br />
c_aluda@yahoo.com<br />
SERVICE PROJECTS<br />
PP Rtn Lee Swi Heng PHF<br />
Tel: 088-710470<br />
swihenglee@gmail.com<br />
ROTARY FOUNDATION<br />
PP Rtn Alice Kunjan PHF<br />
Tel: 088-264058 Fax: 088-210676<br />
alice_sec@yahoo.com<br />
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
SERGEANT-AT-ARMS<br />
PP Rtn Abu Bakar Sheriff<br />
Tel: 016-8394212<br />
abu48bakar@yahoo.com
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
Information on PAN BORNEO RYLA 2011<br />
INTRODUCTION<br />
What is RYLA?<br />
RYLA stands for <strong>Rotary</strong> <strong>Youth</strong> Leadership Awards. It is an intensive training programme<br />
that brings together youth and young adults (ages 14 – 30) to further develop character and<br />
leadership skills whilst at the same time learning more about <strong>Rotary</strong> and its roles.<br />
RYLA’s programme is mainly intended to develop leadership qualities, good citizenship and<br />
personal development among youths.<br />
The objectives <strong>of</strong> RYLA are as follows: -<br />
<br />
<br />
<br />
<br />
To demonstrate <strong>Rotary</strong>’s respect and concern for youth.<br />
To encourage and assist young people in responsible and effective voluntary youth<br />
leadership by providing them with a valuable training experience.<br />
To foster continued and stronger leadership <strong>of</strong> youth by youth.<br />
To publicly recognize many young people who are rendering service to their communities<br />
as youth leaders.<br />
DETAILS ABOUT PAN BORNEO RYLA 2011<br />
Organizers<br />
The RYLA Programme 2011 will be organized by the <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera<br />
(RCKS) in close collaboration with Outward Bound Sabah (OBS).<br />
Dates<br />
Saturday, 12 th March to Tuesday, 15 th March 2011.<br />
Venue<br />
Outward Bound Sabah, KM27, New Papar Road, Kinarut, Sabah.<br />
Theme<br />
“<strong>Youth</strong>s – <strong>Builders</strong> <strong>of</strong> a <strong>Better</strong> <strong>Tomorrow</strong>”
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
Programme Format<br />
<br />
<br />
<br />
<br />
Talks/Lectures<br />
Outdoor activities designed to develop self-confidence, effective teamwork and<br />
leadership qualities.<br />
Community Service Projects.<br />
Workshops and Group Discussion.<br />
Participants<br />
<br />
<br />
Open especially to youths (male and female) residing in Sabah, Sarawak, Labuan and<br />
Brunei.<br />
Ages: 15 – 26 years old.<br />
Maximum number <strong>of</strong> participants is 100.<br />
Accommodation<br />
All participants will be accommodated in dormitories. Twelve in each dormitory with<br />
separate accommodation for Boys and Girls.<br />
Registration<br />
Participants are required to submit the duly completed Registration Forms (Form A and B)<br />
not later than 5 th March 2011 to the following address:-<br />
(Ms. Edith Joimin)<br />
Outward Bound Sabah<br />
Locked Bag 181<br />
88996 Kota Kinabalu<br />
Sabah<br />
Tel: 088-750311<br />
Fax: 088-750312<br />
E-mail: info@outwardbound.com.my
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
Registration Fee<br />
Registration fee is RM400/- (Ringgit Malaysia Four Hundred only) per participant. Payment<br />
by cheque is to be made payable to <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera.<br />
The registration fee covers the following expenses/items: -<br />
Accommodation at OBS dormitories<br />
All meals<br />
Transfer to OBS<br />
T-shirt/ Cap/ Bag/ Name Tag<br />
Stationary<br />
Certificate <strong>of</strong> Attendance<br />
Use <strong>of</strong> OBS facilities and equipment<br />
Linen<br />
Group Insurance<br />
Group Photo<br />
The registration fee does not cover the following items: -<br />
Personal toiletries (including toothbrush/paste/soap).<br />
Towel.<br />
Sun block / Insect repellent.<br />
Telephone calls.<br />
What to Bring<br />
Please refer to Appendix B<br />
What Not to Bring<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
Jewelry.<br />
Expensive personal items (e.g. designers label shoes and apparels).<br />
Large sum <strong>of</strong> money.<br />
Liquor.<br />
Cigarettes.<br />
Drugs.<br />
Electronic Device (e.g playstation, laptop etc.)<br />
Languages<br />
Lectures and instructions will be in English and Bahasa Malaysia.
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
Meals<br />
All meals will be Halal. Participants with special dietary requirements are advised to inform<br />
the Secretariat before the commencement <strong>of</strong> the Camp.<br />
Airport And Bus Terminal Pick-up<br />
Arrangements can be made to pick-up participants from the airport (Terminal 1 or 2) and City<br />
Bus Terminal, Inanam to OBS. Flight and bus details must be submitted to the Secretariat at<br />
least 1 week before the commencement <strong>of</strong> the programme. For alternative arrangement,<br />
please contact the Secretariat.<br />
Early Check-in / Late Check-out<br />
All participants must check-in at OBS on Saturday, 12 th March 2011 between 8.00 am to<br />
9.00 am. Checkout time is 1.00 pm on Tuesday, 15 th March 2011.<br />
Outstation participants who may require accommodation prior to/after the programme may<br />
stay at the OBS or make their own arrangement. Those wanting to stay at OBS must inform<br />
the Secretariat.<br />
Rules<br />
All participants are expected to abide by the Rules and Regulations imposed by the<br />
Organisers and OBS.<br />
Drinking, Smoking and Gambling<br />
Drinking, smoking and gambling are strictly prohibited within the OBS compound.<br />
Lecture Topics<br />
Full eminent speakers will speak on the following topics: -<br />
Lecture I<br />
Lecture II<br />
Lecture III<br />
Lecture IV<br />
Lecture V<br />
Lecture VI<br />
Lecture VII<br />
- What is <strong>Rotary</strong> and what it does for the Community.<br />
- The Fundamentals and Ethics <strong>of</strong> Good Leadership.<br />
- Good Manners and Civic Mindedness.<br />
- Communication Skills<br />
- Our Environment, Our Responsibility<br />
- Human Rights<br />
- Health and Fitness
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
Programme<br />
The master programme is at Appendix B. Some activities may be changed due to unforeseen<br />
circumstances.<br />
Further Enquiries<br />
Please contact the following persons for further details/clarification: -<br />
<strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera<br />
Rtn. Ian Thow (H/p: 012 828 0188 E-mail: ianthow@gmail.com)<br />
Rtn. Datuk Gabriel William (H/p: 0198617330 E-mail: exedir@outwardbound.com.my )<br />
Outward Bound Sabah (Office Tel: 088 750311)<br />
Ms. Edith Joimin (info@outwardbound.com.my)<br />
Mr. Benjamin Benedict (asst_director@outwardbound.com.my)
Outward Bound is an educational, non-pr<strong>of</strong>it organization committed to helping<br />
people reach their potential. The educational philosophy behind the wide variety <strong>of</strong><br />
programmes is the use <strong>of</strong> outdoor activities to achieve personal development.<br />
For half a century the Outward Bound Philosophy has been successfully facilitated in more than 50<br />
countries around the world. Since 1985, Outward Bound Sabah has adapted this methodology to the<br />
local environment and conducted courses designed to achieve certain objectives.<br />
Benefits <strong>of</strong> active participation in an Outward Bound Sabah course include:<br />
Increase self confidence<br />
Enhanced initiative and resourcefulness<br />
Developed leadership qualities<br />
Greater self discipline, determination and<br />
Productive teamwork<br />
motivation<br />
Improved communication skills<br />
Divided into groups and supervised by highly trained instructors, course members partake in a diverse<br />
range <strong>of</strong> activities such as:<br />
Ropes confidence course<br />
Kayaking<br />
White water rafting<br />
Rock climbing<br />
Orienteering<br />
Flying Fox<br />
Sailing<br />
Team problem solving<br />
Abseiling<br />
Solo camp<br />
Programmes incorporate overnight or extended expeditions—Jungle Trekking in the Crocker Range,<br />
Sailing among islands <strong>of</strong> the South China Sea and river or sea Kayaking.<br />
Outward Bound uses challenging outdoor activities to help people from all walks <strong>of</strong> life realize<br />
their physical and mental potential. The emphasis is on “learning by doing” in a safe, supportive<br />
environment. Outward Bound uses outdoor activities for educational purposes. The activities are<br />
designed so that everyone, with the willingness and determination to try, can succeed at their<br />
own level.<br />
Safety<br />
<strong>International</strong> Courses<br />
For all Outward Bound activities safety is <strong>of</strong><br />
paramount importance. Activities are carefully<br />
planned, tested and constantly supervised by qualified<br />
and experienced instructors. Participants are trained<br />
in and must abide by, basic safety procedures.<br />
Staff<br />
The Instructional Staff are vital component to the<br />
success <strong>of</strong> any programme. Instructors are chosen<br />
after a rigorous selection procedure and undertake<br />
extensive training to develop the necessary technical<br />
and people skills. Many instructors travel overseas for<br />
training and placements and Outward Bound Sabah<br />
receives visiting instructors from other countries who<br />
broaden the knowledge and experience base <strong>of</strong> the<br />
staff.<br />
Outward Bound Sabah is rapidly gaining a reputation<br />
for excellence not only in Sabah but also at the<br />
international level. Participants from more than 10<br />
countries have benefited from OB courses, with<br />
regular groups coming from Singapore, Brunei, Hong<br />
Kong and United Kingdom.<br />
Location and Facilities<br />
The incredibly diverse natural environment <strong>of</strong> Sabah<br />
provides a perfect backdrop for Outward Bound<br />
activities. The school is situated 25km South <strong>of</strong> Kota<br />
Kinabalu on a beautiful and quiet beachfront. The<br />
100 acre site, between the Kawang River and coastal<br />
foothills, incorporated accommodation, conference<br />
rooms, dining hall, boathouse, <strong>of</strong>fices etc., as well as<br />
being the location for many <strong>of</strong> the course activities.
OUTWARD BOUND SABAH<br />
Experiential Education and Outdoor Activities<br />
What is “Experiential Education”?<br />
“Experiential Education” is education that makes conscious use <strong>of</strong> participants’ experience<br />
by integrating them into the curriculum. Any experience involves a combination <strong>of</strong> all the<br />
senses (smell, hearing, sight…), emotions (pleasure, anxiety, fear, empathy…), physical<br />
condition (fitness, strength, energy level) and cognition (constructing knowledge, decision<br />
making, solving problems…). By using participants’ own experiences, this form <strong>of</strong> education<br />
addresses them in their entirety, as: thinking, feeling, physical, emotional, and social<br />
beings.<br />
“Outdoor education” uses challenges in the outdoor environment to provide intense<br />
experiences. From these shared experiences, students are viewed as valuable resources<br />
for their own education, the education <strong>of</strong> others, and the well being <strong>of</strong> the communities <strong>of</strong><br />
which they are members.<br />
What is the educational method?<br />
The “Experiential Education” method (pedagogy) is simply “learning by doing”. This is based<br />
on supportive groups confronting challenges and sharing their experiences to help each<br />
other to develop their skills. Experiences are then investigated using the “learning circle”:<br />
plan / do / review. The reviewing <strong>of</strong> an activity allows participants to learn “Hard Skills”<br />
and S<strong>of</strong>t Skills” at group and individual level. The Hard Skills are the methods, processes,<br />
techniques and the use <strong>of</strong> outdoor equipment needed for outdoor activities. S<strong>of</strong>t Skills are<br />
interpersonal and human relations skills, which include: social skills, self-confidence, trust,<br />
leadership, teamwork and communication.<br />
What are the aims <strong>of</strong> the programme?<br />
Personal development through “Experiential Education”. Outward Bound courses provide<br />
each participants with the opportunity to understand their personal strengths and<br />
weaknesses and to develop their skills.<br />
At group level: decision-making, cooperation, time management, social competence,<br />
productive teamwork, task leadership, team spirit, problem solving.<br />
At personal level: self-confidence, achievement, motivation, intellectual flexibility, selfdiscipline,<br />
emotional control, initiative, creativity, resourcefulness.<br />
For each programme, Outward Bound Sabah establishes an educational progression and<br />
selects activities to fulfill specific aims.
ROTARY YOUTH LEADERSHIP AWARDS (RYLA 2011)<br />
“<strong>Youth</strong>s – <strong>Builders</strong> <strong>of</strong> a <strong>Better</strong> <strong>Tomorrow</strong>”<br />
APPENDIX B<br />
DAY/DATE TIME ACTIVITY Venue<br />
Day 01<br />
8:00AM<br />
Registration<br />
Main Hall<br />
12 th March,<br />
2011<br />
Saturday<br />
9:00AM<br />
Camp Briefing<br />
• Sing-along<br />
• Laughing exercise<br />
• Camp rules & regulations<br />
Conference<br />
Room<br />
10:00AM<br />
Lecture I – Good Manners and Civic<br />
Mindedness.<br />
Conference<br />
Room<br />
11:00AM<br />
OBS Activities<br />
• Team goals<br />
• Name<br />
• Leader, group cheers<br />
• Slogan, flag<br />
• Team dynamics<br />
Conference<br />
Room<br />
12:30PM<br />
Lunch<br />
Dining Hall<br />
1:30PM<br />
Official Opening Ceremony<br />
• Welcoming address by President <strong>of</strong><br />
RCKS<br />
• Group Photo<br />
• Refreshment<br />
Main Hall<br />
3:00PM<br />
Lecture II - What is <strong>Rotary</strong> and what it<br />
does for the community.<br />
Conference<br />
Room<br />
4:00PM<br />
Tea Break<br />
4:30PM<br />
Ridge Run Exercise<br />
5:30PM<br />
Dance Exercise & Clean-up<br />
Car Park<br />
6:30PM<br />
Dinner<br />
7:30PM<br />
Lecture III – The Fundamentals and<br />
Ethics <strong>of</strong> Good Leadership.<br />
Conference<br />
Room<br />
8:30PM<br />
9:30PM<br />
Coat-<strong>of</strong>-Arm (Brainstorm on Theme)<br />
Supper<br />
Conference<br />
Room<br />
10.00PM<br />
Goodnight.<br />
Page 1 <strong>of</strong> 1
ROTARY YOUTH LEADERSHIP AWARDS (RYLA 2011)<br />
“<strong>Youth</strong>s – <strong>Builders</strong> <strong>of</strong> a <strong>Better</strong> <strong>Tomorrow</strong>”<br />
APPENDIX B<br />
DAY/DATE TIME ACTIVITY Venue<br />
Day 02<br />
5:30AM<br />
Wake-up<br />
13 th March,<br />
2011<br />
Sunday<br />
6:00AM<br />
7:30AM<br />
8:30AM<br />
10:00AM<br />
10:30AM<br />
Morning Exercise<br />
Breakfast<br />
Lecture IV – Communication Skills<br />
Tea Break<br />
Lecture V – Health and Fitness<br />
Beach<br />
Conference<br />
Room<br />
Conference<br />
Room<br />
11:30AM<br />
12:30PM<br />
Lecture VI – Human Rights<br />
Lunch<br />
Conference<br />
Room<br />
1:30PM<br />
OBS Activities (Ropes Activity)<br />
3:00PM<br />
Tea Break<br />
3:30PM<br />
OBS Activities Continue<br />
6:30PM<br />
Dinner<br />
7:30PM<br />
Nightline Exercise<br />
8:30PM<br />
Group Discussion – Review <strong>of</strong> Day<br />
9:30PM<br />
Supper<br />
10:00PM<br />
Goodnight<br />
Page 2 <strong>of</strong> 2
ROTARY YOUTH LEADERSHIP AWARDS (RYLA 2011)<br />
“<strong>Youth</strong>s – <strong>Builders</strong> <strong>of</strong> a <strong>Better</strong> <strong>Tomorrow</strong>”<br />
APPENDIX B<br />
DAY/DATE TIME ACTIVITY Venue<br />
Day 03<br />
5:30AM<br />
Wake-up<br />
14 th March,<br />
2011<br />
Monday<br />
6:00AM<br />
7:30AM<br />
8:30AM<br />
Morning Exercise<br />
Breakfast<br />
Lecture VII – Our Environment, Our<br />
Responsibility<br />
Beach<br />
Conference<br />
Room<br />
9:30AM<br />
Community Service<br />
12:30PM<br />
Lunch<br />
2:00PM<br />
Traditional Games<br />
Padang<br />
• Blow pipe<br />
• Boling Kelapa<br />
• Melastik<br />
• Tiga Selipar<br />
• Etc<br />
3:00PM<br />
Tea Break<br />
3:30PM<br />
Bush Cooking Competition<br />
Boathouse<br />
Preparation for Bonfire – Presentation<br />
7:00PM<br />
Bonfire<br />
Beach<br />
10:00PM<br />
Goodnight<br />
Page 3 <strong>of</strong> 3
ROTARY YOUTH LEADERSHIP AWARDS (RYLA 2011)<br />
“<strong>Youth</strong>s – <strong>Builders</strong> <strong>of</strong> a <strong>Better</strong> <strong>Tomorrow</strong>”<br />
APPENDIX B<br />
DAY/DATE TIME ACTIVITY Venue<br />
Day 03<br />
5:30AM<br />
Wake-up<br />
15 th March,<br />
2011<br />
Tuesday<br />
6:00AM<br />
7:30AM<br />
8:30AM<br />
Stretching Exercise & Solo Reflection<br />
Breakfast<br />
Panel Discussion<br />
Beach<br />
Beach<br />
10:00AM<br />
Tea Break<br />
10:30AM<br />
Programme Evaluation and Preparation<br />
for Official Closing Ceremony<br />
Conference<br />
Room<br />
11:00AM<br />
Official Closing Ceremony<br />
12:30PM<br />
• Slide Show <strong>of</strong> camp photos<br />
• Sharing by participants<br />
• Skit Group Presentation<br />
• Speech by President <strong>of</strong> RCKS<br />
• Closing Address by Guest <strong>of</strong> Honour<br />
• Certificate presentation<br />
• Presentation <strong>of</strong> awards<br />
• “If We Hold On Together”<br />
• Group photo<br />
1:30PM<br />
Lunch<br />
End <strong>of</strong> Programme<br />
Page 4 <strong>of</strong> 4
FORM A<br />
The Secretariat (Ms Edith Joimin)<br />
Outward Bound Sabah<br />
Locked Bag 181<br />
88996 Kota Kinabalu<br />
Sabah, Malaysia<br />
Tel: 088-750311<br />
Fax: 088-750312<br />
E-mail: info@outwardbound.com.my<br />
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
RYLA (<strong>Rotary</strong> <strong>Youth</strong> Leadership Awards) Camp 2011<br />
Organised By: The <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera<br />
Venue: Outward Bound Sabah, Kinarut, Sabah<br />
Date: 12 th – 15 th March 2011<br />
REGISTRATION FORM<br />
Section A:<br />
To be completed by the participant.<br />
Name: ______________________________________________<br />
Date <strong>of</strong> Birth: ________________________________________<br />
Home Address: _______________________________________<br />
____________________________________________________<br />
____________________________________________________<br />
Gender (Male/Female): __________________________<br />
I/C No: _______________________________________<br />
Telephone: ____________________________________<br />
Fax: __________________ H/P: ___________________<br />
T-Shirt size: ___________________________________<br />
Section B:<br />
To be completed by parent / guardian (applicable to participant below 18 years old only).<br />
Parent / Guardian’s Name: ______________________________<br />
Telephone: ____________________________________<br />
Address: ____________________________________________<br />
____________________________________________________<br />
____________________________________________________<br />
I hereby agree to send my son / daughter _______________________________________________ to the above-mentioned<br />
event and I understand that the <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera will not be held liable for any injury suffered by my son /<br />
daughter.<br />
_________________________________________<br />
Parent / Guardian’s Signature<br />
____________________________________________<br />
Date<br />
Important note: This form must reach the above address on or before 5 th March 2011. Registration fee is RM400/pax.<br />
All cheques must be crossed and made payable to the <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera.<br />
Page 1 <strong>of</strong> 3
FORM A<br />
The Secretariat (Ms Edith Joimin)<br />
Outward Bound Sabah<br />
Locked Bag 181<br />
88996 Kota Kinabalu<br />
Sabah, Malaysia<br />
Tel: 088-750311<br />
Fax: 088-750312<br />
E-mail: info@outwardbound.com.my<br />
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
RYLA (<strong>Rotary</strong> <strong>Youth</strong> Leadership Awards) Camp 2011<br />
Organised By: The <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera<br />
Venue: Outward Bound Sabah, Kinarut, Sabah<br />
Date: 12 th – 15 th March 2011<br />
REGISTRATION FORM<br />
Section C:<br />
To be completed by the school (if applicable).<br />
School Name: ________________________________________<br />
Telephone: ____________________________________<br />
Address: ____________________________________________<br />
____________________________________________________<br />
____________________________________________________<br />
Permission is granted to ____________________________________________ <strong>of</strong> I/C No: ___________________________<br />
to attend the above-mentioned event.<br />
___________________________________________<br />
Principal’s Signature and Official Stamp<br />
____________________________________________<br />
Date<br />
Section D:<br />
To be completed by sponsor (if applicable).<br />
Sponsor Name: ______________________________________<br />
Telephone: ____________________________________<br />
Address: ____________________________________________<br />
____________________________________________________<br />
____________________________________________________<br />
I / We hereby wish to sponsor ______________________________________ <strong>of</strong> I/C No: ____________________________<br />
to attend the above-mentioned event.<br />
__________________________________________<br />
Sponsor’s Signature<br />
____________________________________________<br />
Date<br />
Page 2 <strong>of</strong> 3
FORM A<br />
The Secretariat (Ms Edith Joimin)<br />
Outward Bound Sabah<br />
Locked Bag 181<br />
88996 Kota Kinabalu<br />
Sabah, Malaysia<br />
Tel: 088-750311<br />
Fax: 088-750312<br />
E-mail: info@outwardbound.com.my<br />
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
RYLA (<strong>Rotary</strong> <strong>Youth</strong> Leadership Awards) Camp 2011<br />
Organised By: The <strong>Rotary</strong> Club <strong>of</strong> Kinabalu Sutera<br />
Venue: Outward Bound Sabah, Kinarut, Sabah<br />
Date: 12 th – 15 th March 2011<br />
REGISTRATION FORM<br />
Section E:<br />
Mode <strong>of</strong> transportation (Please check () which ever applicable)<br />
No, I do not require transportation to Outward Bound Sabah, Kinarut, Thank you!<br />
Yes, I require transportation to Outward Bound Sabah, Kinarut, Sabah. Please take note <strong>of</strong> the following arrival time<br />
and disembarking location. Thank you!<br />
I will be arriving by: Flight Time <strong>of</strong> arrival: __________________ Flight no: ___________________<br />
Bus / Land<br />
Time <strong>of</strong> arrival: __________________ Vehicle no: __________________<br />
Remarks: ___________________________________________________________________<br />
___________________________________________________________________________<br />
___________________________________________________________________________<br />
Important Note: The Organiser will arrange pick up at selected time on 12 th March 2011 at Airport (Terminal 1 and<br />
2) and City Bus Terminal, Inanam ONLY. Participants requiring transportation will be informed duly on the pick up<br />
schedule. For alternative arrangement, please contact the Secretariat.<br />
Page 3 <strong>of</strong> 3
FORM B<br />
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
Part 1 - MEDICAL HISTORY (To be completed with medical <strong>of</strong>ficer)<br />
1. IS THERE A HISTORY OF/HAVE YOU EVER<br />
HAD<br />
(a) Chest pain, High blood pressure, heart problems<br />
eg. Heart murmur, Extra heart beat or other heart<br />
abnormality<br />
NO YES If Yes, describe<br />
(b) Asthma, Bronchitis, Tuberculosis, Sinusitis, Other<br />
lung problems<br />
(c) Fits, Epilepsy, Fainting Attacks, Migraine, Sever<br />
head injury<br />
(d) Eye problems/poor vision<br />
(e) Ear problems/deafness<br />
(f) Nervous illness<br />
(g) Diabetes<br />
(h) Allergy to medicines/food/others<br />
(i) Bone or joint injury<br />
(j) A carrier status for any infectious disease?<br />
(k) Medical treatment within last two years<br />
2. IS THERE A NEED FOR/DO YOU REQUIRE<br />
(a) Routine Medication<br />
(b) Special diet<br />
3. IS THERE/DO YOU HAVE<br />
(a) Any disability<br />
(b) Pregnancy<br />
(c) Any other medical information <strong>of</strong> note<br />
4. TETANUS IMMUNIZATION<br />
(compulsory)<br />
Date <strong>of</strong> last immunization<br />
5. Height : ______________ meters Weight : _______________ kilograms<br />
____________________ ____________________ _____________________<br />
Name <strong>of</strong> Clinic Name <strong>of</strong> Doctor Signature and Date<br />
REV 1.0 Page 1 <strong>of</strong> 2
FORM B<br />
YOUTHS – BUILDERS OF A BETTER<br />
TOMORROW<br />
Part II – MEDICAL DECLARATION BY APPLICANT (to be signed by ALL applicants)<br />
I declare that all the information provided above are true. I am currently not suffering from any acute<br />
ailments or diseases.<br />
___________________<br />
_______________________________<br />
Date<br />
Name &Signature<br />
SCHOOLS STUDENTS (Please bring along your school health booklet when you go for your<br />
medical examination<br />
PART III – CERTIFICATION OF FITNESS (to be completed by Medical Examiner)<br />
I have this date ____________________examined _______________________________________<br />
(name)<br />
and found *him/her *FIT/UNFIT to participate in the Outward Bound programmes and activities.<br />
Remark :<br />
_________________________________________________________________________________<br />
_________________________________________________________________________________<br />
_________________________________________________________________________________<br />
________________________<br />
Name <strong>of</strong> Doctor<br />
_______________________________<br />
Signature<br />
________________________<br />
Clinic Stamp<br />
_______________________________<br />
Date<br />
*Delete where not applicable<br />
PA/OBS/1/94(2)<br />
REV 1.0 Page 2 <strong>of</strong> 2
APPENDIX C<br />
OUTWARD BOUND SABAH<br />
Locked Bag 181, 88996 Kota Kinabalu, Sabah, Malaysia<br />
Tel: 60 88 750311 Fax: 60 88 750312<br />
E-mail: info@outwardbound.com.my<br />
RECOMMENDED PERSONAL CLOTHING AND EQUIPMENT LIST<br />
You can arrive in t-shirt and loose long pants (track suit bottom).<br />
2 pairs long sleeved shirts 1 towel & sarong<br />
3 pairs comfortable shorts 3 sets <strong>of</strong> under clothing<br />
1 pullover / jumper Sunscreen<br />
1 pair <strong>of</strong> sandals Insect repellent<br />
3 pairs <strong>of</strong> socks Toiletries<br />
3 T-shirts Washing soap or powder<br />
1 pair sturdy sport shoes<br />
1 waterpro<strong>of</strong> jacket / raincoat<br />
Linen i.e pillow case, blanket and bed sheets<br />
1 torchlight with spare batteries<br />
Spectacles, if worn, with retaining cord and a spare pairs<br />
1 hat and sunglass for sun protection<br />
Notebook and pen<br />
Optional items: Personal medication, camera etc.<br />
Money: Large sum <strong>of</strong> money should not be required. However, there will be<br />
opportunities to buy souvenirs at OBS.