2017 TOPS Registration
Event Timing: Sunday, July 16th, 2017 from 8:30am to 4:30pm
Event Address: 13016 University Blvd, Sugarland, TX 77479
Contact us at (281) 933-8118 or TOPS12th@gmail.com
Email address *
Kid's name *
Your answer
Age *
Your answer
Physical Health Conditions *
Your answer
Has this child attended TOPS in the previous years? *
Kid’s T-shirt size *
Parent/Guardian’s Name *
Your answer
Will parent/guardian attend the event as participant not volunteer ? *
If Yes, what is parent’s t-shirt size?
Parent’s phone number *
Your answer
Home Address *
Your answer
I hereby the undersigned give permission to my above-mentioned child to attend the Youth Tobacco& Obesity Prevention Summit organized by the Vietnamese Culture & Science Association (VCSA). As part of the program, I give consent to having my child weighed and measured. This information will be kept confidential. I hereby hold VCSA and its staff harmless from any liabilities or claims from any accidents that may happen during the Summit. *
MM
/
DD
/
YYYY
Signature *
Your answer
Requirements:
age 7-16 | signed waiver form | in healthy physical condition
have their own transportation to and from Houston Museum of Natural Science

Registration starts at 8:30am to 9:00am

Fee
$15 per kid includes:
• 1 admission ticket to the museum

• workshop presentations

• free lunch

• 1 free t-shirt + small items

• team activities and games

If parents or guardians wish to participate, please indicate in the registration form.

$15 per parent includes:

• workshop for parents

• free lunch

• free t-shirt


Please note Registration is NOT complete until full payment AND confirmation email is received.
For payment options, please follow the instructions on the confirmation email.
If you fill the registration online, you do not need to scan and email us the waiver form. We automatically collect the waiver form once you submit this application.
SPONSOR/DONATION
If you would like to contribute to this meaningful event through sponsorship or a gift donation (food, utensils, etc), please send your gifts or make your check payable to:
The Vietnamese Culture & Science Association
Vietnamese Youth Tobacco & Obesity Prevention Summit
13080 Bellaire Blvd, suite G
Houston, TX 77072
Tax ID: 76-0360557. For additional information on sponsorship or general inquiries, please call VCSA at (281) 933-8118 or TOPS leads: Phat (832)348-7964 or Vivian (713)298-5491
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms