New Visitors Form
Onnuri Church Children's Ministry (Revised 06/20/20)
Student's Korean Name 학생의 한글성명 *
Student's English Name 학생의 영어성명 *
Date of Birth 생년월일 *
Sex 성별 *
Current Grade 학년 *
Address 주소 *
City *
State *
Zip *
Are you a member of Onnuri Church? 온누리 교회 등록교인 이신가요? *
Church currently attending if not Onnuri church member 온누리교인이 아니신 경우 출석중인 교회
Home Phone # 자택 전화번호
Parent's Cell # 보호자 핸드폰 번호 *
Parent's Email 부모의 이메일 *
Emergency # 비상연락처 (친척 또는 다른 부모) *
Allergy or Special need 알러지 특이사항
Guardian Consent 학부모 동의서 내용
As parent or legal guardian, I have reviewed the information below and give my permission for the subject of this release to be involved in the overall activities of the event. I agree that if the subject of this release has to return home for severe discipline violations, it will be at my/our expense.

I understand that all reasonable safety precautions will be taken at all times by Onnuri Presbyterian Church and by its agents during this event. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Onnuri Presbyterian Church, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form.. I acknowledge the fact that my son/daughter has to follow and abide by all the rules and regulations instructed for the event.

I further agree that in a foreseen event, like an accident/illness medical attention has to be given to my child, the faculty responsible may treat my child without having any financial obligation to the church. I hereby release Onnuri Church from all liability for any injuries sustained by my child including specifically all claims, demands, negligence, actions, and judgment sustained by my child. I acknowledge that such activities are conducted for students to have a wholesome educational experience.

I understand that in the event medical intervention is needed, every attempt will be made to contact immediately the persons listed on this form. In the event we cannot be reached in an emergency during the event listed on this form, I hereby give my permission to the physician or dentist selected by the event leader to hospitalize, to secure medical treatment and/or to order an injection, anesthesia, or surgery for my child as deemed necessary.

I understand that my insurance coverage for my child will be used as primary pay coverage in the event medical intervention is needed. Coverage by Community Presbyterian Church through its accidental policy will be used secondarily for expenses my family’s insurance does not cover.

I hereby consent to the use of photographs/videotape taken for publicity/promotional purposes without further consideration. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.

Guardian Consent 학부모 동의 (Read above) *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy