KHAZANAH NASIONAL SL1M - GREEN Batch 7

INFORMED CONSENT AND RELEASE OF LIABILITY

It is the Site Management Team (KHAZANAH NASIONAL SL1M - GREEN Batch 7)’s
policy to provide a safe, healthy, productive training venue and an environment where
every participant continues to strive to exceed their potential. Since drug abuse
jeopardises safety, health and productivity, Site Management Team (KHAZANAH
NASIONAL SL1M - GREEN Batch 7) is committed in maintaining a drug-free training venue.

I understand that according to the Site Management Team (KHAZANAH NASIONAL

SL1M - GREEN Batch 7)’s policy, participants of this programme may be required to submit
urine samples for chemical analysis at any time during training and that the analysis will
be conducted by a laboratory appointed by Site Management Team (KHAZANAH NASIONAL
SL1M - GREEN Batch 7).

I HEREBY CONSENT FREELY AND VOLUNTARILY TO PROVIDE A SPECIMEN

OF MY URINE FOR DRUG/CHEMICAL ANALYSIS. I also consent to the release of the
results of this analysis to Site Management Team (KHAZANAH NASIONAL SL1M - GREEN
Batch 7). I hereby also release Site Management Team (KHAZANAH NASIONAL SL1M -
GREEN Batch 7) and their employees, agents and contractors from any liability arising
from any request to furnish the urine sample, the testing of the urine sample and
decisions concerning my application for employment shall also be based upon the results
of the analysis. Further, I understand that if I refuse to be tested or if any of my test
results is drug-positive, I will be dismissed from this programme with Site Management
Team (KHAZANAH NASIONAL SL1M - GREEN Batch 7) without any compensation.

I understand a documented chain of custody exists to ensure the identity and

integrity of my sample through the collection and testing process.

MY SIGNATURE IS AN ACKNOWLEDGEMENT THAT I HAVE READ,

UNDERSTOOD AND CONSENTED TO THE CONTENT OF THIS DOCUMENT. FAILURE
TO SIGN THE ABOVE CONSENT AND RELEASE SHALL RENDER THE TRAINING
PROCESS AUTOMATICALLY DISCONTINUED.

NAME:___________________ SIGNATURE:______________________

DATE:___________________

WITNESS:

(NAME & DESIGNATION OF WITNESS) DATE:___________________