RESC 2017 Child Registration
Child's Name / 参加されるお子様のお名前
Your answer
Child's Name (Hiragana) / 参加されるお子様のお名前(ひらがな)
Your answer
Birthday / 生年月日
Postal Code / 郵便番号 (ex: 123-4567)
Your answer
Address / 住所
Your answer
Who is allowed to pick up your child from RESC? (Hiragana) / RESCへは、どなたがお迎えにいっらしゃいますか?(ひらがな)
Your answer
Is it okay for my child to be photographed or filmed to be used to promote RESC in future years? / 今後、RESCの宣伝のために、お子様をカメラによる撮影をしてもよろしいですか?
Days Planning to Attend / 参加される日
Child's Height (T-Shirt Size) / お子さまの身長(Tシャツのサイズ)
Contact Information / 連絡先
Telephone Number / 電話番号
Your answer
Email / 電子メールアドレス
Your answer
Emergency Information / 緊急情報
I give permission for my child to participate in ESC. In the event of a medical emergency, I give permission for the staff of ESC to seek medical attention for my child (please be prepared to sign at the event).
Please list any allergies, medication, or other medical conditions affecting your child. / お子様における、アレルギー、服用中のお薬、その他疾患などございましたら、以上にご記入ください。
Your answer
Emergency Contact 1 (Name) / 緊急時ご連絡先1(氏名)
Your answer
Emergency Contact 1 (Relationship) / 緊急時ご連絡先1(続柄)
Your answer
Emergency Contact 1 (Phone) / 緊急時ご連絡先1(電話番号)
Your answer
Emergency Contact 2 (Name) / 緊急時ご連絡先2(氏名)
Your answer
Emergency Contact 2 (Relationship) / 緊急時ご連絡先2(続柄)
Your answer
Emergency Contact 2 (Phone) / 緊急時ご連絡先2(電話番号)
Your answer
Payment Information / お支払いについて
Participation in this year's Redwood English Summer Camp is a one-time fee depending on how many days you attend (snacks, t-shirt, CD, insurance, and bag provided): ¥3,000 for 1-3 days, ¥5,000 for 4-6 days.

You may pay this fee at the event itself, but in order to simplify the registration process and give your kids as much time as possible to enjoy the camp, we prefer that you use one of our two pre-payment options: cash at the Solid Foundation office or bank transfer.

Cash - Pre-pay at Office / 現金でのお支払い(事前):
Please bring your payment with either: 1) a printed copy of your registration (emailed to you after submission), OR 2) your name and registration ID (emailed to you after submission; ex: Cjpa27030643) on an envelope with the enclosed payment.

Bank Transfer / 銀行振込:
You may also send the payment directly via bank transfer (bank information below).
IMPORTANT NOTE: Please include your registration ID (emailed to you after submission; ex: Bjpa27030643) in the transfer, or we may not be able to link your payment to your registration.

三菱東京UFJ銀行 江古田支店
店番190 普通0166644
Solid Foundation株式会社

Payment Type / お支払い方法
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