註冊

你的名字*

你的郵箱*

華僑中文學校註冊單

學期*

學生英文名*

學生英文姓*

中文姓名

性別*

生日*

家中母語*:
其他:

華語程度

班級: 新華語第: 簡体中文第:

住址*

英文學校名稱

年級*:

家長/監護人 1

英文名*:
英文姓*:
中文姓名:
關係:
住家電話:
手機:
工作電話:

家長/監護人 2

英文名:
英文姓:
中文姓名:
關係:
住家電話:
手機:
工作電話:

緊急聯絡人

姓名:
關係:
住家電話:
手機:
工作電話:

家庭醫師

姓名:
住址:
電話:

AUTHORIZATION FOR EMERGENCY MEDICAL CARE AND CLAIM WAIVER:
I HEREBY ACKNOWLEDGE MY CHILD’S ENROLLMENT IN AMERICAN CHINESE SCHOOL (ACS) AND I GRANT MY PERMISSION FOR MY CHILD TO
PARTICIPATE IN ALL ACS ACTIVITIES. I HEREBY AUTHORIZE THE EMPLOYEES OF AMERICAN CHINESE SCHOOL TO ADMINISTER GENERAL FIRST
AID TREATMENT FOR ANY MINOR INJURIES OR ILLNESSES EXPERIENCED BY MY CHILD. IF THE INJURY OR ILLNESS IS IN NEED OF EMERGENCY
TREATMENT, I AUTHORIZE ACS TO SUMMON ANY AND ALL PROFESSIONAL EMERGENCY PERSONNEL TO ATTEND, TRANSPORT, AND TREAT THE
CHILD. I AGREE TO ASSUME FINANCIAL RESPONSIBILITY FOR ALL EXPENSES OF SUCH CARE. I AM HEREBY WAIVING ALL CLAIMS AGAINST ACS
AND/OR ROWLAND UNIFIED SCHOOL DISTRICT FOR ANY ILLNESSES, ACCIDENTS, INJURIES OR DEATH.

退費辦法: 所有退費皆需扣除手續費$50 後其辦法如下: 開學前可退全費,開學後第一週退半費,第二週起概不退費

本人已領取”家長須知”並同意配合 (I have read and approved the above statement)

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