2021-2022 Adult Chinese Program Registration Form
Start on August 21th, 2021 to May 2022
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2020-2021 Adult Chinese Program
Student Status 學生(舊生或新生)
How do you know about this program 您如何得知該課程？
Hsi Lai Temple Website 西來寺網站
Advertising /Flyer 廣告/簡章
Buddha‘s Light Hsi Lai School Facebook 佛光西來學校FB網站
Recommend from family or friends 親友推薦
Returning Students 本校舊生
Student's Last Name 學生的姓氏
Student's First Name 學生的名字
Student's Chinese Name
Student's Date of Birth
Student's E-mail Address
Language Spoken at home
Cell Phone Number
Home Phone Number
Work Phone Number
Emergency Contact Number 緊急聯絡電話
Allergies / Remarks
EMERGENCY AUTHORIZATION & WAIVER OF CLAIMS : I request that the above named student be permitted to participate in the Buddha’s Light Hsi Lai School (BLHLS) activities. He/She is in good physical condition, but in case of illness or accident, BLHLS has my consent to secure necessary medical attention for the above named student. I, (please print your full name),hereby release and discharge BLHLS, its directors, officers, teachers, instructors, staff members, and all other associated entities (the “Releasees”) from all claims, demands, costs, expenses, actions and causes of action, whether in law or equity, in respect to death, injury, loss or damage to the above student or his/her property however caused, arising out of the above student’s participation in activities at or related to the School, whether or not on the School’s premises. I hereby indemnify and hold each of the Releasees harmless from any and all damages, costs, losses and expenses suffered by him/her arising out of such participation and activities. CONSENT: I give my consent to Buddha’s Light Hsi Lai School to use any of the photos taken during my child/children’s participation in any of the activities of Hsi Lai School for the purpose of communicating, promoting, fundraising and, or other information about the class and the school as a whole.
I have fully read and agree to the above mentioned Agreement.
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