Training Consent Form1. I understand that I will be involved in the following activities that take place during training:(1) Use of a PFD (Personal Floatation Device) during Sea Survival Training (Water entry [1m inheight], swimming, towing, use of a life raft, being hoisted from water by rescue strop).
(2) Basic First Aid employing a training dummy.
(3) Use of a Davit Lifeboat System.
(4) Extinguishment of a fire and fire extinguisher implementations.
(5) Evacuation training from obscured and/or zero visibility (blindfold/cosmetic smoke).
2. I understand there are risks associated with this training and I take full responsibility for any injuriesand/or losses that may occur to me or others due to my negligence during training.
3. I enter into this training with a positive attitude and responsibility towards the health and safety ofothers.
4. I understand that I will not obtain my certificate if I do not participate in all sections of this training(Lecture and Practical).
5. I give the staff full permission without repercussion from me or anyone associated to me toadminister First Aid and will follow all directions given in the event of an emergency.

Expected date of training: Y

MD～YDate: YMMDDSignature:※ You may elect to not participate in any part of this training even though all aspects of this training must becompleted to fulfill the required assessment. This includes but not limited to the lecture, Test and practicalapplication sections.NSTCDocument Code:QMS10610ReferencePersonal Information Consent FormIssue #:001Issue Date:03/14Revision #:Revision Date:個人情報の取扱いに関する同意書Prepared by:TNApproved by:RIPage1 of 2Your Privacy Matters to UsAt NSTC (Nippon Survival Training Center), we are committed to protecting your privacy. We respect your privacy andwant you to understand how we safeguard your personal information.
How We Collect Your InformationWe collect and keep information about you, which is needed to provide the products and services you request. Wecollect information from you, either directly or through your company’s representatives.
How We Use Your InformationWe use your personal information to provide the products and service you or your company requests, which includes: Creating training certificates Maintaining a record in our training database Creating invoices and receiptsWe may be required to share or distribute your personal information to third party organizations that require yourinformation in order for NSTC to issue certification.
The Certification Body of specific training Insurance company Your employer Relevant company requiring your training historyWe may use your information internally to create statistical reports that help us understand the needs of our clients andhelp us manage our business.
SecurityNSTC will not release your personal information to any person or organization that is not reasonably involved in thedelivery of your requested service or product.
 Paper files containing your personal information are secured (locked storage) as soon as processing iscompleted. These files are kept for a period of five years and then destroyed.
 Electronic files are backed up daily. If not updated, your personal information will automatically be deletedafter five years.
Your Right to Access Your InformationYou have a right to access the personal information that we have about you in your file. If we have information that is notcorrect, you can have it corrected. To access your information or to ask us to correct information, you can contact us at: 2-6-27Ginza, Tobata-ku, Kitakyushu-shi, Fukuoka-ken, 804-0076, Japan TEL : +81-93-884-2020 info@n-s-t-c.comor in person / writingConsentDo you understand and consent to Nippon Survival Training Center gathering your personal information for the purposesdescribed above? If yes, please sign below.
Print Name:Date:Signature:（本文を）印刷した場合、管理の対象外とする。
If printed, this is an uncontrolled copy.Concent form for Training on Infection AgreementI understand the following conditions regarding infection order to join the training（1） The training may be cancelled or partially cancelled due to any situation including spread ofinfection, test positive for infection, or any other unavoidable reasons.
（2） In case the training is cancelled due to (1) above, delegates who have not completed thetraining will attend the same training planned alternately by NSTC at a later date. If the alternativetraining dates are not available, the course fee will be refunded. No refunds will be made for expensesother than the course fee (travel, accommodation, etc.).
（３） If you are infected with infection or suspected to be infected as having following symptoms,(Current or recurrent onset of cold-like symptoms such as fever, cough, sore throat, taste disorder,etc.) you will not be allowed to participate in the training.
(4) If you are found to be in poor health condition during the course (fever of 37.5℃ or higher,cold-like symptoms, etc.), you will not allowed to attend the training.

Training CourseExpected date oftraining

年⽉⽇ 〜年⽉⽇Company NameName(PrintSignature)ver.2023.05.08