CKC Registration 2019-2020
Form Description
Student's First & Last Name 参加者 フルネーム *
Your answer
Student's Gender 参加者 性別 *
Student's Birthday(MM/DD/YYYY) 参加者 生年月日 *
Grade for 2019-2020 School Year [学年] *
Allergies or medial conditions [参加者の体調、食物アレルギー等などについて伝えておきたいこと]: *
Your answer
Parent/Guardian First & Last Name 保護者 フルネーム *
Your answer
Parent/Guardian Email 保護者 メールアドレス *
Your answer
Parent/Guardian Phone Number 保護者 電話番号 *
Your answer
Release of Liability
I give permission for my child(ren) to participate in Calvary Kids Club (CKC) 2019-2020. I release Calvary Chapel Okinawa, its officers, employees, and agents from any liability whatsoever for any injury, death, loss or damage to property, sustained by any member of my family in attendance. I agree to defend and indemnify Calvary Chapel Okinawa from any liability or loss they might sustain by reason thereof. In the event I cannot be reached in an EMERGENCY, I hereby give permission to the physician selected by the church leadership to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for my child(ren) named above. I agree that any photographs taken of my child at Calvary Kids Club (CKC) 2019-2020 by Calvary Chapel Okinawa are the property of Calvary Chapel Okinawa and may be used in future publications as deemed appropriate.
I fully understand and agree to the above terms. 上記について理解した上、同意致します。 *
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